Hepatitis A is the most common preventable disease vaccine among travellers. It is a virus transmitted by direct person to person contact and via contaminated water, ice, shellfish harvested in sewage-contaminated water or from contaminated raw, inadequately cooked or frozen fruits, vegetables and other food.
Vaccines: Havrix, Avaxim
2 doses are required, initially and 6 to 18 months depending on the vaccine. Last-minute traveller can get vaccine right before travel and complete series when they return.
No booster dose required, usually lifetime immunity.
Age: Havrix Junior for children ages 2-15 years
Approximately 2 billion people worldwide have been infected with Hepatitis B, and more than 350 million persons have chronic lifelong infections. Hepatitis B is endemic in most countries of the world, especially the Far East, Middle East, Africa, South America, Eastern Europe and Central Asia. Hepatitis B is a virus transmitted via blood, and other body fluids, e.g. unprotected sex.
Vaccine: Engerix B
3 doses required, initially, after 1 month and 6 months from the initial treatment. Travelers must get 3 doses before travel to have full immunity. If getting last-minute vaccination, the traveler may opt for a Fast track regime which requires vaccine 4 doses, initially, at 1 week and 3 weeks, 4th dose is given after 1 year and provides long term immunity. No booster dose is required.
Age: Pediatric from age 0-19
Vaccine: Twinrix
Dosing regime is the same as the Hepatitis B vaccine, at 0, 1 month and 6 months. A fast track may be given for last minute travel at 0, 7, 21 and 365 days. No booster required.
Age: Twinrix Jr age 1 -18 years
Yellow Fever is a virus transmitted via the bite mosquito and occurs in parts Africa and tropical South America. Yellow fever can be fatal and there is no treatment for it. Some countries require evidence of Yellow Fever vaccine in order to travel to that country.
Vaccine: YF-VAX
YF-VAX is a live vaccine and may be contraindicated in some individuals. In certain situations, based on one’s health, one may not be eligible to receive the Yellow Fever vaccine. As such, we can provide you with a Yellow Fever exemption certificate.
Only 1 dose is required for lifetime protection and should be administered a minimum of 10 days before travel.
Typhoid is a bacterium transmitted mainly by consuming contaminated food or water. There are approximately 26 million cases per year and can cause serious illness. High-risk areas are countries in South Asia such as India, Pakistan and Bangladesh, Southeast Asia and Africa.
Vaccines: Vivotif, Typhim
Vivotif- A live oral vaccine in capsule form. The traveller takes 1 capsule every other day, 4 doses in total. The vaccine should be completed 1 week before travel to ensure immunity. A booster is required every 7 years. Must be 6 years of age and over.
Typhim- injectable vaccine should be administered 2 weeks before travel. A booster dose is needed every 3 years. Must be 2 years of age and over.
Neither vaccine is 100% effective, and the traveller should still follow food and water precautions.
Age:
Meningitis is a bacteria transmitted person-person via respiratory droplets from an infected person. The highest incidence occurs in Sub-Saharan Africa in the “meningitis belt’ and Saudi Arabia during Hajj or Umrah (a religious pilgrimage to Mecca). Saudi Arabia requires proof of vaccination before they will provide a Visa to people making Hajj or Umrah in Canada, it is part of the routine vaccinations given during childhood.
Vaccine: MMR (measles, mumps, rubella). A total of 2 doses are required 28 days apart
Measles is a virus transmitted from person to person via airborne droplets or from contact with oral or nasal secretions of an infected person. It is highly contagious with a greater than 90% rate of infection non-immune contacts. Globally large outbreaks have been occurring due to declining immunization rates and an increase in international travel. A traveller should ensure that they have had at least 2 doses of the vaccine in their lifetime. If travelling to a country where there is currently an outbreak, it is advisable to get an MMR booster.
Vaccine: Dukoral
Dukoral is a live oral vaccine administered in 2 doses and provides protection against diarrhea caused by heat-labile toxin-producing enterotoxigenic E. coli (LT-producing ETEC). Dukoral is suitable for children over the age of 2 and for adults. Dukoral should be ideally taken 2 weeks before arriving at your destination and requires 2 doses taken one week apart. The vaccine lasts for approximately 5 years, and a booster dose may be needed if the last treatment was over 5 years ago.
JE is transmitted by mosquitoes and is one of the most severe cases of encephalitis worldwide. Approximately 50,000 cases with 15,000 cases of long-term neuropsychiatric problems and 10,000 deaths yearly are due to JE.
JE is mainly a concern in rural agricultural areas where there are standing water, e.g. rice fields. JE risk varies depending on destination, season, duration of travel and activities a traveller may be engaged in. The mosquitoes bite mainly at dusk and dawn and primarily outdoors. JE occurs mostly in Asia, especially S.E. Asia.
Vaccine: Ixiaro – 2 doses are required 28 days apart. If the traveller is leaving sooner, it can be given 7 days apart.
Rabies is a virus transmitted via the saliva of a rabid animal. The signs and symptoms of rabies in an animal is not always apparent as symptoms can vary. It can also be transmitted if rabid animal saliva comes into contact with broken skin. All mammals are susceptible to rabies though dogs and bats are often the culprits. Approximately 16-200 per 100,000 travellers are exposed to rabies annually.
Vaccine: Imovax Rabies, Rabevert
The vaccine is available for prevention as well and involves a series of 3 vaccinations at 0, 7 and 21 to 28 days before travel. Post-exposure vaccination is still necessary even if a pre-exposure vaccine has been given, but it is simplified; only 2 doses are required on days 1 and 3. Also, if travellers are going to a remote location or to countries where it is not readily available as they have more time to get to a medical practitioner for treatment. Unless the animal is caught and tested for rabies, a traveller must always seek treatment since this disease is fatal.
Avoiding animal bites is important:
Shingles, also known as herpes zoster, is a disease that affects the nervous system. Shingles are caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Individuals who have had chickenpox can develop shingles later in life, as shingles is a reactivation of the varicella-zoster virus. Shingles are contagious, and those who have an active infection should take care to minimize the spread of the virus.
Vaccine: Shingrix. Administered in 2 doses.
The first dose is administered at Day 0, followed by a booster dose after 2 to 6 months after the initial treatment.
Travellers should also consider getting vaccinated against the flu virus. The flu vaccine is a quadrivalent vaccine that is provided free to all Albertans with a valid Alberta Health care card, and pharmacists can vaccinate children 5 years and older against the flu virus.
Tetanus is transmitted via cut or scratch that is exposed to tetanus bacteria or via skin that is punctured by a contaminated object, e.g. nail, animal claws, glass etc. It can cause muscle rigidity and spasms and can sometimes be fatal.
Vaccines: Td, Tdap, Dtap or Adacel
Vaccine (Td, Tdap, Dtap or Adacel) is available in combination with Diphtheria and/or Pertussis and should be administered every 10 years. If a person has been exposed and it is more than 5 years since the last vaccination, a booster dose should be given.
Diphtheria is typically a respiratory illness transmitted by exposure to respiratory droplets in the air (e.g. from an infected person coughing) or by close contact with an infected person. In tropical countries, Cutaneous Diphtheria is present and causes skin lesions. It is transmitted by coming into contact with the infected lesion.
Respiratory diphtheria symptoms usually start 2-5 days after exposure and affect mucous membranes of the upper respiratory tract (nose, pharynx, larynx, tonsils and trachea). It starts with mild fever, sore throat, difficulty swallowing, loss of appetite and a hoarse voice. The trademark symptom of diphtheria is a pseudo-membrane that covers the tonsils, pharynx, larynx, nasal passages and possibly the trachea.
Vaccines: Td, Tdap, Dtap or Adacel
Vaccine (Td, Tdap, Dtap or Adacel) is available in combination with Tetanus and/or Pertussis and is recommended every 10 years.
Pertussis is transmitted person to person via respiratory droplets in the air on contact with secretions. In developed countries, infants are at the highest risk as they are too young to be vaccinated.
Pertussis typically presents as a mild upper respiratory infection with minimal or no fever. Symptoms start 7-10 days after exposure (range: 6-21) and are followed by spasmodic coughing (may sound like a “whoop”), and can often result in vomiting. Infants under 6 months of age may have symptoms of gagging, gasping and shortness of breath.
Vaccination is essential for travellers as immunity wanes, and if exposed to Pertussis, they can become infected. Pregnant women should be vaccinated at 27-36 weeks of pregnancy as antibodies are passed on to the infant.
Vaccine (Tdap, Dtap or Adacel) is available in combination with Tetanus and Diphtheria and is recommended every 10 years and at least once after the age of 19.
At Travel Clinic YYC, our designated pharmacists are available to advise as well as formulate vaccination and medication requirements for school trips abroad. At your convenience, we can advise and inform parents on all the vaccination requirements for school trips as well as assist with administering the vaccinations and prescribing the necessary medications for your children to ensure a healthy and safe trip abroad.
Pneumococcal Polysaccharide 23 Valent Vaccine (Pneumovax 23) – can be provided for all individuals 65 years and over as part of the routine immunization protocol, and is provided free of charge to all Albertans who are 65 years and over. In certain conditions, individuals aged 19-64 years may be eligible to receive this vaccine based on their medical condition.
Vaccine: Prevnar 13
Prevnar 13 vaccine is also provided to those individuals with certain medical conditions (e.g. Immunocompromised, chronic renal failure, HIV infection, Hodgkin disease, etc.) based on an assessment made by our trained and knowledgeable pharmacists.
Our Calgary travel clinic offers many travel vaccinations and recommendations based on your health and the country you’re travelling to.
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As clinical pharmacists, we believe in protecting our clients and ensuring a safe and enjoyable trip. Travel Clinic YYC is a service to make travel health more attainable by providing you access to us via video chat for the initial consultation.
