FAQ: what a traveler should know about vaccinations before the trip

A vaccine is a way to show the immune system the signature of a threat, to which an immune response will be developed over several training cycles.

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

• Kill the carrier faster than the immune response will be developed.
• Change faster than the immune system can recognize pathogens.
• Disguised and hiding in places where it is very difficult to access the pathogen.

Therefore, in some cases it is better to arrange exercises in advance. These are vaccines. An adult resident of the city is vaccinated against the most dangerous infections in childhood. With outbreaks of infections or when a person is placed in a hazardous environment, it makes sense to do preventive vaccinations. Travel refers to such situations.
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Let's first deal with the educational program, then move on to travel and a list of actions.

Why travel is dangerous?

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

So, traveling is when you are not in a familiar environment that your immune system is used to. After the flight and as a result of the reaction to thousands of new external factors, easy chaos begins to reign, and you become less colonially resistant to pathogens. Plus, in a new environment, pathogens can be found that are simply not there where you usually live.

The reverse is also true: you can be a carrier of pathogens that are not in the current environment. And then not lucky locals.

How do vaccinations work?

There are 4 main types:

1. You can pick up a weakened version of the pathogen strain, which is similar to a real combat, but does not pose a threat to a healthy body. These are vaccinations against chicken pox, influenza, yellow fever, and so on. This is the easiest way to learn: “training enemies” act against the immune system.
2. You can inactivate viruses and bacteria (for example, by placing them in a formaldehyde environment) and show their bodies to the body. Examples are hepatitis A, tick-borne encephalitis. The immune system finds the corpses of enemies somewhere in the body and begins to train to kill them again and again, because this is “living with zhzhzh” 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 very quickly be selected on the basis of previously obtained data.
3. You can enter toxoids (weakened or modified versions of toxins of microorganisms) - then the body's defense learns how 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 “high-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, DNA / RNA signature in its pure form) and etc. Examples of molecular vaccines are hepatitis B (viral envelopes without a nucleus), human papillomavirus and meningococci.

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

What are the side effects?

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

Most of the side effects are due 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 little. She will give the answer, and at the same time furniture can also suffer. But this is a necessary part of learning to protect.

Does the vaccine affect only one strain?

Not really. Here the comparison with 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 if you infect another, the immune response will be formed faster. That is, there is less risk of complications, weaker symptoms.

Influenza virus resembles a balloon from which surface glycoproteins and proteins protrude. The most important (hemagglutinin and neuraminidase) are mentioned in the name of a strain like H1N1. Influenza can mutate one of the proteins and turn into H2N1. Then the coincidence will be partial and the body simply reacts less actively. A “shift” may 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 close you from different sets of meningococci. Meningitis itself can be caused by hundreds more reasons.

That is, in general, the 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 slightly farther versions.

What to do before the trip?

The first step - even before buying a ticket, see country recommendations from a tour operator or somewhere else. The best thing is not the memo, which you will be given to the travel agency, but the current recommendations of the World Health Organization. It also makes sense to look at a summary of the country 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 transfer in Africa, then you may be required to be vaccinated against a pathogen characteristic of a transfer airport.

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

The alternative is to go to the doctor and consult with him. It is better not to the district therapist, but to the infectiologist hospital where patients are brought from airplanes. His recommendations will be based on approximately the same sources, but at the same time he interprets them more accurately and applies them to your state taking into account the collected history. Experts on vaccinations before traveling in Moscow are, for example, at the Martsinovsky Institute.

So, you have a list of mandatory and desirable vaccinations. Then only you 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 avoid being vaccinated against rabies. Your right. But I remind: WHO makes recommendations for travelers based on statistics. And if it says what is better to do, then it is better to do.

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

Not.

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

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

Thirdly, not all vaccines are combined with each other, that is, they will give injections to everyone and will not come out immediately.

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 later, if this is your first visit to a tropical country.

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


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

For example, for Somalia, a vaccine against cholera is needed.

Here is another map.

And what, you need to defend against all this in Russia?

Yes. Pay attention to the notes and vectors. If you do not have immunization against Japanese encephalitis in Moscow, then do not worry. The most accessible natural foci are in Vladivostok, and even then not every year. But if you are going to Vladivostok, then it is worth thinking. In practice, information on the Russian Federation on the WHO website is not very accurate, because data is usually provided to a country that has one or two biomes. We have a very healthy homeland, so the set for 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, then it is enough to get vaccinated against the flu and to “freshen up” childhood vaccinations in time. If you go to the taiga or go kayaking, then you definitely need tick-borne encephalitis vaccination. If you are going to spend a lot of time with animals or go to the caves - from rabies (bats carry it). Well, if you go to the south or to the village without sewage, then from hepatitis A. But what about hepatitis B is useful in case of assistance in a rural clinic, a cut in a nail salon, dentistry along the way or a sudden blood transfusion. He fell, stumbled, woke up - hepatitis B.

Vaccines work forever?

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

This means that it would be a good idea to start by updating what you missed to update, then add basic “long-playing” things, and then take root before dangerous journeys.

So what to do?

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

Usually you need to update tetanus (this is a set of three pathogens in one vaccine) - this is every 10 years. Most likely, something else from your childhood vaccinations is also over.

Check the effect of the vaccine, by the way, is simple: in most cases, you can take specific antibodies and see if there is still protection. Only the analysis should be prescribed by a doctor, because there are “current” versions of antibodies, and there are “long-term” ones. You are interested in the second.

Then add strategic vaccines. This is usually hepatitis A and B, human papillomavirus.

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

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

What is a highly recommended adult?

• Whooping cough, diphtheria and tetanus - update every 10 years to an adult. It is useful in Russia and everywhere on the planet.
• Hepatitis A - lifelong immunity after the course.
• Hepatitis B - life after the course (but you need to check the credits after 10 years).
• Measles, rubella, parotitis - update every 10 years to an adult.
• Chickenpox - a lifelong immunity after a course or illness suffered in childhood.
• Poliomyelitis is a lifelong immunity after the course.
• Meningococcal disease is a lifelong infection if you have been vaccinated over the age of 5 years.
• Human papillomavirus - once in 15 years (some people have lifelong immunity, update after checking the titer).
• Tick-borne encephalitis - every 3 years, if you like to sit by the fire in Russia.

Is it possible immediately and everything?

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 usually do not do in one day. Genetically modified can be done in a crowd, but not more than three vaccines per day, so as not to increase the burden on the body.

BCG, yellow fever vaccines and rabies vaccine (rabies) are not usually used in conjunction with other vaccines and among themselves.

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

Most childhood and adult vaccines differ only in dosage. That is, if you prick two children instead of an adult - in most cases it is normal. It is considered for one.

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

Are there diseases that you can protect against without a vaccine?

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

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

You can take pills prophylactically in order not to get HIV infection, but we hope you don’t really need such trips.

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

When it is possible, when it is impossible to take root

There are contraindications. In general, if you have a cold before your journey, you do not 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 a vaccine. This is especially true of frequently ill children. Therefore, always consult a doctor and do not hide all your conditions and chronic diagnoses.

Read examples of contraindications here .

Practical contraindications in order not to do vaccination - units. For example, for live vaccines, this is HIV infection and other types of immunodeficiencies.

In the case of chronic diseases, the list of vaccines may be broader than usual due to an increase in specific risks. Plus, we must look at the contraindications of specific vaccines. All this will be checked by the therapist at the preventive reception before vaccination in the hospital.

Is it possible to take root abroad before another trip?

Yes. Moreover, you can buy a vaccine somewhere in a pharmacy with us or abroad and bring it to your hospital so that they can give you documents about it. This is true when the desired vaccine is not in hospitals in your city. Before such an operation, it is very important to check the hospital's sanitary requirements for vaccine transportation.

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 at least use the “default” option.

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

It is better to go where the guarantee will figure out that this is not a Russian infection, because a district physician can be bewildered for a couple of days, which will dramatically affect the prognosis of the disease. That is, it is best to reach (or take an 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 giraffe). Most likely, you are poisoned or have a cold, but they will test you for all that is suitable for the symptoms - from dengue to malaria. This is a few tests. It will be a little scary by the appearance of people who suddenly put masks on their faces, but not very painful and not very long. Such laws in the Russian Federation, and, in general, it is good for your personal survival.

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

If you are still sick, you first 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 transfer it (unless you were pouring blood on each other over the entire board, but then you will first need a psychiatrist's consultation). The same goes for 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 report to the Sanitary and Epidemiological Supervision (Rospotrebnadzor), and then they will inform everyone and take measures to protect against bio-threats.

I read everything, I understand, and I want to take root before the trip in a month. How to do it?

Call your hospital and ask if there is a vaccine against the pathogen that interests you. There is? Say you want her. You will be recorded at the reception to the therapist, then he will examine you, ask you, if there are no contraindications, she will send you to the procedural one. There you will receive a vaccine (a shot in the shoulder, for example), then you will read out a list of symptoms that need to be monitored on the next day. Then sit for half an hour before the therapist's office or treatment room. After half an hour, the doctor will look out, make sure that you are not covered with anaphylactic shock, and let him go home. If it was an injection, then you will not be able to wet and scratch it for a couple of days.

If there is no vaccine in your hospital, then call the next one. All the same, most likely, this is a paid service, so it is not particularly important for you where to get it. The only thing you need to do is to take away the vaccination papers - it’s better to copy their copies to your file in the main hospital.

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

Thank you for consulting the tropical doctor and doctor, Victoria Valikova, the founder of the volunteer clinic Health & Help in Nicaragua and Guatemala . If you are interested about her clinic - link here .

But other publications "Tutu. Tours" and "Tutu. Adventures": about going on tours , yachting - it can be inexpensive .