Travel vaccines can cost a bundle. Asking these questions could save you some money. Part one of a two-part series.

Getting vaccinated is one of the easiest things you can do to stay healthy abroad. Being proactive about your health is part of responsible travel: You protect your health and the health of the communities and people you meet.

Travel vaccines are not covered by government health insurance in North America so the costs can add up. Travel clinics charge a consultation fee in addition to the price of vaccines, although this may be covered by private insurance. Your family doctor and local public health department may offer vaccines at a lower cost. There are also travel clinics that don’t markup vaccines, although they can be hard to find.

Not every health risk is a threat to every traveller. You may be able to reduce vaccination costs by working with your health practitioner to select the vaccines that offer the best protection on your budget.

Do you really need that shot? It depends.

Start by asking yourself these questions and meet with your health practitioner to decide what’s appropriate for your trip.

What’s my risk of getting a vaccine-preventable disease at my destination? Find out if there are current outbreaks or ongoing epidemics at your destination. In some areas, whether it’s the rainy season or the dry season will also affect the illnesses that are present.  For example, in the temperate areas of Southeast Asia, the risk of Japanese Encephalitis is higher during, and right after, the rainy season. Japanese Encephalitis vaccination is recommended if you’re staying on a farm or visiting agricultural areas in southern China, but isn’t necessary for an urban area like Guangzhou.

How long is my trip? Your risk of getting ill increases the longer you’re travelling. For example, if you’re hiking in rural Panama for three weeks, the rabies vaccine may be recommended, but the vaccine may not be necessary if you’re spending one week running a workshop at a university in Panama City.

What will I be doing? Will you be backpacking, visiting family, volunteering, working, on a tour, or a little bit of everything? Just like your trip length, the activities you’re planning affect which vaccinations you may need. Visiting family and relatives for two months in India increases your risk of getting Typhoid Fever, as opposed to staying in a 5-star hotel in Shanghai, where the risk is much lower.

Are there vaccines I should not be taking? Not every vaccine is a good choice for every traveller. Travellers on immunosuppressive therapies, for example, should avoid the Yellow Fever vaccine. Travellers with allergies to vaccine ingredients like neomycin or those already taking other medications should talk to their health practitioner about their vaccination options.

Can I protect myself without getting vaccinated? You can reduce your risk of numerous illnesses by washing your hands frequently, eating only well-cooked foods and fruits you can peel, drinking disinfected water, and using insect repellent and bed nets to prevent bug bites. Say, for example you are planning a week-long resort vacation in Grenada that includes some day hikes. The Typhoid vaccine may not be necessary as long as you’re drinking disinfected water and eating well-cooked foods. On the other hand, for trips to low-resource settings (like humanitarian work in a refugee camp) where sanitation is likely to be poor, the cholera vaccine is recommended in addition to taking food and water precautions.

For some health risks such as Zika virus, Chikungunya, and Dengue, there are no preventive vaccines, so it's important to know what you can do to reduce your risk. In the case of these three illnesses, take meticulous anti-mosquito bite measures.

Don't leave it until the last minute

Consider how much time you have before your departure. Ideally, you should book an appointment with your health practitioner or travel clinic six weeks before your departure so your body has time to build up immunity. This also gives you enough time to receive subsequent doses of vaccines that are given in a series. Even if you’re short on time, it's recommended that you squeeze in a last-minute appointment: you’ll still develop partial immunity which is better than no protection at all!

Regardless of where you’re going, your first step should be to make sure your routine immunizations are up-to-date. They’re available free from your health practitioner. Hepatitis A and B are worth the cost if they weren’t part of your routine immunizations: They provide long-term protection from two common viruses (which can also cause outbreaks back home!). If you need vaccines that can’t be administered by your health practitioner, make an appointment at a travel clinic.

Don’t ignore required vaccines

You may be required to get the Yellow Fever vaccine, regardless of whether there’s a risk of Yellow Fever at your destination. A valid Yellow Fever vaccination certificate is legally required to enter many countries. Only certain travel clinics administer this vaccine. Be aware that the certificate only becomes valid 10 days after vaccination.

Here’s an example of a trip where you would need a valid Yellow Fever vaccination certificate: You’re planning to spend a month touring Peru and Brazil, followed by one week of volunteering in Costa Rica. There is no risk of Yellow Fever in Costa Rica, but you’ll need a valid Yellow Fever vaccination certificate to enter the country because risk of Yellow Fever is present in the countries you have previously visited. Costa Rica requires proof of vaccination since the mosquito responsible for transmitting Yellow Fever is present in the country. This prevents the virus from being introduced into Costa Rica.

Cheaper vaccines abroad? Maybe, but beware

Sometimes it’s necessary to get vaccinated abroad, particularly if the vaccination you need isn’t available in your country or if you’ve had an unexpected change of itinerary. That said, it’s better to get vaccinated before your departure if you can. While vaccines may be cheaper abroad, the shots you need may not be available at your destination, the quality may vary, and they may not have been stored correctly. It also takes time to develop immunity.

Counterfeit medications are common around the world. These “medications” include substances that don’t contain the right amount of active ingredient and may contain toxic chemicals. Counterfeiters use sophisticated methods to copy the packaging on real medications and it can be next to impossible to pick out a fake. Any medication can be counterfeit, including brand name and generic over-the-counter drugs, malaria pills, antibiotics, and vaccines.

If you need to get vaccinated abroad, visit a reputable doctor or pharmacist and never buy medications from a street market. IAMAT maintains a list of vetted English-speaking doctors around the world who can also refer you to a reputable pharmacist. If you’re completing a vaccine series that you started back home, make sure the next dose is from the same manufacturer.

Read part two of this article where we look at vaccines for long-term travellers and travellers to rural areas.

Daphne Hendsbee, IAMAT’s Communications and Marketing Specialist, strives to present complex health information in a way that is concise, accurate, and easy to understand. She is especially interested in global health and the social determinants of health.

Tullia Marcolongo is the Executive Director of IAMAT. Her goal is to communicate travel health issues in a relatable manner, giving travellers all the options available to them to make an informed choice. She is a member of the International Society of Travel Medicine (ISTM), the American Society of Tropical Medicine and Hygiene (ASTMH), and holds a Certificate in Travel Health.

IAMAT’s mission is to make the world a healthier place to travel by providing travellers with impartial health information and access to an international network of English-speaking doctors.