vaccinations cost vietnam

The one thing that I have found whilst planning this cycle trip is that is has been an endless opportunity to learn new things.  For example, I found out that Trypanophobia is the name given to people who have a fear of injections, whilst Belonephobia is an abnormal fear of sharp pointed objects.  When I was at university in the early 2000’s (as a mature student) I shared a house with this 6ft Yorkshireman called Chris, and one day I had to take him to the hospital as he had cut his finger.  Anyway, when the doctors looked at his finger they advised that it only needed steri stripping rather than stitching, and that he would also need a tetanus shot.  Well, I nearly cried laughing as the nurse came towards him with the injection and this 6ft Yorkshireman went completely pale and nearly passed out even before she had given him the shot.  I’m sure that Chris will have a different recollection now that he is married with a few kids, but I would definitely say he has Trypanophobia .

For this cycle trip, I have totted up the vaccinations that I will need to have and it will mean somewhere in the region of 15 injections.  This may sound weird given the amount of injections that I am getting, but I am actually not too concerned that I will contract a disease en route. I think that even though I will be travelling through some remote areas there is still only a slight chance of actually catching a disease.  The main reason that I intend to get fully vaccinated before setting off is for peace of mind, and that it is much more convenient to do it now whilst I am in one place.

It should also save time in the event that I am unlucky enough to get ill during the cycle; for example, if you get bit, or even licked, by a dog infected with Rabies then you would need to take a course of 5 injections over a 21 day period.  However, if you have already had the pre-exposure vaccination of 3 injections then you only require a further 2 – one on day 1 of exposure and one on day 3.  This potentially saves you having to stay in one place for 3 weeks, or even rerouting your trip to fit in cities where you can get the subsequent injections.

For this trip, I think that a bigger concern than contracting a disease is that I will have to rely on untreated water sources for long parts of my trip.  For me, this will be the more likely cause of having to take time off the bike.  Nearly every tour cyclist I have met has at least one tale about having chronic diarrhoea at some point on their journey, and for some reason the funniest stories are often associated with tents.  However, there is always the other extreme and if you are fortunate to meet Fraser Baillie on his cycle around the world – cyclehacker.com – be sure to ask him about his trip to the doctors in Aosta, Italy.

The ability to cycle the back roads and to camp long term in the wild depends on having a constant source of safe water. This means that water borne diseases are probably more of a definite risk to me than mosquito borne diseases.  On this trip, to try to prevent this risk I will be using the latest technology to purify the water.  I am going to be relying a ultraviolet purification system – The Travel Tap. This technology is proven to be the most effective method for disinfecting bacteria from water.  The UV rays destroy illness-causing micro organisms by attacking their genetic core (DNA).

The Travel Tap is a British product and quite weirdly a claim on their website states that it even purifies urine as tested by UK marines.  My back up water purification system for this trip will be Chlorine Dioxide tablets.  I have used these before and I can confirm that treated water really does not taste good, but then as long as they allow you to keep on safely pedalling I will put up with it.  Hopefully, with the UV water system and the course of vaccinations then this should help limit the number of days that I lose due to illness.

So how do vaccines work? Well, apparently vaccines help develop immunity by imitating an infection, but this “imitation” infection does not cause any illness. It does, however, cause the immune system to develop the same response as it does to a real infection so the body can recognize and fight the vaccine-preventable disease in the future.

The two main areas that increase my exposure to diseases are firstly mosquito borne routes, and secondly poor levels of sanitation and food hygiene.  In tropical climates, lush jungles, plentiful standing water, and very warm temperatures combined with high humidity create an environment perfect for the spreading and transmission of diseases.  When I spoke to my doctor about this, and explained the trip that I was planning,  he advised that I should be vaccinated for the following common diseases – Cholera (spread by poor hygiene/sanitation), Diphtheria (transmitted by human contact), Hepatitis A (spread by poor hygiene/sanitation), Japanese Encephalitis (transmitted by mosquitoes), Polio (transmitted by human contact), Rabies (transmitted by the lick or bite of an infected animal), Tetanus (transmitted by bacteria) and Typhoid (spread by poor hygiene/sanitation).

Additional diseases may also require vaccination depending on your destination country e.g. certain countries in sub-Saharan Africa, South America and parts of the Caribbean require proof that you have received a Yellow Fever vaccination. Without this proof, you may be denied entry to the country.

The information below gives an overview of the diseases which are prevalent in a number of the countries that I will be cycling through.  If you want more information about any of the vaccinations please click on each disease name.

The information below is compiled from the research I completed prior to my trip and should not be relied upon to make medical decisions.  It is important that you should consult a doctor to discuss your own medical history and trip details, so that vaccinations can be prescribed based on your own particular needs.

Cholera

Cholera is an acute diarrhoeal illness caused by a bacteria. The disease infects the small bowel and causes painless, watery diarrhoea. It is known to infect only humans. More common during floods and after natural disasters, in areas with very poor sanitation and lack of clean drinking water. It would be unusual for travellers to contract cholera if they take basic precautions with food and water and maintain a good standard of hygiene.

Do I need it?

Vaccination against Cholera is normally only recommended if you’re travelling to areas where the infection is widespread, or if you are likely to have limited access to medical services.

Vaccination Schedule

The Cholera vaccine is given as a drink, where the vaccination ingredients are mixed with water. For adults and children over the age of six, two doses of the vaccine are needed to protect against cholera for two years. After this, a booster is required if you continue to be at risk. All the doses must be taken one to six weeks apart. If more than six weeks passes between doses, you’ll need to start the full vaccination course again. Ideally, the vaccination course should be completed at least one week before travelling.

Period of protection

2 years

Dengue Fever

There are certain diseases that you may encounter where there is currently no vaccine available.  One of these that is especially prevalent in Vietnam, and South East Asia, is Dengue Fever.  It is a viral illness that is transmitted to humans by female mosquito bites. The mosquito that spreads dengue bites during the day and, as opposed to many of the mosquito borne diseases outlined on this page, is apparently more common in urban areas than rural areas. Symptoms include fever, headache, severe joint, bone and muscular pain – hence its other name ‘breakbone fever’. Treatment concentrates on rest and the maintenance of the patient’s body fluid volume.    

Diphtheria

Diphtheria is a potentially fatal contagious bacterial infection that mainly affects the nose and throat, and sometimes the skin. Diphtheria is highly contagious. It’s spread by coughs and sneezes, or by contact with someone with diphtheria or items belonging to them, such as bedding or clothing. The infection is usually caught after being in close or prolonged contact with someone who has the condition or is carrying the infection. Risk is higher if mixing with locals in poor, overcrowded living conditions.

Do I need it?

In the UK, the Diphtheria vaccine is offered as part of childhood vaccinations programme. Adults should consider having a booster vaccine when travelling to parts of the world where diphtheria is widespread, or if your last dose was more than 10 years ago.

Vaccination Schedule

Single injection.

Period of protection

10 Years

Hepatitis A

The most common cause of Hepatitis A is eating food contaminated by the stools of an infected person as a result of poor personal hygiene. For example, you may get Hepatitis A if you eat food prepared by an infected person who has not washed their hands properly. It is also possible to become infected with Hepatitis A by drinking contaminated water. Eating foods such as shellfish contaminated by raw sewage can also lead to you becoming infected.

Do I need it?

In the UK, the Hepatitis A vaccine is offered as part of childhood vaccinations programme. Vaccination against Hepatitis A is recommended if you are planning to travel to, or live in, parts of the world where it is widespread, particularly if levels of sanitation and food hygiene are expected to be poor

Vaccination Schedule

If you need vaccination, a single injection of the vaccine should be given two weeks before you leave, although it can be given up to the day of your departure if necessary. This will protect you against Hepatitis A for about a year. A booster dose, given six to 12 months after the first dose, will protect you for at least 20 years.

Period of protection

Single injection – 1 year.   Two injections – 20 years

Hepatitis B

You can get infected with Hepatitis B if you have contact with an infected person’s blood or other body fluids. The vaccine gives protection against the Hepatitis B virus, which is a major cause of serious liver disease, including cirrhosis and liver cancer.

Do I need it?

The vaccine is normally only recommended for vulnerable groups including:

  • people travelling to high-risk countries
  • people who change their sexual partners frequently
  • men who have sex with men
  • babies born to infected mothers
  • anyone who receives regular blood transfusions or blood products
  • people with any form of liver disease
  • people travelling to high-risk countries
  • people who work somewhere that places them at risk of contact with blood or body fluids, such as nurses, prison staff, doctors, dentists and laboratory staff

Vaccination Schedule

3 injections over a 4 – 6 month period

Period of protection

Life long protection

Japanese Encephalitis

Japanese Encephalitis is a viral disease found in South-East Asia and the Indian subcontinent. The infection is spread by the bite of an infected mosquito. This particular type of mosquito favours breeding sites in and around rice paddies. Transmission patterns are highly specific to locations and vary year to year; in some countries transmission is seasonal and in others, disease occurs all year round.

Do I need it?

It’s very rare for travellers visiting risk areas to be affected by Japanese Encephalitis. It’s estimated that less than one in a million travellers develop Japanese Encephalitis in any given year. However, the risk is greater if you’re planning to visit rural areas or go hiking or camping.

Vaccination Schedule

3 injections – Day 1, Day 7 and 1 month to 1 year later

Period of protection

5 Years

Malaria

Malaria is a life-threatening disease caused by Plasmodium parasites that are transmitted to people through the bites of infected night-biting female mosquitoes. About 3.2 billion people – almost half of the world’s population – are at risk of Malaria and nearly 2000 people a year return to the UK with Malaria.  Young children, pregnant women and non-immune travellers from malaria-free areas are particularly vulnerable to the disease when they become infected.

Malaria is preventable and curable, and increased efforts are dramatically reducing the Malaria burden in many places. Between 2000 and 2015, malaria incidence among populations at risk (the rate of new cases) fell by 37% globally. In that same period, Malaria death rates among populations at risk fell by 60% globally among all age groups, and by 65% among children under 5.  Sub-Saharan Africa carries a disproportionately high share of the global Malaria burden. In 2015, the region was home to 88% of Malaria cases and 90% of Malaria deaths.

There is no ‘scientific’ evidence to suggest homeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, yeast extract spread (such as Marmite), tea tree oils or bath oils offer any protection against mosquito bites.

Incubation period of malaria

The minimum period between being bitten by an infected mosquito and developing symptoms of malaria is 8 days, so a high temperature/flu like symptoms starting within the first week of your arrival in a malaria area is not likely to be Malaria.  Malaria can also take several months to develop after being bitten by an infected mosquito and in some cases up to  a year or more; however symptoms are most likely within a month after getting bitten.

Symptoms and signs of malaria

Malaria almost always starts with a fever, sweats, chills and/or shivering.  The temperature will usually be above 38 degrees C and may come and go.  Other symptoms include: headache, feeling sick, aching muscles, vomiting, cough, stomach pains, confusion and diarrhoea which because they are common to many other diseases make it difficult to tell if they are caused by malaria or by other infections such as flu or a virus.

Treatment of malaria

You should consult a doctor to discuss your own medical history and trip details so that Malarial treatment medication can be prescribed based on your particular medical history.

If, after spending more than a week in a Malarial area, you develop a high fever over 38 degrees and have any of the symptoms outlined above then you should assume it is Malaria and seek medical attention straight away. You require a blood test.

Many of the same antimalarial medicines used to prevent Malaria can also be used to treat the disease. However, if you’ve taken an antimalarial to prevent Malaria, you shouldn’t take the same one to treat it.  Most doctors will prescribe a combination of different antimalarials to overcome strains of Malaria that have become resistant to single types of medication.

If you are travelling in remote areas where no immediate medical help or reliable Malarial testing is available then you should carry with you a course of treatment for Malaria infection that should be commenced immediately symptoms develop, and you must then make your way to reliable medical attention.

How to take your treatment

The following is based on advice from Nomad Travel Clinic:

Firstly, if you are taking Malaria prevention medication then stop.  Take either Paracetamol or Ibuprofen to lower your fever. If your fever is controlled, it makes it less likely that you will vomit your Malaria treatment medication.  Then, immediately take your first dose of standby Malarial medication.  If you  vomit within 30 minutes of taking the Malaria treatment medication, repeat the first dose of them (not the Paracetamol/Ibuprofen).  If you vomit 30 – 60 minutes after taking the first dose then repeat treatment but take only HALF the first dose.

If you were taking Malaria prevention drugs then you should restart these 1 week after taking your first treatment dose.

Do I need to take preventative medication?

You should consult a doctor to discuss your own medical history and trip details so that Malarial treatment medication can be prescribed based on your particular medical history.

This is the one question where the opinion of travellers is most divided.  In the 1990’s, when I was living in Lome in West Africa I contracted Malaria.  I was not taking antimalarials because, to be honest, I couldn’t really afford them and I was put off by the side effects of the medication that I had seen my friends go through.  My initial symptoms were flu-like and I thought that it was nothing more than I was coming down with a cold.  These symptoms quickly progressed to the full monty of a fever, headache, sweats, chills and vomiting.

At this stage, a friend took me to a Peace Corps medical unit which was based in the city for a blood test.  (As an aside, when we arrived at the clinic the doctors were actually stitching up the leg of a horse that a local lad had brought in as he could not afford to have it treated by a vet). The blood test is a very critical part of the treatment process as it not only confirms the diagnosis but it also identifies the the species of Malaria parasite causing the infection. I was then prescribed a course of Malarial medication and with the correct treatment, I was back on my feet within a couple of weeks.

When I was back in the UK just prior to starting this trip I visited the vaccination clinic of Nomad Travel in Bristol.  After discussing my needs, and the countries I would be cycling through, with the doctor she prescribed a combination of Malarial treatment drugs, Atovaquone and Proganuil Hydrochloride 250mg/100mg, that were specific to my needs. In the case of symptoms developing, I would need to take 4 tablets in a single dose at the same time each day for 3 days.  Always taken with or after food.

Vaccination Schedule

There is currently no vaccine available that offers protection against Malaria.  It is recommended that travellers take antimalarial medication to reduce the chances of getting the disease.  However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid bites is also important.  When taking antimalarial medication you need to ensure that you get the right antimalarial tablets for the region of the world that you will be travelling to as mosquitoes in different areas have become resistant to certain types of antimalarial medication.

Polio

Polio virus only infects humans. It is very contagious and spreads through person-to-person contact. The virus lives in an infected person’s throat and intestines. It enters the body through the mouth and spreads through contact with the faeces of an infected person and, though less common, through droplets from a sneeze or cough. You can get infected with polio virus if you have faeces on your hands and you touch your mouth. 

Do I need it?

In the UK, the Polio vaccine is offered as part of childhood vaccinations programme. If you’re planning to travel to a polio-affected country, you should get vaccinated if you’ve not been fully vaccinated before, or have a booster dose if it’s been 10 years or more since your last dose of the vaccine.

Vaccination Schedule

Single injection

Period of protection

10 Years

Rabies

Rabies is a disease transmitted through bites and scratches of animals, most commonly dogs, bats, cats, raccoons, skunks, and foxes. If not treated this disease is always fatal. The vaccine is recommended for persons working with animals, young children, persons with extensive outdoor activities in rural areas (trekkers and cyclists), and persons with prolonged stays in endemic areas.

Do I need it?

There are 2 types of vaccination schedule – pre-exposure and post exposure. The pre-exposeure schedule is recommended for people travelling to an area for one month or more where Rabies is common in animals and there is no access to prompt and safe medical care, or you are taking part in activities that may expose them to Rabies, such as trekking in a jungle.

Vaccination Schedule

Pre-exposure vaccination:  3 injections – Day 1, Day 7 and Day 21 or 28. If you subsequently are bitten by a rabid animal you still require 2 further injections

Post-exposure vaccination:  If you have not already completed the pre-exposure injections then you need to have 5 injections – Day 1, Day 3 and Day 7, Day 14, and Day 28.

Period of protection

None. The pre-exposure vaccination just reduces the amount of post-exposure vaccinations you will need.

Tetanus

Tetanus is caused by bacteria called Clostridium tetani. These bacteria can survive for a long time outside the body, and are commonly found in soil and the manure of animals such as horses and cows. If they enter the body through a wound, the bacteria can quickly multiply and release a toxin that affects the nerves, causing symptoms such as muscle stiffness and spasms.

Do I need it?

In the UK, the Tetanus vaccine is offered as part of childhood vaccinations programme. An additional dose of the tetanus vaccine is usually still recommended as a precaution if you’re travelling to an area with limited medical facilities and your last dose of the vaccine was more than 10 years ago.

Vaccination Schedule

Single injection

Period of protection

10 Years

Tick Borne Encephalitis

Tick-borne Encephalitis is a viral infection spread to humans by the bite of a small spider-like parasite called a tick. It’s a rare infection that’s only acquired abroad in certain European and Asian countries.  

Do I need it?

Ticks are found in forests, woods, grasslands, riverside meadows, marshes, brushwood and scrub lands. They usually live in the undergrowth, where they can easily get onto people’s clothes or skin. The risk is greater in northern European and Asian countries. Although the chance of being infected is slim you should think about being vaccinated if you’re planning to go hiking or camping.  There’s currently no cure for Tick Borne Encephalitis, so treatment aims to help relieve symptoms until the infection passes.

Vaccination Schedule

3 injections – Day 1, Day 31 and 6 months to 1 year later.  

If immunity is required more quickly, a second dose can be given two weeks after the first dose, which gives slightly less protection than the first schedule.

Period of protection

3 years

Tuberculosis

Tuberculosis is caused by a bacterium called Mycobacterium tuberculosisTuberculosis. It is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person.

Do I need it?

In most healthy people, the immune system (the body’s natural defence against infection and illness) kills the bacteria, and you have no symptoms. Vaccination is rarely given to anyone over the age of 16 – and never over the age of 35, because it doesn’t work very well in adults. It is, however, given to adults aged between 16 and 35 who are at risk of Tuberculosis through their work, such as some healthcare workers.

Vaccination Schedule

Single injection

Period of protection

Varies depending on age.

Typhoid

Typhoid fever is caused by a type of bacteria called Salmonella typhi. This isn’t the same bacteria that cause salmonella food poisoning, but the two are related. The Salmonella typhi bacteria will be in the stools of an infected person after they’ve been to the toilet. If they don’t wash their hands properly afterwards, they can contaminate any food they touch. Anyone else who eats this food may also become infected. Less commonly, the Salmonella typhi bacteria can be passed out in an infected person’s urine. Again, if an infected person handles food without washing their hands properly after urinating, they can spread the infection to someone else who eats the contaminated food.

Do I need it?

Vaccination is strongly recommended if you’re going to be staying or working with local people, or if you’re going to be staying for prolonged periods in areas where sanitation and food hygiene are likely to be poor. In Europe, most people who get Typhoid fever develop it while visiting India, Pakistan or Bangladesh.

Vaccination Schedule

Either as a single injection or 3 capsules taken on alternate days

Period of protection

2 years

Yellow Fever

Yellow fever is a serious viral infection that’s spread by certain types of mosquito. It’s mainly found in sub-Saharan Africa, South America and parts of the Caribbean. The virus that causes Yellow Fever is passed to humans through the bites of infected mosquitoes. The mosquitoes that spread the infection are usually active and bite during daylight hours and are found in both urban and rural areas. Yellow Fever can’t be passed directly from person to person through close contact.

Do I need it?

Some countries require a proof of vaccination certificate before they will let you enter the country. You should be vaccinated at least 10 days before you travel, as this will allow enough time for your body to develop protection against the Yellow Fever infection.

Vaccination Schedule

Single injection

Period of protection

10 Years

Cost of vaccinations

Yellow Fever vaccination, Ho Chi Minh City, Vietnam

In the UK, many of the vaccinations outlined above are free.  As I was living in Vietnam prior to this cycle tour it meant that I had to pay for nearly all of the vaccinations at private clinics.  Though, I must say that the prices quoted from the clinics varied hugely – for the Hep A vaccination I was quoted £40 by one clinic but just £15 at another.  As with all things in life it pays to shop around.

The standard procedure at all clinics was that I was shown the vaccine vial to check the country of origin and the expiry date.  The vaccine was then administered and the details recorded in a booklet that you take away with you.  For ease of reference, I took the same booklet with me to all of the clinics I visited and asked them to record the details in this.

In the process of getting my vaccinations completed I visited 5 different clinics and had a total of 17 injections and two drinks.  Thankfully, I did not suffer any side affects from any of the vaccinations.  The only outstanding injection that I still need to have is the third Hepatitis B shot, but I will need to wait until around September 2016 to do this.

VaccinationClinicDateCostValid until
Total Cost£158
Blood type test - A+Family Medical, HCMC31st Mar 2016£8N/A
CholeraNomad, Bristol17th Apr 2016£602018
DiphtheriaVictoria Healthcare, HCMC14th Mar 2016£23 (combined Tdap injection)2026
Hepatitis A + B antibody blood testInstitute Pasteur Hospital, HCMC4th April 2016£12 N/A
Hepatitis A Institute Pasteur Hospital, HCMC4th April 2016Do not need as have antibodies.2036
Hepatitis B Institute Pasteur Hospital, HCMC4th April 2016
4th May 2016
4th Sept 2016
£5 per injectionLife
Japanese EncephalitisVictoria Healthcare, HCMC14th Mar 2016
21st Mar 2016
24th April 2016
£2 per injection2021
PolioVictoria Healthcare, HCMC14th Mar 2016£42026
Rabies (pre-exposure)Family Medical, HCMC10th Mar 2016
17th Mar 2016
31st Mar 2016
£0 (insurance)N/A
TetanusVictoria Healthcare, HCMC14th Mar 2016£0 (combined Tdap injection)2026
TyphoidVictoria Healthcare, HCMC14th Mar 2016£62018
Yellow FeverInternational Quarantine Centre, HCMC4th April 2016£182026

All of the information outlined above is taken from advice given by my either my own doctor, or through research that I conducted in March 2016, when I was deciding on the vaccinations that I would need to have prior to my cycle trip.  I would recommend that you also speak to your own doctor for advice rather than just relying on this information or the internet.  However, if you do spot any errors with the above information please let me know and I will change it.

For a complete breakdown of the myriad of additional expenses that you may incur if you set about planning your own cycling adventure click on the following links or use the ‘Costs’ tab at the top of the page:

Finally, if you have read my other pages, you will already know that I intend to record my journey via blog posts. So, if you haven’t already signed up I would love it if you would ‘join’ me on my journey as I cycle around the world by adding your email address to the form at the foot of this page to receive automatic updates.

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