Ulcerative Colitis And Travel Vaccinations: Things To Know

Having Ulcerative Colitis or any other autoimmune disease and getting travel vaccinations isn't as simple as one might think.

There are so many factors to consider like: your type of destination, the kinds of diseases you might be at risk for, whether you are in a flare or not and what medication and treatments you are currently getting.

Before starting our year-long travel adventure in 2020, Sebi and I got all the vaccinations we needed quite early because I am currently getting immunosuppressants (read about my treatment here) and I had to time some shots perfectly.

We probably would not have needed them for the first (unplanned) leg of our journey as it started as a road trip in Europe. But we didn't know back then and our original plan had some very exotic destinations in petto that require a proper preparation.

Careful planning and considerations of climate, water hygiene and food types are essential when travelling with a chronic or autoimmune disease. You should always consult your doctor beforehand and establish some health rules with him.

Here are a few things to know and to consider in terms of Ulcerative Colitis (or other autoimmune diseases) and travel vaccinations.

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Ulcerative Colitis and its symptoms

Every UC patient is different. So is the progression of the disease and the treatments.

I have already covered the disease extensively here so I won't get into it in detail. But here's just a quick reminder of the main symptoms with Ulcerative Colitis so we're on the same page:

The heaviness of each symptom varies from one person to another. So do the secondary symptoms which can be the following:

Ulcerative Colitis and its treatments

Here's the short-list of treatments you might get at some point during the process. This list is non-exclusive as these are only the ones I personally got administered.

Again: for more details on each type of treatment, how they work and what the side-effects are, read below.

Must-read | Travel and Ulcerative Colitis treatments: my personal experience

While having an autoimmune disease does not per se mean that your immune system is weaker but it does react in a different way and most of the more effective treatments in general do considerably slow down the immune system.

That means that you are more prone to catching infections that you would not necessarily if you weren't being treated with what are called 'immunosuppressants' or 'immunomodulators'. This includes all the previously listed medications, except for the mesalazine.

And this goes for simple flu-viruses but also potentially more dangerous diseases that might be prevailing at exotic destinations you consider visiting.

That doesn't mean you shouldn't visit these destinations, no. You just should be extra cautious and well-prepared.

Travel and Ulcerative Colitis: research is key

As a general rule, researching the amount/size/quality of hospitals in the country of destination isn't a luxury, it's crucial. Even though you will most certainly be alright and won't need them, knowing where they are and whether they are trustworthy is essential.

After this initial research on general health systems, the next important element should be getting to know the common diseases on the ground. 

With that in mind, schedule a visit to your specialist and a travel doctor several weeks prior to boarding the plane.

It's also very important to get travel insurance - not only for people travelling with an autoimmune disease, that is. Travel insurance should always be a priority in your budget-planning. Especially when visiting developing countries.

Ulcerative Colitis and travel vaccinations: things to consider

What vaccinations should you consider getting?

Influencing factors

Here again, the most important thing is to get appointments with your gastroenterologist and a travel doctor early on when planning your trip to far-flung destinations. 

Next, it depends on not only the destination itself but also when you are visiting. Some countries have outbreaks of specific diseases at different times of the year (for example during rain-season). 

Another factor to consider is your travelling-style. Hiking in Belize's jungle, Costa Rica's volcano region, Peru's canyons or deserts in Jordan and Namibia is very different from visiting cities like Valletta in Malta, Dubrovnik in Croatia or Copenhagen in Denmark. The travel conditions vary greatly and so do the diseases and their transmission rate.

Take French Polynesia, for example: bugs and sandflies are a plague and Dengue-outbreaks are quite common. And while Costa Rica's Caribbean coast looks the same, the Chikungunya-virus is a lot more active there and doesn't exist on, say, Bora Bora.

Another big difference that influences the amounts of shots you might need is whether you will be staying at five star resort hotels in urbanised areas or frequently camp in the middle of the rainforest, prone to having close contact with rabies-transmitting animals. 

Compulsory vaccinations

There are several countries that suffered such severe outbreaks from hard-to-control diseases that they made certain vaccinations mandatory.

For example in Peru or several African countries, you have to bring proof of vaccination against yellow fever. Read below why this is important, especially when you are treated with immunosuppressive medication.

Other countries require that you are vaccinated against polio, which is one of the 'classic' vaccinations you should have gotten as a child anyway. If not, you might want to consider it if you don't want to be restricted in your travels.

Check out the WHO (World Health Organisation) website for information on diseases and possible vaccination or prophylaxis (in the case of malaria for example).

Timing of vaccinations

For some vaccines, the body takes longer than for others to build immunity. It is important that you get the shots ahead of time to allow a proper protection to be installed. 

Whether you have an autoimmune disease like Ulcerative Colitis or are totally healthy, doctors recommend getting the travel vaccinations at least six to eight weeks prior to departure. 

Ulcerative Colitis treatments and travel vaccinations: live vaccines

The main reason I wanted to draw your attention to this topic is that with most of the Crohn or Colitis treatments cited above, getting live vaccines is almost impossible.

A live vaccine contains a weaker version of the actual virus which induces the development of defences in a healthy body. For people like us with immunosuppressant treatments, it might cause an outbreak of the disease.

Here are some examples of live vaccines:

While most of these vaccines are shots you probably got as a child anyway, some, like yellow fever or typhoid, are not and they are absolutely recommended when travelling around the world.

Like I previously mentioned, the yellow fever vaccination, for example, is mandatory in Peru. You won't be permitted to enter the country without proof that you got the shot.

There is a possibility to get an exemption letter from a doctor but even this does not guarantee that the country will let you in.

What to do then?

That being said, it's not entirely impossible to ever get these needed shots if your goal is to travel to destinations that require it.

Depending on the progress of your autoimmune disease, you could 'pause' your treatment for a while - but only if your specialist deems the risk of a flare-up being low and allows it.

There will then probably be a waiting period between your last treatment and the actual vaccination of three to six months, depending on your type of medication. After finally getting the shot, you will most likely have to wait another three to four weeks before restarting your treatment.

It is crucial that you discuss all of this with your GP and/or gastroenterologist and IBD-team.

If you know that you will get an immunosuppressive treatment but haven't started it yet and you plan to travel to exotic destinations in a near future, it might be advisable to check which vaccinations you could get before starting it.

General recommended (inactive) vaccines

Again, this depends greatly on the destinations you plan on visiting but the most common are the following:

Some other vaccinations you will most likely get when treated with immunosuppressive drugs anyway are influenza (every year) and pneumococcal (renewable every five years).

Add to this the Covid19-vaccine as this will most likely become a yearly shot just like the flu for people with a weaker immune system.

Ulcerative Colitis and travel vaccinations: why should I get them if not mandatory?

Well, if your GP/specialist is not a total douchebag, he will most likely have told you about all the diseases you are at risk for with both Ulcerative Colitis and the possible treatments.

Depending on your destination, would you really want to risk a bad outbreak of some foreign disease and end up in a hospital with very low (if any) hygiene standards?

Also, you never know how exactly your body might react with an autoimmune disease like ours. It might cause a flare-up of the UC and you really, really don't want that, do you?

Preparing a world trip with Ulcerative Colitis: my personal story

For a full list of what we packed in order to feel safe in any case, read about our travel pharmacy below:

Other than the required and recommended travel vaccinations, we got prescription medication in case we wanted to visit areas with a high presence of malaria or dengue.

Some general antibiotic was also a tip from my gastroenterologist, in case I happen to have a sudden flare but can't get to a hospital right away.

Being prone to sea- and altitude sickness, I got myself some (recommended) drugs as well because we knew we would need them.

Then I had to find a way to keep my medication cool while travelling - that was quite the challenge but if you read the linked article, we managed to do it.

Read also | How to avoid getting seasick: the solution?

                      Beating altitude sickness in Cusco: the best tips

                      How to keep medication cool when travelling

At the time we decided to take a gap-year and travel around the world for a while, I was treated with Remicade, a biologic drug of the family of TNF-inhibitors.

Because this gets administered by infusion at the hospital, it would have been impossible to travel for more than two months at a time under this treatment.

So my gastroenterologist suggested trying another kind of drug, a interleukin antagonist called Stelara. That one comes in handy pre-filled syringes that I could use at home (or on the road in this case) every eight weeks.

Because we were absolutely certain to visit Peru at some point (the other destinations were just an approximate plan - Machu Picchu had been very high on my list for ages; I'm an archaeologist after all), I absolutely needed that damn yellow fever shot.

So we decided to stop the Remicade and wait for approximately three months. Then I had all my required shots at once (eight in total!) and we waited another month before I got the first Stelara-shot.

And that was that. I didn't have any complications or side-effects from any of the vaccines. But that's not necessarily the rule. Here again, every person is different and thus has different reactions to vaccines.

Ulcerative Colitis treatments and travel vaccinations: conclusion

To summarise: it is not only possible to get travel vaccinations even when treated with immunosuppressant drugs but also advised!

Research is important to know where you want to go and when you might be there, which disease is 'popular' in what area and what type of accommodation you will be staying at.

Be early enough as some vaccines take a while to really have the wanted effect and you might have to time some shots like the one against yellow fever in accordance with your treatment.

It's not something to get discouraged by. Yes, it requires a bit more organisation than a healthy person who could just wing it. But that's the thing with autoimmune and chronic diseases: they are our constant travel companion, for life. So not only should you deal with it but learn to accept it as such.

I mean, this blog alone is proof that it is indeed possible to explore our beautiful world despite struggling with nasty diseases like Ulcerative Colitis (or asthma; or lipoedema; or side-effects from drugs).

So don't give up if travelling the earth is your dream. Midst a few adjustments and supportive doctors, family and friends, there is so much you can do.

I hope this article helped to clarify some things and eliminate doubts you had. If you have further questions (or just need a bit of encouragement), don't hesitate to comment or send me a message.

Also, please feel free to pin and share this article for others to see and to support us.

As ever

xx

Cyn

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