Apologies to readers that have seen this article before.  It was lost as a result of blog disruption and I am re-posting it.

For those traveling internationally, an essential issue to discuss with your doctor at your pre-travel medical visit is vaccination. Vaccination often divides opinion, inciting strong emotional responses from parents and health carers alike. In view of this, I will state my position at the outset. I believe a child should be vaccinated against a disease if the risks of getting the disease (and its outcomes) outweigh the risk posed by the vaccination itself. Vaccination involves giving a small dose of a dead, or weak live virus or bacteria. The body responds to this dose by remembering the virus or bacteria and developing an immune response. If, at a later time the body is exposed to that virus or bacteria again, the immune system is able to mount a fight, preventing the body from becoming sick. Vaccination is one of the most effective interventions we have available to us to prevent disease. Despite this it has been estimated that 2.2 million children die each year around the world as a result of illnesses that could have been prevented by routine vaccination. The Australian immunisation schedule vaccinates against twelve potentially serious infections. Of these twelve, all except polio are still common around the world. In Australia with our high rates of vaccination, even children who are not vaccinated receive some protection due to herd immunity. Herd immunity is conveyed because the children who are vaccinated are less likely to catch the disease and therefore less likely to spread it to those who are unvaccinated. Unvaccinated children travelling overseas may be travelling to countries with less successful vaccination programs and so lose the benefit of herd immunity. For this reason parents taking their baby or small child overseas should ensure their standard Australian vaccinations are up to date. It is sometimes appropriate to accelerate the standard vaccination schedule so that children receive some of their vaccinations earlier than normally given. Talk to your doctor to discover if this would be appropriate for your child. Although the influenza vaccine is not part of the routine immunisation schedule for the general Australian population, I recommend parents have this prior to departure. Exposure to large numbers of people, for example in planes and airports facilitates the spread of respiratory infections such as influenza. Travelling often means being away from regular parental supports so there is less “give” in the system if a parent becomes unwell. Vaccination against influenza offers protection against a common and very unpleasant illness which, if a parent were to get it would influence their ability to care for their baby or child. Annual vaccination against influenza is recommended for children and adults with certain pre-existing illness such as lung and heart disease.

In addition, travel to some regions of the world may expose your family to diseases that are uncommon in Australia and therefore not covered by our immunisation schedule. Vaccinations are available for some of these diseases. Your doctor should discuss which vaccines are recommended for your specific itinerary at your travel visit. Vaccination for some of these diseases should commence a suitable time prior to your departure hence the need for a pre-travel medical visit at least 6 weeks before you leave. In addition to the routine vaccination schedule, vaccination against the following diseases may be appropriate depending on which countries you intend to visit, how long you intend to stay for, what sort of accommodation you will be residing in and the age of your child:

Hepatitis A

Japanese encephalitis

Rabies

Typhoid

Yellow Fever

Mild reactions to vaccinations such as pain, redness and swelling at the vaccination site are common. More serious reactions are rare. Discuss the details of the risks and benefits of the vaccines you are offered with your doctor.

Travel vaccinations can be expensive. It is worth checking with your employers, if you will be travelling for work whether they will cover the expense of vaccinating your family. Finally, parents know how difficult it is to care for their little ones with even a mild illness. Optimising your own health when travelling is a must. Parents and carers travelling should ensure they receive appropriate vaccinations as well.

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