Vaccines

VACCINATIONS

Avaxim and Avaxim Jr (Hepatitis A)

Cost per dose: $60 (adult), $60 (child)

Number of doses: 2

  • Hepatitis A is an infection that damages the liver
  • You can get Hepatitis A by drinking contaminated water or eating raw fruits and vegetables prepared with contaminated water
  • Hepatitis A is a concern when eating locally in developing countries
  • The Hepatitis A vaccine series (two doses of Hepatitis A vaccine typically spaced six months apart) will provide lifetime protection against Hepatitis A
  • Your first shot should be given at least 24h prior to departure

Twinrix and Twinrix Jr (Hep A and B)

Cost per dose: $90 (adult), $60 (child)

Number of doses: 3-4

  • Hepatitis A and B are viral infections that cause liver damage
  • You can get Hepatitis A by drinking contaminated water or eating raw fruit and vegetables prepared with contaminated water
  • Hepatitis A is a concern when eating locally in developing countries
  • Hepatitis B is spread through sexual contact, contaminated blood products and dirty needles
  • While Hepatitis A typically clears after two months, Hepatitis B is a chronic infection
  • Vaccination with Twinrix will stop you from developing both Hepatitis A and B
  • A standard series is three shots over six months, an accelerated series is three shots within one month and a booster at 1 year
  • Your first shot should be at least 24h prior to depar

Typhim Vi and Vivotif (Typhoid)

Cost per dose: $50

Number of doses: 1

Typhoid causes severe stomach upset

  • Typhim Vi is an injection while Vivotif comes as pills.
  • Typhoid is a concern when eating locally outside of North America and Western Europe, particularly for trips lasting over 2 weeks
  • India and Pakistan are hotspots for drug-resistant Typhoid
  • Vivotif is a live vaccine, providing 7 years of protection- it may be a good choice if you intend to do multiple international trips
  • The injectable option is inactivated (not live) and provides protection for 3 years
  • You should get your shot at least 2 weeks prior to your trip

Hepatitis A and Typhoid (Vivaxim)

Cost per dose: $140

Number of doses: 1, then booster of Hep A only

  • Provides protection against Hepatitis A and Typhoid in one combination shot
  • You should get your combination shot at least 2 weeks prior to your trip

Ixiaro (Japanese Encephalitis)

Cost per dose: $250

Number of doses: 2

  • Japanese Encephalitis is a rare serious neurological condition which develops after being bitten by an infected mosquito in certain rural parts of Southeast Asia
  • Two doses spaced at least a week apart confers immunity
  • The hotspot for Japanese encephalitis is the island of Bali- particularly rural areas
  • You should get two shots at least one week before your trip

RabAvert or Imovax Rabies

Cost per dose: $250

Number of doses to complete pre-exposure series: 3

  • Avoid close contact with wild animals, as scratches and bites may transmit rabies
  • Consider getting vaccinated for any trip, particularly if you will be travelling for a prolonged period or if you are are heading somewhere ‘off the beaten track’ where it may take some time to reach reliable healthcare
  • If you choose to be vaccinated, you will have three shots spaced over four weeks
  • Worldwide, stray dogs and bats carry rabies, and sometimes other animals
  • Untreated, rabies is 100% fatal
  • You should get 3 shots prior to departure. You should start the series 4 weeks before your trip

Menactra (Meningococcal meningitis)

Cost per dose: $150

Number of doses: 1

  • Meningococcal meningitis is a series illness with a high death rate
  • Menactra is now routinely given to grade 7 students in Ontario
  • The ‘meningitis belt’ in sub-Saharan Africa takes its name from meningitis outbreaks that occur annually during the dry season (December to June)
  • If you are traveling to sub-Saharan Africa during the dry season, it is a good idea to get vaccinated

YF-Vax (Yellow Fever)

Cost per dose: $300

Number of doses: 1

  • Yellow fever is a serious illness with a very high death rate (20%) that can result from being bitten by an infected mosquitos in parts of South America and sub-Saharan Africa
  • Immigration officials in many Yellow fever-endemic countries will require you to show them your yellow fever vaccination certificate
  • Across Canada, Travel Clinics require a special designation to be able to administer Yellow Fever vaccine: Travel Clinic @ MDACC has this designation
  • The World Health Organization previously recommended one dose every 10 years
  • In 2016, the WHO changed their recommendation so that now one dose of Yellow fever vaccine is thought to provide lifetime immunity (with several exceptions)
  • Yellow fever vaccine should be given at least 10 days prior to your trip

Dukoral (Cholera and Traveller's Diarrhea)

Cost per dose: $100

Number of doses: 2

  • Cholera is common in settings with poor sanitation such as aid and refugee camps
  • Individuals with Cholera experience severe diarrhea and abdominal cramps which can lead to dehydration
  • Dukoral is a self-administered oral vaccine which can prevent cholera and Traveller’s diarrhea
  • Two doses of the liquid vaccine mixture are taken at least a week apart
  • Individuals with Cholera experience severe diarrhea and abdominal cramps which can lead to dehydration
  • Dukoral is a self-administered oral vaccine which can prevent cholera and Traveller’s diarrhea
  • The second dose of Dukoral should be taken at least one week before your trip

Shingrix (Shingles)

Cost per dose: OHIP funded for aged 65-69, $155 if private pay

Number of doses: 2

  • Anyone with a history of chickenpox may develop shingles
  • Shingles vaccine is recommended to anyone over 50 to prevent shingles as well as the chronic nerve pain that sometimes results from the infection
  • Shingles can be triggered by stress, and, for some, travel is a stressful.

Tetanus-containing vaccine

Cost per dose: OHIP funded

Number of doses: 1 every 10 years

  • Tetanus infection (or lockjaw) is thankfully uncommon in Canada, but it certainly does exist abroad
  • Make sure you are up to date with your tetanus vaccine
  • Tetanus can be transmitted via spider bites as well as rusty nails lodged in the skin
  • Tetanus vaccine is always given in conjunction with diphtheria, and sometimes alongside pertussis and/or polio.

Measles Mumps Rubella (MMR)

Cost per dose: OHIP covered

Number of doses: 2

  • Unfortunately, outbreaks of measles have become quite common across the globe due to reduced uptake in MMR vaccination
  • The ‘research’ linking autism to the MMR vaccine has been completely disproven
  • In recent years, some measles outbreaks have been traced to airports
  • If you are travelling internationally (even to the USA) with infants under 12 months, considering getting an early MMR
  • Adults should have evidence of at least one- ideally two- measles-containing vaccines or a history of measles to be considered immune