For some time now, the word "vaccination" has been used almost exclusively in connection with Corona, and it has been quite controversial. It has almost been forgotten that there are also other vaccinations, some of which are expressly recommended or even mandatory for entry into certain countries. If your dog or cat is traveling with you, in some states there is also an obligation to provide proof of vaccination, not against Corona, of course, but against rabies, for example.

In many European countries, the topic of "corona vaccinations" has led to a real split in society into three groups: vaccination advocates, vaccination opponents and undecided. During the whole discussion, it really got "under the wheels" that in many countries you need completely different vaccinations for entry or that they are expressly recommended. This is usually due to the fact that there are diseases there that are transmitted by mosquitoes, for example, which are not an issue in Europe or only occur extremely rarely.

Make a decision after consulting a doctor

Even if certain travel vaccinations are not explicitly required, it can still make sense to have them. However, the emphasis is clearly on "can", because the decision whether to vaccinate or not should be made by everyone, regardless of what it is about. However, it makes sense to inform yourself before making a decision and, if necessary, to seek advice from a doctor. Not every vaccination is really useful and vice versa it can be that you underestimate a possible danger.

The corona pandemic and the reduced travel activities have also meant that the topic of travel vaccinations has been somewhat forgotten. Quite logical, because traditionally you don't have things in your head that you don't need right now. It is therefore possible that some recommended or even mandatory vaccinations may have expired. It is therefore advisable to check this in the vaccination card and, if in doubt, to seek advice, for example from your family doctor.

Even in Europe, the standard vaccinations such as the combination vaccination against diphtheria, tetanus, whooping cough and polio, the vaccination against measles, mumps and rubella, but also those against hepatitis B and TBE should be up to date. Early travel medical advice is recommended for trips outside of Europe, because even if no vaccinations are required for entry into a certain country, some can still be important for personal protection.

Inquire in good time

"A planned holiday is a good incentive to have your vaccination status checked and updated if necessary, even for trips within Europe," explains Hermann Laferl, specialist in infectious diseases and tropical medicine at the Favoriten Clinic. For long-distance travel, well-founded travel medicine advice is even more important. "A look at the information from the travel agency is usually not enough," emphasizes Dr. Ursula Hollenstein, infectiologist and specialist in tropical medicine and member of the Science Busters. "Often it is only stated that nothing is 'mandatory'." However, the vaccinations recommended for personal protection should be distinguished from this. The type of trip can also be decisive for the necessary vaccinations or prophylactic measures.

Refresh regularly

Aside from COVID-19, the past few years have shown why it is important not to back down on vaccinations. In Austria, for example, individual cases of mucosal diphtheria or skin diphtheria have been reported since 2014 after 20 diphtheria-free years, and in 2022 even two cases of respiratory diphtheria. "The disease can be very severe and cause long-term damage to the heart and kidneys, among other things, and even death," reports infectiologist Laferl.

Polio (infantile paralysis) should have been eradicated by now, but it hasn't been completely eradicated yet. A smaller outbreak occurred in Ukraine in 2021. "Due to the war and the interrupted vaccination campaign, especially for children, it is to be feared that polio will also spread more again," Laferl fears and emphasizes the need to refresh the quadruple vaccination (diphtheria, tetanus, pertussis, polio) as adults every 10 years to leave, from the age of 60 every five years. This is also important with regard to tetanus (lockjaw), since the pathogens are found practically everywhere in nature.

Hepatitis B is a major health problem not only in Austria, but globally. The most serious consequence of the infection is chronic liver inflammation, which can go as far as liver cirrhosis and liver cell carcinoma. To avoid this, this vaccination should also be refreshed every 10 years after the basic immunization. The TBE vaccination has to be given a little more frequently – namely every five years or every three years from the age of 60. "The virus is widespread throughout Austria, but also in many European countries," emphasizes vaccination expert Laferl. He recommends travelers from Western European countries who go on holiday with us to have their immunizations done beforehand.

Mandatory vaccinations

The vaccinations required for long-distance travel are often quite confusing for laypeople. For example, the yellow fever vaccination is generally required upon entry into some West and Central African states. In many other countries, such a vaccination only applies if you are traveling from a yellow fever country. For the travel doctor, however, it is clear, regardless of the respective regulations: "You shouldn't expose yourself to the risk of falling ill." In addition to infections that are almost asymptomatic, there are serious illnesses with bleeding and organ failure, which are fatal in over 50% of cases. Another mandatory vaccination is that against meningococcal ACWY, but only for participating in pilgrimages in Saudi Arabia. "For us, this vaccination is part of the children's vaccination program, for adults it only makes sense when traveling south of the Sahara - from Gambia to Ethiopia - regardless of age," explains Hollenstein.

Rabies: Rare but deadly

It is also important to educate travelers about rabies. "The disease transmitted by animal bites is rare but 100% fatal," Hollenstein warns. Unlike other vaccinations, if you get a bite, you need a double booster in the country itself (vaccine is usually available in the main cities), despite basic vaccinations, she explains, unless the vaccination was given immediately before the trip. “Unvaccinated people need an immunoglobulin and a multi-part vaccination within 48 hours. However, in large parts of Asia, Africa and South America, immunoglobulins are only available in very few cities. So it is better not to take the risk of needing them.”

Dangerous mosquitoes

Japanese B encephalitis, transmitted by mosquitoes, is an issue in Asia, especially in the summer, but there is currently an outbreak in Australia as well. In many Asian countries it is known and feared as the most common viral encephalitis. "Travellers should also protect themselves in the corresponding areas with the help of a vaccination," advises the tropical medicine specialist. “The vaccination is very well tolerated, two vaccination doses must be administered before the start of the journey. The third partial vaccination, which provides protection of over 97 percent for about 10 years, is given after a year at the earliest, preferably before the next trip to Asia.”

"Mosquito repellent is also essential in countries with diseases that are transmitted by mosquitoes," explains Hollenstein. "It has a broad effect and can therefore reduce the risk of many diseases."

Malaria: prophylaxis versus rescue medication

Despite mosquito repellent, malaria prophylaxis may be necessary at some destinations. In this case, too, a thorough consultation makes sense. "Basically, a distinction is made between taking a medication as a preventive measure and taking an emergency medication with you, which only needs to be taken when needed," explains the tropical medicine specialist, adding: "However, once the country has reached a certain incidence of malaria, you should no longer rely on the emergency medication." In any case, side effects are rarer than one would often hear in the circle of acquaintances. Nevertheless, a plan B is recommended if you do not tolerate the drug.

In time for advice

According to the expert, anyone planning a trip to a destination outside of Europe should seek travel medicine advice in good time. Six to eight weeks in advance is best, since vaccinations with multiple doses have to be started early enough. At the same time, she currently recommends pure travel vaccinations with only one dose, preferably at the latest possible time, i.e. about 10 days before departure, in order to avoid unnecessary costs in the event of a travel cancellation.