Immunisation is a well proven way of preventing serious infectious diseases, by stimulating a person’s immune system. We encourage everyone to make an informed decision regarding you and your family’s immunisation, and recommend information from reputatable sources that contain accurate, objective, relevant and understandable information, such as the Ministry of Health, the Immunisation Advisory Centre, and the World Health Organisation. We are also here to help you with our knowledge, and keep you and your family healthy and safe.
Below are information on travel vaccinations, which are but one part of a travel consultation to prepare travellers for a safe and enjoyable journey. If you would like to get travel vaccinations, please make an appointment with your doctor to discuss your needs. In particular, Dr Denise Lucas and Dr Alan Chan both specialise in travel medicine and are Yellow Fever Vaccinators.
Hepatitis A Vaccine
Vaccine: Havrix, single injection, consider booster 6 months to 3 years later
Combined (Typhoid): Vivaxim, single injection, consider Hepatitis A booster 6 months to 3 years later
Combined (Hep B): Twinrix, 3 doses at 0, 1 and 6 months (or Rapid schedule 0, 7 and 21 days with 12 month booster)
Duration: 3 years, or life-long with a booster
Hepatitis A is a viral liver disease that can cause severe illness in adults but tend to be milder in children. Symptoms include fever, yellow eyes and/or skin, vomiting, abdominal pain, dark urine and most people would end up in hospital. It is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person. Food safety, hand washing and vaccination are the most effective ways to combat the disease. The vaccine is routinely recommended to travellers going to South East Asia, Indian subcontinent, Pacific Islands, Africa, South America, Middle East and Eastern Europe.
Vaccine: Vivotif, oral capsules at day 0, 2 and 4
Combined (Hep A): Vivaxim, single injection
Duration: 3 years
Typhoid is a bacterial infection that causes fever, headache, abdominal discomfort, possibly a rash that commonly require hospital admission. It is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person. Food safety, hand washing and vaccination are the most effective ways to combat the disease. The vaccine is routinely recommended to travellers going to South East Asia, Indian subcontinent, Pacific Islands, Africa, South America, Middle East and Eastern Europe.
Vaccine: Merieux, 2 injections at 0 and 7
Duration: life-long, but consider checking immunity after 10 years if high risk
New Zealand is fortunate to be rabies free, but not for the rest of the world. It is important for travellers to be aware of it, because it is a highly fatal disease once symptoms occur. It is transmitted through animal bites, lick or scratches, in particular from dogs, cats, monkeys, bats and rodents. Having vaccination means that if exposed, only 2 further doses of the vaccine is required for treatment. However if not vaccinated prior, 5 doses is required but more importantly, Rabies Immunoglobulin is required to be injected to the wound which is a very expensive and scarcely available resource in developing countries. It is not uncommon for travellers to be repatriated or transferred to a more developed country for appropriate treatment. The vaccine is recommended to travellers planning to do outdoor activities, animal encouters including wildlife, monkeys at temples and bats in caves, especially for children who are most at risk
Cholera & Travellers Diarrhoea Vaccine
Vaccine: Dukoral, oral 2 doses up to 6 weeks apart (3 doses for children)
Duration: 2 years
Cholera is now becoming a relatively uncommon infection due to increasing sanitation around the world, and usually the only travellers at risk are those going to known outbreaks or aid workers in refugee camps or after natural disasters. However the Dukoral vaccine had shown to provide some protection against Enterotoxigenic E. coli (ETEC), which mades up anywhere from 0 to 50% of bacterial cause of travellers diarrhoea, depending on the destination. The vaccine is therefore sometimes recommended to travellers who is willing to spend extra money to get a modest risk reduction in travellers diarrhoea.
Hepatitis B Vaccine
Vaccine: Engerix-B, 3 doses at 0, 1 and 6 months (or Rapid schedule 0, 7 and 21 days with 12 month booster)
Combined (Hep A): Twinrix, 3 doses at 0, 1 and 6 months (or Rapid schedule 0, 7 and 21 days with 12 month booster)
Hepatitis B is a viral infection that attacks the liver, and many people then become chronic carriers with the risk of developing cirrhosis and liver cancer later in life. It is present worldwide including New Zealand, and especially common in Asia, Africa, South America, Middle East and Eastern Europe. Travellers maybe at risk if they are likely to be exposed to blood or bodily fluids, including sexual exposure, tattoo/piercing, medical or dental care and even manicure/pedicure. Childhood vaccination & catch up programme in New Zealand started in 1988, and most people born after 1983 are likely to have been vaccinated. Therefore, is it usually recommended for travellers born prior to 1983 to have up to date Hepatitis B vaccination.
Vaccine: ADT Booster, single injection
Duration: 10 years
Tetanus is an infection characterised by severe muscle spasms and can be life threatening in some cases. It can be caught from contaminated wound by soil, dust or faeces, and therefore especially recommended for activities with high risk of injuries or bites. It is part of the routine vaccinations, and as a general principle travellers should be up to date with all routine vaccinations.
Vaccine: Fluvax/Fluarix/Influvac, single injection
The flu is a very common and widespread disease caused by the influenza virus, with outbreaks occurring each year during winter or all year around in the tropics, as the virus constantly evolve into new strains. International travellers are particularly at risk due to increased exposure in places such as airports & cruises, as well as being in a new environment with different local strains of the virus. It is strongly recommended for all international travellers, especially to those with other pre-existing medical conditions or pregnant.
Whooping Cough Vaccine
Vaccine: Boostrix (includes tetanus), single injection
Duration: 5 years
Pertussis (or whooping cough) is sometimes called the “hundred day cough”. It is present worldwide, highly infectious, and a frequent but often underestimated cause of prolonged cough. It causes a very severe respiratory illness in babies and is part of the routine childhood vaccinations. Vaccination is recommended for travellers exposed to over-crowding (e.g. festivals, Hajj pilgram) or with significant medical conditions.
Vaccine: IPOL, single injection
Duration: life-long (after a booster given as adult)
Polio is a virus that can cause nerve damage leading to permanent muscle weakness in some people. It is acquired from contaminated food & water and poor hand hygiene. Although it is close to worldwide eradication, there had been a recent resurgence in the last few years. In 2014 the World Health Organisation (WHO) declared the spread of polio a public health emergency of international concern, and issued temporary recommendations regarding polio vaccination for international travellers.
As of August 2017, the WHO requires travellers staying for more than 4 weeks in Pakistan, Afghanistan and Nigeria to have proof of polio vaccination in the last 12 months. It is also recommended for countries including Democratic Republic or Congo and Syria. Countries previously recommended but now downgraded include Cameroon, Niger, Chad, Central Africa Republic, Ukraine, Guinea, Madagascar, Laos and Myanmar. See Polio Global Eradication Initiative for the latest information.
Vaccine: Menactra (tetravalent ACYW), single injection
Duration: 5 years
Meningococcal disease is caused by a bacteria called Nesseria meiningitidis, which is one of the two main causes of bacterial meningitis (the serious type) as well as sepsis (blood poisoning). There are 5 main strains/group, namely A,B, C, W & Y, and in New Zealand group B & C have been the most common.
However, the overall risk of getting meningococcal disease is low in New Zealand compared to travellers with particular itineries, in particularly travellers going to sub-Saharan Africa “meningitis belt” area as well as being in crowded conditions are most at risk. So much so, that it is mandatory for all pilgrims going to the Haj to have certification to proof having the 4 group/tetravalent ACYW vaccine, see Ministry of Health of Saudi Arabia.
Yellow Fever Vaccine
Vaccine: Stamaril, single injection
Glenfield Medical Centre is an authorised yellow fever vaccination centre. See Yellow Fever Vaccination page for more information.
Japanese Encephalitis Vaccine
Vaccine: Jespect, 2 injections 4 weeks apart
Duration: 1-2 years
Japanese Encephalitis is a mosquito borne disease, and the rate of infection in travellers to Asia is estimated to be less than 1 in 1 million. However, the risk is significantly higher in rural agricultural areas with rice cultivation and flood irrigation, and sometimes these areas can be close to urban zones. Therefore, vaccination is usually recommended to travellers staying in rural areas of Asia for over a month during the rainy/transmission seasons, see Centres for Disease Control for further information.
Malaria Prophylaxis & Insect Avoidance
Malaria is one of the most important diseases travellers need to be prepared for prior to their journey. It is spread by mosquitos, and one of the strains Plasmodium falicparum can quickly cause life threatening disease with high rate of mortality if untreated. There are no vaccines for malaria, but it can be prevented by taking prophylaxis medications and doing mosquito prevention like insect repellent with DEET (recommended to be at least 30%).
There are 3 different prophylaxis commonly used by travellers, namely doxycycline, Malarone and Lariam. Briefly, doxycycline is a funded medication but needs to be taken daily over an extended period, Malarone is taken daily over a short period with minimal side effects but expensive, and Lariam is taken weekly over an extended period but has significant rate of psychiatric side effects. Consult your doctor to see which one is best suited for your requirement. Prophylaxis is routinely recommended for travellers going to Africa, South America, Indian subcontinent and parts of South East Asia.
Vaccine: BCG, single injection
Tuberculosis is uncommon in New Zealand and most cases are from people coming from overseas. The vaccine is unreliable in adults to prevent lung tuberculosis infection. Therefore, only children age under 5 who may travel to countries with high tuberculosis rate or have household members who do, require vaccination. Places considered to have high tuberculosis rates (more than 40 per 100,000 population) includes:
- Indian subcontinent
- China, Hong Kong, Taiwan, Korea
- South East Asia (except Singapore)
- some Pacific nations (except Cook Islands, Niue, Samoa, Tokelau and Tonga)
- Russia and the former Soviet states
- most of Africa
- much of South America
However since 2015, there has been a global shortageof BCG vaccines due to manufacturing issues, and since early 2016 to date there has been no supply, see Ministry of Health. People travelling overseas should consider vaccination when overseas.
BCG vaccine is normally given by the Auckland Regional Public Health Service and not at GP clinics. To book call 0800 FOR BCG (367 224). See Auckland Regional Public Health Service for lastest information on BCG vaccine availability.
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