Only the most masochistic person could say they liked injections, but even if you have an extreme fear of needles, a job abroad in certain countries could require a jab or two. Working in Western Europe and North America is usually safe for UK nationals who have kept up to date with government issue injections (such as the dreaded TB jab in secondary school) but if you have let things slide you may need a booster for mainstream diseases such as polio or tetanus.
Travel Immunizations and Vaccinations
For those venturing further afield, your new job may legally require proof of some immunisations, with several more strongly recommended. If you are heading to Peru, for example, they will not let you in without a Yellow Fever certification, and anyone going to Sub-Saharan Africa would be extremely foolish to forget their malaria medication.
With different vaccinations needed for different countries, it is easy to get confused, especially if you plan to travel before, during or after your time working abroad. Here is a quick overview of the major diseases you may need jabs for, their effects and the cost of the vaccination.
Check our travel immunizations chart for an easy reference guide to which injections generally needed for different continents, although these may differ slightly for individual countries. Although this article is intended to give you some background information on vaccinations, it is no replacement for a meeting with your GP or health worker.
Hepatitis A
All strains of hepatitis are liver infections, and the name actually means “liver inflammation” in Latin. The virus is spread through human feces, and is commonly contracted through contaminated food and drink. In poorly sanitised areas, direct contact with human excrement will also result in the spread of Hepatitis A. It is available on the NHS in a combination vaccine with Typhoid. A booster jab is needed for Hepatitis A 6 -12 months after the first injection, and it gives immunity for 20 years.
Typhoid
Typhoid is a bacterial disease spread by food that has come into contact with feces. It is not usually fatal, but very unpleasant as symptoms include chronic diarrhea, fever, dehydration, internal haemorrhaging and sometimes rashes. Without treatment, it can take around a month for the body to recover.
It is available on the NHS in a combination vaccine with Hepatitis A. There is no booster needed, but immunity lasts for only 3 years.
Hepatitis B
Hepatitis B is a liver inflammation that is transmitted through the blood or bodily fluids, and can lead to severe liver diseases. The vaccine for Hepatitis B is not currently available on the NHS, and it is not cheap, as it requires four staged injections, at around £35 a pop. There are different schedules available depending on how close to departure you are, the shortest being day 0, day 7 and day 21. If you are more organised you can have the middle schedule, which is an injection in month 0, another in month 1 and a third in month 2. Both of these schedules require a fourth booster injection a year after the initial course is finished, which grants immunity for five years. If you have time to spare the best schedule is month 0, month 1 and then month 6 before departure, which also immunises you for 5 years but does not require a booster.
Tetanus, Diphtheria, Poliomyelitis
Luckily for the needle-phobic, the vaccinations for these three diseases are usually combined into one injection. Tetanus and polio are standard immunisations given in the UK in childhood, so depending on your age, you might not need a booster. Tetanus is transmitted through infected cuts, diphtheria through the air, and polio through faecal-oral transmission. There is no fixed schedule for the combined vaccine, it is available on the NHS, and lasts for 10 years.
Japanese B Encephalitis
This mosquito-borne virus is a required vaccine for South-East Asia and the Indian subcontinent. Although in the majority of cases there are no symptoms, sometimes the disease can cause brain inflammation or permanent brain damage, even death. Most prevalent in rural areas, if you are planning to work for more than a month in a risky area it is recommended that you have the injection.
It is expensive, as the vaccine itself costs around £40 per shot and you need to have three of them. Some clinics may also have a prescription/admin charge. The usual schedule for Japanese B Encephalitis is day 0, day 7-14 and day 28 before departure. A booster injection is needed every three years if you remain in, or revisit, a risky area.
Rabies
Another extremely expensive vaccination, but one worth considering as for rabies there is no known cure once it has set in. Rabies is spread through bites from an infected animal, and symptoms progress quickly from nausea and depression through to mania and confusion, eventually leading to a coma and death. Vaccines are the only way to protect against the disease, and pre-departure schedules consist of three injections given on day 0, 7 and 21. Costing between £40-50 per injection, with an admin charge in many places, this vaccination is likely to be hardest on your budget.
However, if you are unfortunate enough to be bitten, there is hope. If you have had the vaccine pre-departure, you need two additional injections after the incident, so you will need to get medical attention immediately. If you did not have the jabs before you left Britain, a longer course of five injections will be needed immediately, which have side effects of their own.
Yellow Fever
This vaccination is only needed for certain South American and African countries, but is taken extremely seriously – like Japanese B Encephalitis, if a country requires you to be immunised against Yellow Fever, you need to produce a certificate to pass the border! It’s a nasty illness that affects the blood and internal organs – its name comes from the jaundice caused in sufferers, along with fever, vomiting and bodily aches, culminating in delirium, coma and death. It has an extremely high mortality rate for a preventable disease.
Yellow Fever requires just one injection, taken at least 10 days before travel, but it costs around £45. It will grant you immunity for 10 years, so worth the outlay if you intend to work in high-risk areas frequently or for an extended period of time.
Malaria
Malaria medication consists of tablets, rather than injections. There is a range of different prescriptions available, and the most appropriate one will be prescribed based on your destination and medical history. You usually have to start taking before you leave the country and continue for a fixed period of time upon your arrival. Prices vary by brand and the length of time you will be working in the area.
There are many different places you can go to for advice about what vaccines are best for your time working abroad. The internet is an invaluable resource, although sometime the information can be conflicting. The best approach is to visit a qualified health worker or your GP and discuss your individual needs. If you’ve left it to the last minute, travel clinics such as those provided by Nomad may be able to help, although bear in mind you may need to pay for vaccines which would be free on the NHS.
TRAVEL VACCINATION RESOURCES
www.netdoctor.com
www.fitfortravel.scot.nhs.uk
www.patient.co.uk
www.nhs.uk/chq/pages/Category.aspx?CategoryID=67
www.nomadtravel.co.uk