Getting your international travel vaccinations (known in the UK as travel immunisations) is a question of common sense, especially if you're going to places of risk. But wading through the many varieties and requirements is a bit like walking through a maze - which vaccinations you need, which ones are optional, how they will affect you...
What exactly is a vaccination, anyway? Simply put, it exposes your body to a disease after the disease has been disarmed. This allows your body to build up its own protection and fight the disease.
But this build-up doesn't happen automatically, so you should see your doctor a good 6-8 weeks before you travel to an infected area. Some vaccinations take several weeks to become effective.
What follows is culled from professionals and from my own experience - but please don't take my word for it. Do your own research - I'm a civilian, not a medical doctor!
This information will at least help you get started. A word of caution - some of these vaccinations are not safe if you're pregnant so make sure you tell your doctor if you are, even in the earliest stages.
There are three kinds of vaccines for travel: routine (which you should have had as a child), advisable (if you're traveling to countries that have the disease) and mandatory (you'll need it before they let you into the country).
Routine vaccinations are those that should be kept up-to-date no matter what, even in-between trips. These include such things as whooping cough, measles, tetanus, diphtheria and polio. They haven't been eradicated, and outbreaks do occur, even close to home and may require boosters every few years.
There are a number of advisable international travel vaccinations - getting these depends on whether the areas you're headed for are known to have this disease. Get your free copy of Dr Mariana Calleja's Your Body Meets the World, a global travel vaccination guide, if you want the heavy lifting done for you.
Hepatitis A is caused by contaminated food. Be especially vigilant with seafood (it could come from polluted water), and make sure all food is cooked properly and your water is clean. Wash your hands often. Hep A is potentially deadly, especially if you're over 50. The vaccination is very effective.
Hepatitis B, on the other hand, is a sexually-transmitted infection that affects the liver. It is passed through sex, blood and saliva, including unscreened blood transfusions, tatooing, sharing needles or from mother to child. It is difficult to treat so if you plan to have sex make sure it's as safe as possible, bring new syringes with you if you're traveling for many months in poor and unsanitary destinations, and don't go near needles unless you're sure they're sterile. I usually carry a set when I'm heading off the beaten path where I might find a health practitioner but no clinic, along with a doctor's prescription: you don't want border guards assuming you're an injecting drug user. Many other travelers recommend against taking these along, so your choice.
A certain type of meningitis (group A) is a serious threat to travelers and can be deadly so vaccination is a must if you're traveling to a region with an outbreak - check first. The disease is spread by an infected person who coughs or sneezes.
You can catch rabies if you're bitten or scratched by an infected animal, usually dogs, foxes or bats - so stay away from animals you don't know. If you're planning on visiting an infected area, a rabies vaccine might be worth considering. It won't stop the disease but might buy you time. This is a serious one so if bitten or scratched, get to a doctor immediately. It is curable, but will kill you if you don't get immediate medical care.
Catching cholera is relatively difficult - it is spread by a bug through water and food contaminated by sewage, but it takes a lot of bugs to get sick so chances are you won't catch it unless there's an epidemic where you're going. Cholera can provoke severe diarrhea, dehydration and even death but proper hygiene should prevent it as long as there's no epidemic present. Like hepatitis A, cholera can be caught from raw or undercooked food, especially seafood from dirty water.
Another illness spread by food and water - this time contaminated by feces - is typhoid. As is the case with cholera, it is easily treatable with antibiotics and there is an effective vaccine. Be particularly vigilant where hygiene is minimal.
Japanese encephalitis is rare and found only in the Far East. This isn't a common vaccination for travelers so check the situation before you go.
The only mandatory jab these days is the yellow fever vaccine for entry into some developing countries, or if coming from a country where yellow fever is present. Some multi-country travel in the developing world may require this vaccination.
Yellow fever is a viral infection spread by mosquito bites. Unlike malaria, you can catch it both in the city and in rural areas, although it tends to be limited to the interior of countries. Also unlike malaria, these mosquitoes bite in daytime. There is no treatment for it, although you can get care for some of its symptoms - jaundice and kidney failure for example.
When you make your first appointment at the health clinic, let your doctor know you'll be needing a yellow card - or International Certificate of Vaccinations. Each time you get a new vaccination, it'll be stamped in this yellow booklet. Leave a photocopy at home when you travel or email one to yourself - if you lose it you'll at least be able to keep track of your upcoming booster shots.
Also, not all diseases have vaccinations. For example, there is no vaccination against ebola or HIV.
An important point is that even experts disagree on the specifics of international travel vaccinations so please, read up carefully about risk. The level of risk will be different if you stay in the city or if you travel widely through the countryside, and just because a country as a whole is listed as a risk doesn't necessarily mean you need the vaccination if you're only visiting part of it. A holiday in Rio de Janeiro and a month-long adventure trek in the Amazon are two very different trips, for which you'll need different travel vaccinations.
No vaccine is 100% effective, so take sensible precautions, whatever else you do.
And finally, don't let the cost of vaccines deter you - they're not perfect, but some of them may save your life.
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