First port of call
If you're sticking to well-travelled tourist trails - Bali, China or Vietnam, for example - then you're probably okay to rely on your GP's advice, says Australian Medical Association Vice President Dr Steve Hambleton. It's when you're venturing to more remote places that extra care should be taken. “If you’re backpacking through South America or going to remote areas, I would recommend getting specialised advice. To be honest, most GPs don’t have the expertise to know exactly what vaccinations you should have in those kinds of travel situations. You can you end up getting more shots than you need or not enough.”
Malaria, meningococcal meningitis, rabies, hepatitis A, hepatitis B, typhoid or various strains of encephalitis are just some of the nasties you might need to guard against. Some initial web research is a good idea.
To get the most accurate, up-to-date information on any recent disease outbreaks in the countries you're visiting, consult the following websites:
Off the beaten track
Most GPs don’t take the time or have the expertise to fine-tune vaccinations to a specific traveler and destination, says Dr Tony Gherardin, national medical advisor of the Travel Doctor Group – a nationwide network of clinics listed by DFAT as a health resource for travelers. “Because it’s not a regulated field of medicine, the kind of service you get depends on the level of knowledge or interest the GP has about vaccinations," he says.
Deborah Mills, a GP, is medical director of two travel clinics in Brisbane and spokesperson for the Travel Medicine Alliance, a travel clinic network that’s “owned and run by doctors”. She has written a travel medicine book originally published in 1989 and now in its 16th edition. Aside from holding a Post Graduate Certificate of Travel Medicine from James Cook University, Deborah says much of her travel medicine know-how comes from looking after Australian travelers for the past 20 years.
“One out of 11 Australians goes overseas every year. We tend to go to Asia because it’s close – and where there are plenty of diseases. The problem for most travellers is that they really don’t know what vaccinations they need. If you’re just going shopping in Bangkok, you don’t need a vaccination to cover all of Asia, but most GPs will give you everything just to be safe.”
How much are you up for?
Medicare only covers the consultation, not the shots, so the costs can quickly add up. GPs may not have all the required vaccines in stock, in which case they'll write you a script for the vaccine. This provides the opportunity to check prices at different chemists.
Vaccination prices may be slightly higher at travel clinics, but you're less likely to receive and pay for shots you don't need and more likely to get well-informed advice. New vaccines are usually the most expensive. The Travel Doctor website advises you budget about $300-$600 per person (including a travel medical kit) for average trips to the remoter parts of the developing world.
The average cost of a single travel vaccine can vary from $45 to $85, with the yellow fever vaccine costing $75 per shot. Malaria pills cost between $1-$5 a day and the multi-shot regime for rabies and Japanese B encephalitis can amount to $300-$360. Doctor's consultation fees and nurse's fees also need to be added to determine the total cost.
If you have private health insurance, it should cover most vaccinations over $32, and you can make a Medicare claim for shots that are not specifically travel-related, such as flu shots.
Specialist travel clinics
Even clinics, whilst specialists in the field, are not immune to the temptation to upsell vaccinations, so it pays to shop around. “There is an inherent conflict of interest with travel medicine,” AMA's Dr Hambelton says. “You’re recommending things and also selling them. If your trip requires a lot of vaccinations, your GP should be able to direct you to a qualified travel doctor. There are some excellent travel doctors out there who take great pride in their work.”
But beware, the term “travel medicine” is used indiscriminately and some make questionable claims. In addition to The Travel Doctor, DFAT and the Health Department single out Travel Clinics Australia as a health resource for global travelers. Along with recommendations from a trusted doctor or travel mate, these are worth looking into if you’re venturing off the beaten track.
About yellow fever
One souvenir you don't want to bring back from your travels is yellow fever. It can enter your system through a mosquito bite in any one of about 45 countries throughout Africa and South and Central America. Stage one of the disease – which sets in anywhere from three to six days after the bite – involves muscle pain, fever, nausea, vomiting and a bad headache. If you’re unlucky enough to get to stage two, you’re looking at kidney and liver failure and a 50% chance of surviving – all within two weeks of getting sick.
If you’ve recently been in one of those 45 countries you need a valid yellow fever vaccination certificate when you arrive back in Australia. If you don’t have one and show symptoms, you may end up in quarantine. At present, it’s the only mandatory travel vaccination in Australia and the only one that has to be given by a clinic that meets World Health Organisation standards.