Up until now I have travelled to countries that do have any additional health related requirements. I simply get my travel insurance, pack my European Health Insurance Card (EHIC / E111) if I’m going to Europe, and off I go.
Next month I am heading off to South Africa, a far away land outside of Europe that contains many unknowns. Added to that, I am going on a safari to the only part of South Africa that has a malaria risk – Kruger National Park. I figured it was time to understand what medication and vaccinations I need, and how to get them as cheaply as possible.
(Note I did this 6 weeks before my trip – actually you should do it at least 8 weeks before. This gives you time to ensure you can receive all the vaccines you need, as well as buy a little extra time just in case what you need isn’t available)
What Do I need?
Firstly I needed to establish exactly what is required for South Africa, and there are plenty of websites that are available to help. One such website is provided by the NHS (UK National Health Service) and is called Fit For Travel. Simply click the country you are travelling to and it will give you a list of vaccinations advised, as well as other travel advice including recent changes to what may be required (for example since I last checked 6 people in Johannesburg have contracted measles – luckily I am fully vaccinated but it is worth checking back before you leave).
For South Africa, the site firstly suggested checking all my standard vaccines were up to date. It advised immunisation against Diphtheria and Hepatitis A. It also said to consider vaccines against Cholera, Hepatitis B, Rabies, Tetanus and Typhoid. I am travelling via Dubai which does not have a risk of yellow fever transmission so I do not need a vaccination certificate.
Where do I get them?
Some of them may be Free!
As the first recommendation was to check that my standard vaccines were up to date I booked an appointment with my local nurse. I have moved around quite a lot and registered at a number of doctors surgeries over the last few years, and something they can request is a vaccination history. I now have a spreadsheet with all of mine on which is something I highly recommend doing so you know what immunisations you have had.
Looking at my records, the nurse saw that my DTP was out of date. This covers Diptheria, Tetanus and Polio; one of the advised vaccines and one of the ones to consider! This booster lasts 10 years and was free through the NHS so she immunised me there and then.
Through the NHS I also received a combined Hepatitis A / Typhoid vaccination, the other advised and one of the other ones to consider. Typhoid lasts for three years, while Hepatitis A requires a booster after 12 months which then covers you for 20 years (possibly 40 years as they are looking at extending it).
Whilst I was there the nurse spoke to me about Cholera and suggested I won’t need immunising as I won’t be travelling anywhere with bad water. It was definitely worth talking through my holiday with her as we could look more closely at my trip and what specific risks I would be exposed to. I am hoping to travel more over the next few years, and so we decided it would be worth me getting vaccinated against Hepatitis B and Rabies, but it may not be necessary for you. The risk of Rabies is if something randomly bites you, and the risk of Hep B is if you get injured and end up in a hospital needed a blood transfusion where the hygiene may not be the same as the UK. Although both these scenarios are unlikely to happen, I would prefer to be covered just in case – even if that mean paying!
Some of them won’t be Free…
Different NHS trusts offer different vaccinations for free, but where I live Hepatitis B and Rabies aren’t included. There are a number of places where they can be bought from including dedicated travel clinics, but I decided to use Boots the Chemist. Not only did their prices seem cheaper than other companies, but with a Boots Advantage Card you earn 4 reward points for every pound spent. Combining that with double points vouchers, it actually knocks quite a bit off the final bill!
I booked an appointment at my local branch online, where I also filled in a questionnaire about my trip; where I was going, how long I was going for, and a bit of my medical information. At my appointment we then reviewed that information and generated a list of vaccinations I require which matched the previous list (always a good start!). I declined Cholera after the advice from the nurse, but accepted Hepatitis B and Rabies. I was also given some information on the different anti-malarial tablets on offer and chose which ones I wanted (Malarone).
That first day I received my first Hepatitis B vaccination, but I had to go back the next day for the first Rabies vaccination as they had none in stock. Apparently there had been a national shortage of the Rabies vaccination, and up until recently people had been changing where they got each course from based on who had a supply. Based on this I would definitely recommend getting sorted sooner rather than later to ensure you are protected before your trip!
Hepatitis B and Rabies both require three doses, so over the last few weeks I have been returning for each dose based on the advice of how long should be left between each. The follow up doses for Rabies are 7 days and 28 days, while Hepatitis B is 28 days and 56 days, so my final dose will be after I get back from my trip. This is not ideal but is OK, especially as I am at low risk of contracting it. My advice? Get sorted earlier than I did!
Do they Hurt?
Yes and no. All the vaccines I mentioned go into the muscle at the top of your arms. As I often had two at a time, I had one in each arm. The following days I had minor discomfort when I reached up to a high shelf, but it wasn’t enough to stop be doing anything other than going to the gym (an excellent excuse to avoid exercise!).
How much did they Cost?
- Diptheria, Tetanus and Polio – Free!
- Hepatitis A / Typhoid – Free!
- Hepatitis B – £40 x3 = £120
- Rabies – £55 x3 = £165
- Malaria (Malerone) – £2.11 x12* = £22.32
Total cost = £307.32!
* Only required for the part of my trip in the risk area, the three day safari to Kruger National Park. I require 2 tablets for two days before I go, 3 tablets for each day of the safari, and 7 tablets for after the safari to take one each day; a total of 12.
Over £300 is a lot of money, especially when you consider I will need another £40 Hepatitis B booster in 12 months, and if I do get bitten the Rabies vaccine doesn’t make me immune; I will still need more vaccinations. But, what they do offer is some peace of mind and some protection if the worst was to happen.
Factor in the cost of vaccinations before you book your trip. I hadn’t realised how expensive they were, and so the money I have saved by staying on a sofa in Cape Town has now been taken up with this expense. The UK is fortunate to have the NHS which has reduced some of the cost, but it is likely to be more expensive in other countries.
Also consider how you react to vaccinations / medication before you travel to a country where they are recommended. I don’t usually (touch wood!) react to anything, and I had no real issues with any of the vaccinations. I have read stories of people on anti-malarial tablets so I will see how I cope with them next month, but if you are likely to react, spend some time with your doctor discussing your options.
Hopefully you will find this useful. Is there anything else I should consider during my next trip? Leave your comments below.