Vaccines were one of the first things I thought about when I began to plan my trip. People try to save days going to get the vaccines as late as they can. FAIL! Most of the vaccines need more than 1 dose and time between doses. Additionally, if you’re going to a region where you need several vaccines it can be an EPIC FAIL. I needed 7 vaccines, although I didn’t need to get 5 more since in Europe we’re already immunized for them since we’re kids. I came to the doctor 3 months in advance. Anyway, even if you’re not going to vaccinate in that moment, you should go to the doctor with enough time. He/she will do a vaccination calendar for you.
In this post you’ll find all the vaccination information needed for a backpacking trip to Asia and Oceania (vaccinations for Southeast Asia are mainly enough for the rest of Asia and for Oceania).
Where to get the vaccines
This section will be mostly useful for Spaniards, particularly for Madrid people Other Spaniards can find here; a full list of vaccination centers in Spain.
In Madrid we have 3 vaccination centers:
- Centro Monográfico de Salud (CMS) Internacional
- Montesa Street, 22, Building C, Ground Floor.
- Price: 37€. Card payment. Yellow Fever is an additional bank payment of 18,51€ using the forms given by the center.
- Prior appointment needed by:
- Web del Ayuntamiento
- Phone: 010 (for calls from Madrid city) / 91 529 82 10 (for calls from other towns in Madrid region).
- Carlos III Hospital
- Sinesio Delgado Street, 10, 1st Floor, “Unidad del Viajero” (Traveler Unit).
- Price: Free except Yellow Fever vaccine whose price is 18,51€.
- Prior appointment needed by:
- Portal de Salud de la Comunidad de Madrid
- Phone: 914 532 672 / 914 532 780
- Face-to-face in Carlos III Hospital, Sinesio Delgado Street, 10, in the Traveler Unit’s secretary’s office (first floor).
- Francisco Silvela Street, 57, 1st Floor.
- Price: 18,51€ each vaccine. Cash payment.
- Prior appointment needed by:
- Web de Cita Previa
- Phone: 912 729 441 / 912 729 442 / 912 729 443
Difference of prices is unbelievable. The cheapest one is Carlos III Hospital, obviously, and it’s the one I’ve come.
In case you need the Japanese Encephalitis vaccine the cheapest one would be the CMS Internacional. Look out, none of the centers have these the vaccines and you have to buy them:
- Cholera and Typhoid Fever since they’re oral vaccines and must be bought in a pharmacy with the prescription.
- Japanese Encephalitis must be acquired in the pharmacy with the prescription. This vaccine is not covered by the Spanish Health Care System and its price is 85,86€ each dose. 2 doses are needed so the total price is 171,72€
Update 30-March-2015: Thanks to Miguel Lozano and Isa who confirmed that the Japanese Encephalitis vaccine is included with the 37€ of CMS Internacional, what makes that place the cheapest one when that vaccine is needed and me the most crummy guy for paying quite a lot more money than needed.
Update 31-October-2015: Thanks to gybi who tells me in the comments that the CMS Internacional is not paying the Japanese Encephalitis vaccine anymore.
- Tick-Borne Encephalitis must be acquired with the prescription in Consejería de Sanidad de la Comunidad de Madrid, Sección de Suministro de Medicamentos Extranjeros (C/ Sagasta, 6, planta baja). You’ll also need a doctor’s note to justify you need it. This is mine one:
When you go there to buy the vaccine you must bring a small cooler since it needs to be below 8 ºC (46 ºF). Once the nurses inject you the first dose they’ll save the rest for you. The price of this vaccine is 22,88 each dose and you need 3 doses, but the Health Care System covers it partially and I just had to pay 9,15€ per dose, so 27,45€ in total.
In the table inside the PDF file I’ve detailed what vaccines do we need for a trip to Asia and Oceania including rural regions and voluntary works, as well as information about them (you can see it easily if zoom in):
You won’t need a couple of them:
- Tick-Borne Encephalitis. It’s a disease transmitted by a tick found in the Russian South strip and in Center-East Europe. You must be immunized when sleeping in the field is expected. I had to be vaccinated due to my intention to come back Europe from Asia exactly through that region. Although I think the effect will be gone when I decide to come…
- Yellow fever since it’s only needed if you come from a country where it’s known to exist (or you’ve been there). That’s not the case of Europe. If anybody ask you for it in the border it’s just because they want to cheat you, so be careful.
In addition, in the same PDF, I attach the Spanish vaccination calendar so you can see what vaccines do we already have and not booster needed:
- Hepatitis B
- DTP (Diphtheria-Tetanus-Pertussis)
- TV (Measles-Rubella-Parotiditis).The vaccine against mumps (Parotiditis) created by Berna Lab (Rubini strain) is considered like defective since it’s less effective. Those people born between 1995 and 1998 as well as those born between 1985 and 1988 should visit the doctor to check-up their vaccination and get a new Triviraten dose if needed.
Nowadays kids are immunized against more diseases than some years ago, but you don’t need those additional vaccines.
Other diseases and how to avoid them
Having so many bugs inside us still there are some others we’re not protected against:
- Dengue. It’s a fever which lasts around one week and can develop red rash similar to measles. A second infection after the first one could become hemorrhagic dengue, which can be mortal.
- Malaria. There is not a vaccine but there is curative treatment. In Spain the medicine used is Malarone and every box comes with a full treatment. However, malaria is a serious disease and we must go to a hospital as soon as we suspect. So do it always when you have high fever (higher than 38 ºC (100 ºF)). If don’t have a hospital near (within 24h after the beginning of the fever), then start the Malarone treatment while we find it. Malarone can be also used like a prophylactic (preventive medicine), but ingestion for medium or long-term is not healthy. Just in case we need to look for other medicine, its active substances must be atovaquone and proguanil hydrochlorid
- Traveler’s Diarrhea. Diarrhea produced when contaminated food or water are eaten. It disappears after 4 or 5 days even if not treated but the bacteria destruction can be sped up with antibiotics like Azithromycin. Besides Azithromycin also Sueroral should be drunk to recover fluids and nutrients.Antibiotics like Azithromycin are used for bacterial diarrhea, like blood diarrhea, since they destroy the bacteria. Once there is not more blood in feces antidiarrheals can be used reducing fluid secretions. The most recommendable antidiarrheal are the ones based in racecadotril, like Tiorfan, so that they reduce the secretions fluidity. Antidiarrheals like Fortasec are based on loperamida and reduce the intestinal motility (the body system to move the food from the mouth to the anus), so they reduce the capacity to defecate (it’s like putting a plug in the ass ), but they also avoid our body expels the microbes causing the diarrhea.
When read the travel recommendations of medical institutions, we can easily conclude that’s better to stay at home rather than travel and get sick because they tell you not to eat or drink anything that’s not strictly controlled. And that’s difficult even in the first world. You can imagine that backpacking around SE Asia that’s not happening. So I’ll just follow some basic rules so that I can enjoy my trip and reduce the possibility to become sick:
- Reduce as much as possible raw food (although I’m not going to refuse Asian delicacies just to not eat them raw).
- Drink bottled water whenever possible.
- Drink fizzy drinks since it’s an acid environment where viruses and bacteria are difficult to find.
- Make suspect water drinkable even to brush my teeth.
- Sleep using mosquito net coated with Permethrin, an insecticide.
- Use light colors and long-sleeved clothes, especially at dawn and evening, to prevent mosquito bites and coat my clothes with Permethrin.
- On skin not covered with clothes use insect repellent.I’m still finishing a new post about how to protect oneself against mosquitoes and I explain what type of repellent we have to use as well as how to coat clothes and mosquito net with Permethrin
- Do what locals do: when in Rome, do as the Romans do.
- Apply common sense.