FAQ: what a traveler geek needs to know about vaccinations before traveling

    Madagascar closes borders!A vaccine is a way to show the immune system the signature of a threat to which an immune response will be developed in a few training cycles.

    Any struggle of an organism against an infectious disease is an attempt to recognize a threat signature and work out countermeasures. In the general case, this process is conducted until the full result, that is, until recovery. However, there may be infections that:

    • They kill the carrier faster than the immune response is developed.
    • Change faster than the immune system can "recognize" pathogens.
    • They disguise themselves and hide in places where it is very difficult to access the pathogen.

    Therefore, in some cases, it is better to arrange exercises in advance. This is the vaccine. An adult resident of the city is vaccinated against the most dangerous infections in childhood. When outbreaks of infections or when a person is placed in a hazardous environment, it makes sense to take preventive vaccinations. Traveling refers to such situations.

    Let's first deal with educational program, then move on to travel and a list of activities.

    Why are travel dangerous?

    Suppose you fly to Africa. There is an increased risk of yellow fever. A simple vaccine will cost you about 1,500 rubles, along with a therapist and treatment room services, a vaccine of a higher level - 3,000 rubles. It is impossible to recover from yellow fever with specialized medicines (that is, you can only maintain the body’s resources until it can cope), it’s easy to get sick, mortality is about 10%, the main vector is mosquitoes. The vaccine has almost no side effects. Is vaccination worth it? Maybe yes. But you decide.

    So, travel is when you are not in the familiar environment that your immune system is used to. After the flight and as a result of a reaction to thousands of new external factors, mild chaos reigns in the body's defense, and you become less colonially resistant to pathogens. Plus, in a new environment, there may be pathogens that simply do not exist where you usually live.

    The converse is also true: you can be a carrier of pathogens that are not in the current environment. And then no luck to the locals.

    How do vaccinations work?

    There are 4 main types:

    1. You can choose a weakened version of the pathogen strain, which is similar to a real battle, but it does not pose a threat to a healthy body. These are vaccinations against chickenpox, flu, yellow fever and so on. This is the easiest way to learn: "training enemies" are opposed to the immune system.
    2. You can inactivate viruses and bacteria (for example, by placing them in a formaldehyde medium) and show their bodies already to the body. Examples are hepatitis A, tick-borne encephalitis. The immune system finds somewhere in the body the corpses of enemies and begins to train to kill them again and again, because it is a "zhzhzhzh" for a reason. When a familiar strain enters the body, it will be clear what to do with it in general terms, and then the immune response will be selected very quickly based on previously obtained data.
    3. You can introduce toxoids (weakened or modified versions of the toxins of microorganisms) - then the body's defense will learn to deal with the effects of bacteria, which will give much more time for the formation of countermeasures during infection. It turns out that you are not affected by the symptoms of the disease, and the body there calmly and quietly deals with pathogens, and you do not even know what they were. This is, for example, tetanus.
    4. Everything new that belongs to the hi-tech category is modifiers of gene complexes (so that some protein besides the main function at the same time cuts the DNA of the pathogen, for example), molecular vaccines (when the body is provided, in fact, with a pure DNA / RNA signature) and etc. Examples of molecular vaccines are hepatitis B (envelopes of viruses without a nucleus), human papillomavirus, and meningococcus.

    Please note that there is no direct relationship between the type of vaccine and its side effects. It may seem to you that a real living pathogen will be more dangerous than a molecular vaccine, but it is not. The same yellow fever vaccine is considered one of the safest: the chances of side effects are very difficult to distinguish from the statistical error of the measurement methods.

    What are the side effects?

    The most common case is an allergic reaction. For example, a hepatitis B vaccine can exacerbate an allergy to yeast dough. There are more complex reactions, but in the general case they are all reversible. For irreversible (severe) consequences, thorough statistics are compiled, and the vaccine is not allowed to be used if the specific risk for the individual from the disease is likely to become infected, transferred, cured, and so on, than the risk of complications. Simply put, it is always rational to use the vaccine when it is recommended in the region.

    Most of the side effects are related to the fact that you release a weakened virus, toxin, molecular debris and other exogenous things into the body. To teach the immune system to fight, you first need to knock it a bit. She will give an answer, and furniture can also be damaged. But this is a necessary part of defense training.

    Does the vaccine affect only one strain?

    Not really. Here the comparison with the signature analysis is somewhat incorrect. The immune system builds something like a perceptual hash. This means that if you are vaccinated from one of the strains of the flu, then when infected with another, the immune response will be formed faster. That is, the risk of complications is less, the severity of symptoms is weaker.

    The flu virus is like a ball from which surface glycoproteins and proteins stick out. The most important ones (hemagglutinin and neuraminidase) are mentioned in the name of the strain like H1N1. Influenza can mutate one of the proteins and turn into H2N1. Then the coincidence will be partial and the body will simply react less actively. Or a “shift” can occur when both proteins change, for example, in H2N3. Then you have to recognize the threat almost from the very beginning.

    Please note that this applies to similar stamps of one disease. In the case of meningitis, for example, we are talking about completely different pathogens, and different vaccines block you from different sets of meningococci. And meningitis itself can be caused by hundreds of other reasons.

    That is, in general, a vaccine contains one or more strains of the most common type of pathogen. It helps to develop resistance to them and their close versions, to speed up the response time to their own slightly more distant versions.

    What to do before the trip?

    The first step is to look at country recommendations from a tour operator or somewhere else before buying a ticket. The best thing is not the memo that will be given to you at the travel agency, but the current recommendations of the World Health Organization. It also makes sense to look at a country summary from the same WHO: there are recent outbreaks of infections and their consequences. Check the biosafety barrier requirements of the target country. For example, if you have a flight with a change in Africa, you may be required to be vaccinated against a pathogen specific to a transfer airport.

    In some cases, you may not be allowed to enter certain countries without a vaccination document - this must be checked in advance. This is usually either a visa requirement or the current epidemiological situation.

    An alternative is to go to the doctor and consult with him. It is better not to the local therapist, but to the infectious diseases specialist of the hospital, where patients are brought from planes. His recommendations will be based on approximately the same sources, but at the same time he will interpret them more accurately and apply to your condition, taking into account the collected history. Specialists in vaccinations before traveling in Moscow are, for example, at the Marcinovsky Institute.

    So, you have received a list of required and desirable vaccinations. It is only up to you to decide whether to follow the recommendations or not. For example, you may decide that if you do not meet any animals along the way, then you can not get a rabies vaccine. Your right. But I remind you: WHO makes recommendations for travelers based on statistics. And if it says what is best to do, then it is better to do.

    I’ll come a couple of days before the trip, “buff”, and everything will be fine?


    Firstly, the deployment time of antibodies is from a couple of days to 3-4 weeks (this is the primary set, maybe more).

    Secondly, some vaccines are given in courses of 2-3 times.

    Thirdly, not all vaccines are combined with each other, that is, it will not work out for everyone to inject.

    This means that you need to go for vaccinations three weeks before the trip, if you need a couple of new properties in the body, and six months if this is your first visit to a tropical country.

    Here is the page of WHO recommendations for travelers to Russia from nowhere (without dangerous foci along the way):

    It is very good to look at vaccinations in the consular department of the Ministry of Foreign Affairs. A complete list of countries is here. There you can see other features of the country.

    For example, Somalia needs a cholera vaccine.

    Here is another card.

    And what, you need to protect yourself from all this in Russia?

    Yes. Pay attention to notes and vectors. If you do not have a vaccine against Japanese encephalitis in Moscow, then that's okay. The most affordable natural foci are in Vladivostok, and even then not every year. But if you are going to Vladivostok, then it is worth considering. In practice, information on the Russian Federation on the WHO website is not very accurate, because usually the data is provided to a country that has one or two biomes. We have a very healthy homeland, so the set for Lake Baikal will be different from the set for Krasnodar or Arkhangelsk.

    What exactly to do for survival in Russia depends on the type of tourism. If you are going to live in the center of Moscow, it is enough to be vaccinated against influenza and timely “refresh” children's vaccinations. If you go to taiga or go kayaking, then you definitely need vaccination against tick-borne encephalitis. If you are going to spend a lot of time with animals or go to caves - from rabies (bats carry it). Well, if you go to the south or to the village without a sewer, then from hepatitis A. Well, about hepatitis B, it’s useful in case of assistance in a rural outpatient clinic, a cut in a nail salon, dentistry along the way or a sudden blood transfusion. Fell, stumbled, woke up - hepatitis B.

    Do vaccines last forever?

    Not. Some allow you to develop lifelong immunity, some act for a long time (for example, diphtheria - 10 years), some very short-term (Japanese encephalitis - for 1 year). Then the effectiveness of antibodies and their production slowly fall.

    This means that it’s a good idea to start by updating what you missed updating, then add basic “long-playing” things, and then get vaccinated before dangerous trips.

    So what to do?

    Right here and now, start by updating your anti-virus databases. Specifically check out your entire set of childhood vaccinations. Get to the doctor and ask them to tell you what vaccines you are missing.

    Usually, tetanus needs to be updated (this is a set of three pathogens in one vaccine) - this is every 10 years. Most likely, something else from your childhood vaccinations has also ended.

    Checking the effect of the vaccine, by the way, is simple: in most cases, you can pass specific antibodies and see if the protection is still effective. Only a doctor should prescribe an analysis, because there are "current" versions of antibodies, and there are "long-term" ones. You are interested in the second.

    Then add strategically important vaccines. Usually it is hepatitis A and B, human papillomavirus.

    If you often travel to certain regions (or will definitely be there in the coming years) - look at long vaccinations like yellow fever, typhoid fever.

    And only then act before traveling according to the recommendations of WHO, the Ministry of Foreign Affairs or a doctor.

    What is an adult highly recommended from the kit?

    • Whooping cough, diphtheria and tetanus - renew every 10 years for an adult. Useful in Russia and everywhere on the planet.
    • Hepatitis A - lifelong immunity after the course.
    • Hepatitis B - lifelong after the course (but you need to check the titers after 10 years).
    • Measles, rubella, mumps - renew every 10 years for an adult.
    • Chicken pox is a lifelong immunity after a course or a childhood illness.
    • Polio - lifelong immunity after a course.
    • Meningococcal infection is lifelong if vaccinated over the age of 5 years.
    • Human papillomavirus - once every 15 years (some retain lifelong immunity, renew after checking the titer).
    • Tick-borne encephalitis - every 3 years, if you like to sit by the fire in Russia.

    Is everything possible at once?

    Not. In one cycle, you can get 1-3 vaccines, then you have to wait a month in the general case until the next.

    Some vaccines are combined, some are not. Live vaccines are usually not given in one day. Genetically modified can be done in bulk, but no more than three vaccines per day, so as not to increase the load on the body.

    BCG, yellow fever vaccines and rabies vaccine (anti-rabies) - these are usually not given together with other vaccinations and among themselves.

    Some vaccinations cannot be given during pregnancy. This applies to live measles, rubella, mumps and chickenpox vaccines containing live attenuated viruses.

    Most childhood and adult vaccines differ only in dosage. That is, if two children are injected instead of an adult, this is normal in most cases. It counts as one.

    Abuse of vaccines is also not necessary. Follow only rational recommendations, do not inject everything. The capabilities of the immune system are not endless, too much training may not be the best idea either. Doubt - consult a doctor.

    Are there any diseases that can be protected without a vaccine?

    Yes. There is no vaccination against the same malaria, so there are two options - either drink prophylaxis, or be treated when you are already sick. Well, either douse yourself with mosquito repellent every hour and believe that you are lucky.

    Specifically, in the case of malaria, look at specific pathogens in the travel region: some are treated without problems, some are not. Those that are not: it may turn out that it is better to drink prevention and suffer from its side effects (frequent and not very good). Where there are no such pathogens, it may turn out that it is better to take a chance and spray with a spray. You decide. When there is no flash, these are just recommendations.

    You can take pills prophylactically so as not to get infected with HIV, but we hope you do not really need such trips.

    It is also highly recommended that you have a first-aid kit with you so that if you catch an intestinal infection or worms, scabies or any of the simplest, you have something to help yourself. It is better to compose it with the same specialist who will prescribe you vaccination before the trip. Or with your therapist.

    When is it possible, when is it impossible to vaccinate?

    There are contraindications. In general, if you have caught a cold before a trip, you don’t need to go to the doctor for a vaccination in the midst of a cold. But the same temperature 39 and other signs of the disease do not always interfere with getting the vaccine. This is especially true for frequently ill children. Therefore, always consult a doctor and do not hide all your conditions and chronic diagnoses.

    Read examples of contraindications here .

    There are few practical contraindications for not vaccinating. For example, for live vaccines, this is HIV infection and other types of immunodeficiencies.

    In the case of chronic diseases, the vaccine list may be wider than usual due to increased specific risks. Plus one has to look at contraindications for specific vaccines. All this will be checked by the therapist at the preventive reception before vaccination in the hospital.

    Can I get vaccinated abroad before another trip?

    Yes. Moreover, you can buy a vaccine somewhere in a pharmacy here or abroad and bring it to your hospital so that you can be given documents about it. This is true when the right vaccine is not available in the hospitals in your city. It is very important to check the hospital's sanitary requirements for transporting the vaccine before such an operation.

    Vaccines for the diseases I need are different. Which one to choose?

    The simplest choice is between cheaper and more expensive. As a rule, the more expensive one is either another principle of pathogen inactivation, or a larger library of strains, or there is something that otherwise increases its effectiveness and reduces the likelihood of side effects.

    When there are several vaccines and they are of different types, it is better to consult a doctor or, in extreme cases, use the “default” option.

    I'm back, and something is not very good for me ...

    It’s better to go to a place where they’ll figure out with a guarantee that this is not a Russian infection, because the local therapist can be confused for a couple of days, which will dramatically affect the prognosis of the disease. That is, it is best to go (or get to the ambulance) to the infectious diseases hospital. Be sure to tell the doctors where you were and what you did (for example, you tried raw meat according to local recipes, stroked cute bats, kissed a giraffe). Most likely, you have been poisoned or caught a cold, but they will check you for everything that’s appropriate for the symptoms - from dengue to malaria. These are a few analyzes. It will be a little scary from the sight of people who suddenly put their masks on their faces, but not very painfully and not very long. Such laws are in the Russian Federation, and, in general, this is good for your personal survival.

    And what will happen to the passengers of the plane in which the patient flew?

    If you still get sick, then first you need to establish what. Further actions depend on the infection. If it was malaria, then without the presence of mosquitoes on board, it is almost impossible to transmit it (unless you were pouring blood on top of each other there, but then you need to consult a psychiatrist first). The same thing happens with dengue, zika, chikungunya and yellow fever. But if it is measles or meningococcal infection - everything is different, and measures can be taken. The doctor will inform Sanepidemnadzor (Rospotrebnadzor), and then they will inform everyone and take measures to protect against biohazard.

    I read everything, understood and want to get vaccinated before the trip in a month. How to do it?

    Call your hospital and ask if the vaccine is for the pathogen you are interested in. There is? Say you want her. You will be made an appointment with the therapist, then he will examine you, ask if there are no contraindications, he will send you to the treatment room. There you will receive a vaccine (an injection in the shoulder, for example), then you will be read out a list of symptoms that should be monitored on the next day. Then sit for half an hour in front of the therapist’s office or treatment room. After half an hour, the doctor peeps out, makes sure that you are not covered by anaphylactic shock, and let him go home. If it was an injection, then for a couple of days it will not be possible to wet and scratch it.

    If there is no vaccine in your hospital, call the next one. Anyway, most likely, this is a paid service, so it’s not very important for you where to get it. The only thing, do not forget to pick up the vaccination papers - it is better to file copies of them with your dossier at the main hospital.

    Sometimes documents must be kept for travel. For example, after vaccination against yellow fever, they will give a special book that you need to carry with you to the same Panama. Otherwise, you will be allowed inside the country for a maximum of 12 hours.

    Thank you for the consultation with tropologist Victoria Valikova, founder of the Health & Help volunteer clinic in Nicaragua and Guatemala . If interested about her clinic - link here .

    And here are other publications “Tutu.Tours” and “Tutu.Adventures”:about going on tours , yachting - it can be inexpensive .

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