Dear Michelle,

The reason why your 3yr old didn't need anything other than typhoid is because he probably had them, ie Polio, Diptheria and Tetanus as part of the general infant innoculation programme and probably the Hep A too depending on circumstances, and won't be in need of having booster shots yet. You'll probably find that you'll be called in for him to have a set of booster shots as he moves from Primary to Secondary school. Whereas your records probably showed that you hadn't had any boosters for 10 years or more.

I think that many people misunderstand why their GP or practice nurse recommends that they have these boosters when they consult them about holiday jabs. They do it because it's good practice to keep your protection against all these diseases up to date regardless of whether you are going on holiday somewhere where the risks are greater. It's very rare for anybody to catch any of these diseases in the UK now because on the whole the NHS does a good job of keeping us all innoculated against them but if we get complacent and don't keep having the boosters we do risk losing the collective herd immunity and they'll rear their head again. We've already seen this happen with measles as a result of MMR vaccination rates dropping below the rate required to maintain herd immunity in some areas.

Generally speaking, regardless of where you go on holiday and even if you never leave the UK it's a good idea to go for these jabs every 10 years in order to maintain protection against what are still potentially killer diseases.

SM

under what circumstances would my son have already had the hep a vaccination? i was assured byt he nurse that he had no need for it but had he been an adult then he would. the nurse made it quite clear to me that it was just a precaution anyway for myself to have it but children dont have as much need for it so there was no point putting him through too much unneccesary stress..but thans sm i kinda think i understand what ur saying......

Hi Michelle,

Looking back over my post, it would have been better to have said 'possibly' rather than 'probably'. Generally speaking our public health in the UK is protected by the fact that our drinking water is rarely contaminated by sewage (which greatly increases the risk of picking up Hep A) but it does sometimes happen after flooding etc. So people living in areas where there has been a recent risk of drinking supplies having been contaminated by sewage will be routinely offered vaccination, as will people if there has been an outbreak of Hep A in their area. Anybody who goes swimming in open water near sewage outlets or might end up eating contaminated shellfish will be recommended for vaccination too.

For example, we have a local swimming club that specialises in open sea endurance swimming and though the cleanliness levels at our local beaches are excellent, untreated sewage can end up being discharged into the estuary after heavy rainfall that causes flash floods as we had last Friday. So the Club insists that all members are vaccinated against Hep A and because it can be transmitted from person to person they advise that people should seriously consider having the whole family vaccinated while they're at it.

So without knowing your family details or situation, even though Hep A is not routinely administered to kids, there are plenty of circumstances which can arise whereby they might have have been 'done'. To be honest, given that catching Hep A can be nasty and the disease can cause complications it would always be on my list of 'might as well have it as not'. Personally, I would only not bother if you can be sure that you or your children will never be swimming in open water. As I said, not many people catch it in Britain these days but plenty of people catch it from swimming in the Med and anywhere else where raw sewage is discharged into the sea without treatment and then bring it home with them. Remember too that many older ferry boats and leisure craft discharge the contents of their loos straight into the sea too. Some of the sewage slicks I've seen in the Canaries in the past have convinced me that I would never go swimming in the sea there without an up to date Hep A vaccination record.

The following website provides some good basic info on what Hep A is and how it is transmitted etc:

http://www.bbc.co.uk/health/conditions/hepatitisa1.shtml

SM

Ironic or what Having posted recently that I've not had jabs for years, I went to see the nurse today for my annual heart check-up and mentioned I was off on holiday in October. The subject of jabs came up and she said they were free and if I liked she could do them there and then. They were three combined in one jab and two in the other - one jab for each arm - so I rolled up my sleeves and held my arms out. She agreed they weren't essential for Tunisia but said I might as well have them as I was a frequent traveller. Incidentally she said most of them last for 3 years and one of them for 10, but if I go back in six months for a booster that one will last for 20 years). Don't ask me which ones were which as she didn't have a card to give me but it's on the surgery's computer and I'm sure they will get in touch when the time is right.

thanx sm............dont think my son will be swimming in the sea to perfectly honest...the thought of it makes me nervous. i get nervous about him getting swept away etc so nooooo way will he in the open water.

Hi Aslemma,

Hep A normally requires a booster dose 6 months after the first for long term protection and it's worth remembering going back for it. Over the years I've now had 2 lots of Hep A innoculation plus boosters 6 months later and have been advised that I've probably got lifetime protection because the second lot 'tops you up' to such an extent that your immune system becomes 'bomb proof in the words of my practice nurse :-)

As for the rest it suggests that you've had a booster more recently for one than the rest. For example, if you've not had a polio or diptheria booster since you were a child then that's probably why they're recommending a quicker top-up after 3 years but you might well have had a tetanus booster more recently if you've been to A&E with an open wound injury that could have been contaminated with soil/ground dirt because they would routinely give you a tetanus jab in those circumstances. Once you've got a good baseline immunity for all these a 10 yearly booster is all you need.

SM

PS: It's interesting to note that the US authorities advise their citizens to have almost the same vaccinations for travel to Western Europe that ours advise for travel to Tunisia with the added warning of higher reported levels of Mumps, probably as a result of lower take-up rates for the MMR vaccination in recent years!

http://www.cdc.gov/travel/westeurp.htm#vaccines

Thanks for that SM. I seem to remember I had some jabs about 15 years ago when I went off to Australia via Bangkok, Singapore and Hongkong. One more booster should be enough for me as at my age (no, I'm not telling :roll:) I doubt if I'll still be travelling when that one runs out

Well, I do know Aslemma's age - and I bet you that she will still be flying out when it is time for her next booster!! Aslemma - Jenny

Shokran jazeela Jenny. I hope so Ishallah

hi i think its 6 wks before you go you need it..also we had a booster jab within 10 mths which protects us for 10yrs ( i think)

can anybody tell me if you need jabs to travel to tunisia

just the tetanus shot

Just had my booster Hep A and was told it lasts for 20 years

20 years

Yes madam and there's no need for you to laugh, I laughed enough for both of us when the nurse told me. I might, however, have the typhoid top-up as apparently that only lasts 3 years.

hi can any one tell me if they have been to tunisia with out vaccinations and did they have problems

Hi

I have been four times in the last 3 years without and never had a problem.

Regards

Daveyboy

We went last year (PEK) - the wife and son had theirs, but I didn't - chickened out as I hate needles/injections None of us had any problems, not even a icky tummy.

We are going back in a fortnights time (PEK), and I still haven't had any - much to the wifes dismay!

Here's hoping it aint second time 'un'lucky!!

MJ

Hi mattilad - I have lived in Tunisia for the 6 winter months for the past 6 years and have never had any vaccinations - or been ill. ( And we don't use bottled water either!) Having said that, it is your decision. There are no compulsory jabs, but recommended ones - and many people decide that it is better to be safe then sorry. What-ever your decision, enjoy your holiday. Jenny