Getting vaccinated for Asia

One of the reasons to go back to Spain was to get all the recommended vaccinations sorted before heading to Asia.

While travelling around Europe I hadn't worried much about illnesses or accidents — getting back to Spain for treatment if anything went wrong was quick and easy. I didn't even carry my European health card. Asia is a different game: you're further from home, the diseases are different, and some of the jabs need weeks of lead time, so this isn't something you sort out the day before your flight.

Why book your jabs early

Here's the thing nobody tells you until you're sitting in the clinic: several of these vaccines come in a course of two or three doses spread over weeks or months, and a few only reach full protection a couple of weeks after the final shot. Rabies and Japanese encephalitis in particular are multi-dose. If you leave it to the last minute, you simply won't have time to complete the course before you fly.

My advice — book an appointment at an official travel-vaccination centre six to eight weeks before you leave, ideally more. Tell them every country on your rough itinerary, because the recommendations change depending on where you're going and how long you'll be out there.

The yellow fever vaccine

Since we were heading to Asia but had no idea where we'd go after that, we decided to also get the yellow fever vaccine on top of the Asia-specific ones.

It's the only vaccine that's actually compulsory for entry into some countries — mostly in tropical South America and sub-Saharan Africa, and sometimes demanded if you're arriving from one of those regions. You get a stamped yellow certificate as proof, and you want to keep it with your passport. A single dose now covers you for entry into any country requiring it.

I had no side effects, but Ilze had significant swelling. That sent me googling for more information about the vaccine, and to my surprise I found warnings about a risk of serious reactions — liver, kidney and respiratory complications. The chances of anything that severe are genuinely tiny, but they exist, and the doctor who administered it hadn't mentioned any of this, which surprised me. It's a live vaccine, which is why it's treated with more caution than most and isn't suitable for everyone. Lesson learned: ask about side effects before the needle goes in, not after.

The full list of vaccines we got

The full list we got ahead of our Asia trip is quite long, and so is the number of injections — most of them required two or three doses:

Typhoid fever — spread through contaminated food and water, so squarely relevant for street-food countries.
Polio — usually a booster of the childhood vaccine.
Rabies — a multi-dose pre-exposure course. Worth it if you'll be near animals or far from hospitals, which on a long overland trip you will be.
Japanese encephalitis — mosquito-borne, more of a risk for rural and longer stays in parts of Asia.
Hepatitis A — another food-and-water one, and one of the most common travel infections there is.

All of these were recommended to us at the International Vaccination Centre in Zaragoza, and all free on the Spanish health system. That last part particularly surprised Ilze, who's used to paying before you even open the door of a doctor's surgery in Latvia.

Cholera and the oral vaccine

We were also prescribed a vaccine for cholera, taken orally rather than by injection. The brand name is Dukoral and it's fairly aggressive on the stomach — we both had a very uncomfortable day after taking it. Be ready for that, and don't take it on a travel day.

Malaria: tablets, not a vaccine

Of course malaria came up too. There's no jab for it, so the protection comes in tablet form — we'd be carrying several packs of Malarone.

Because we'd be constantly moving in and out of malaria-risk areas over many months, the clinic told us that taking preventative tablets the whole time simply wasn't viable — you're not meant to stay on them indefinitely. The plan instead was to carry the tablets and treat malaria after the fact if either of us actually came down with it, rather than dosing up daily for a year.

That makes your first line of defence not catching it at all — which means covering up and a good mosquito net. We knew we'd have to buy one the moment we landed, and we did. If you're heading the same way, it's worth reading how we actually kept the mosquitoes at bay in Southeast Asia, because the day-to-day reality of it is messier than any clinic makes out.

A quick, important caveat: malaria advice is genuinely individual — it depends on exactly where you're going, the season, how long you'll stay and your own health. What worked for two long-haul budget travellers crossing dozens of borders is not a prescription. Take the conversation with a proper travel doctor, not with a blog.

A couple of things we learned

This was all part of the bigger job of getting ready for Asia — money, gear, paperwork and health, all at once. Two things stuck with me:

Keep your vaccination record. That little yellow booklet is proof at borders and a reference for any doctor who treats you down the line. Don't lose it.
Health cover matters once you leave Europe. The casual "I'll just fly home if something goes wrong" attitude I had in Europe doesn't hold up in Asia, which is exactly why I'd also sort out travel insurance before going.

8 days until Paris and 11 until Malaysia!

Frequently asked questions

What vaccinations do you need for Southeast Asia?

The ones we were recommended for a long trip were typhoid, hepatitis A, rabies, Japanese encephalitis and polio, plus yellow fever (mainly for onward travel to other regions) and cholera by mouth. Your exact list depends on which countries you're visiting, how long for, and your own medical history — confirm it with a travel clinic rather than copying ours.

How far in advance should I get my travel jabs?

Aim for at least six to eight weeks before departure, and more if you can. Several vaccines — rabies and Japanese encephalitis especially — need two or three doses spread over weeks, and some don't reach full protection until a couple of weeks after the last shot. Leave it too late and you won't finish the course in time.

Is there a vaccine for malaria?

For our trip, no — protection against malaria came as tablets (Malarone), not an injection, alongside avoiding bites in the first place. Because you can't safely take preventative tablets indefinitely, our clinic had us carry them to treat malaria if it actually struck, rather than dosing daily for a year-long trip. Your strongest everyday defence is a mosquito net and covering up.

Are travel vaccines free?

For us in Spain, the recommended Asia vaccines were free on the national health system, with the oral cholera and the malaria tablets heavily subsidised. That varies hugely from country to country, though — in plenty of places you'll pay for travel jabs out of pocket — so check what your own health system covers.

Do I need a yellow fever certificate for Asia?

Generally not for Asia itself, but some countries demand proof of yellow fever vaccination if you're arriving from a region where it's present, and many South American and African countries require it outright. We got the jab because we didn't know where we'd head after Asia and wanted to keep our options open. One dose, plus the stamped certificate kept with your passport, covers your entry needs.