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Author: Sean Keener

Immunizations for Family RTW Travel


I can’t think of a word that is more polarizing in the parenting world than the dreaded “I” word: Immunizations. Otherwise mutually supporting and philosophically generous parents will draw up along battle lines over this word and the emotionally driven marketing on both sides of the issue. Of course everyone has the same end goal: the safety, health, and long term welfare of their children, but that seems to get lost in the fray somehow.
Let me begin by saying two things:

  1. I believe in your ability to choose wisely.
  2. I am not impartial.

1. I believe in your ability to choose wisely

Let me make it clear that I am a firm believer in the right of every parent to direct the upbringing of their child. I believe that every thinking parent has, within her grasp, the ability to make the right decisions for her family, based on the information available. As with education, discipline, nutrition, and a million other aspects of a child’s growth, there is no “one size fits all” plan for immunization and health care. There are so many factors to consider, and so many of them are unique to an individual or family situation. If you’re reading this article, then clearly you’re a thinking parent. You’re concerned about the immunization issue as it pertains to travel, and you’re weighing your options and considering. You understand that travel complicates the issue, and raises the risk, in ways that staying within your home bubble does not. Keep studying, keep reading, and you’ll find the answers you need.

2. I am not impartial.

Immunizations
I’m not impartial. I don’t think anyone is, really. But I’m also not a hardliner. I’m pro-immunization, but I don’t think kids need every single new shot that is run through the “test mill” too fast and cranked out for big-pharma gain. I also think the way we immunize kids is messed up. Too much, too early. I spread things out for our kids. We flat out declined a few of the options (chicken pox and the HPV were two we took a pass on). But I am in favor of immunizing thoroughly.
You see, my Dad was one of the kids who had polio in the 1950’s. He spent much of his childhood in awful children’s hospitals, in wheel chairs and braces. He was unable to walk. He was told all of the things he would never do. It was eventually the Palmer Clinic that began to sort him out, and he’s lived a very full life. In fact, he’s done more than most men do in two lifetimes, but he’s done it all with the use of only one arm, and encroaching weakness that he continually beats back with weights and diligent exercise.
I spent my whole childhood buttoning his shirt cuffs every morning, an unspoken reminder that things don’t come easy for him. I learned to set a nail using my toes, because that’s how my Dad did it. I drive with one hand and reach through the wheel to change the signals because that’s how my Dad did it. There’s a long list of things I’ve watched him do, and emulated, that my husband points out that I’ve inherited from my less than ambidextrous father. Don’t get me wrong, my Dad is not disabled, not in the least. With the exception of one espresso maker, I’ve never seen him “unable” to do anything. He just has to apply strategy to the situation in a way that others do not.
My grandmother fought hard to make sure that my aunt was among the first children to get the Salk vaccine when it became available. One child with polio is enough in a family. She also fought hard to make sure my Dad got what he needed, in an era that was not known for it’s progressive treatment or inclusion of folks who were differently abled.
Having grown up with my Dad, and being handed our family’s legacy, I can’t “not immunize.” It’s unthinkable to me. I will acquiesce that there are risks associated with immunization, but I’ve grown up with the 100% surety of the consequences of not.
So there you go, full disclosure.

I recommend most travel immunizations

Shots
What are the “appropriate” immunizations? Well, that’s where it gets sticky, doesn’t it? Do we need to vaccinate for things that aren’t life threatening? In my opinion, no. Sometimes getting sick provides important immunity in a way that strengthens us. I’d much rather my kids just get chicken pox. Do we need to immunize against things that are behaviorally acquired (HPV, for example)? From my perspective, no, and especially not at nine years old. However, it is important to realize that some of the things that we immunize for that seem like they’re old news, like polio, is a particularly personal example for me, are current events in other countries. We have not vaccinated these diseases out of existence, we’ve merely beaten them back with good “herd” vaccination in the first and second worlds. Which is to say, it’s possible to get away without vaccinations for any number of things in the “civilized” world, because everyone else provides your protection with their immunization. This will not be true everywhere you travel. That bears consideration.
There are also immunizations that are common elsewhere that we don’t bother with in North America. One example: Japanese Encephalitis. When we embarked on our many months in Southeast Asia, I tried hard to get a JE vaccine before we went. It was impossible. None of the travel clinics had it or could get it. When we got to Thailand, it was our first priority, and the pediatrician we saw was confused. She couldn’t understand why our kids hadn’t had it: it’s part of the standard round up for one year olds in her world.
The Centers for Disease Control (CDC) website is an excellent resource for vaccine recommendations by country. You should definitely spend some time researching the information they provide and educating yourself about the risks for the countries you are visiting so that you can make an informed decision.
In addition to the standard childhood vaccinations, I would recommend the following for anyone who travels extensively:

  • Hepatitis A & B– These attack the liver and can cause death. The risk is present anywhere there are sanitation issues, even in the first world.
  • Tetanus– Gabe used his just this week, jamming a metal carving tool into his hand. Ez used his in Thailand, running a rusted fishhook into his foot on the beach. Elisha used his in Guatemala, cutting the tip of his finger off with a filet knife.
  • Meningitis– Meningitis killed my friend when we were in high school. She was on a school trip to Central America. She complained of feeling unwell at dinner. They found her dead in her bed just a few hours later.
  • Typhoid– Typhoid fever exists in places you might not expect: like along the south coast of Italy.
  • Yellow Fever– This one is very destination specific, but if you’re going to be in the equatorial regions where there is risk, you have to have it. Period. Lots of countries won’t let you back in without proof of vaccination.

Do I know people who have traveled without the immunizations and had no problems? Of course! I know many people, families with young children, who opt out of vaccines, at home and abroad, and to date have had no negative consequences. It is a matter of risk assessment and serious soul searching on the part of each parent. I can’t decide for you what you should do with your children. But for me, and for my children, having grown up as I did, having been the places I’ve been, and seen the devastating effect of preventable diseases, I cannot, in good conscience, not immunize my kids for the things that could have permanent consequences. It’s a controversial position, I’m aware of that.
My advice to you? Make an appointment with your pediatrician and discuss your plans, including destinations, in detail. Do your research online. Find a travel clinic and make an appointment to talk, face to face, with an expert in the field about the finer points of your specific travel plans!
Photo credits: blakespot, rocknroll_guitar