So, despite what seems to be general knowledge about the uselessness of the cholera vaccine, the DoH and most GPs still recommend that adults have a single shot and children two doses and a booster before heading to infected areas. Be wary of this shot, which is a dead form of the organism, and only purports to be effective for six months. Besides fever, you can experience serious allergic reactions to this drug, nerve damage and even mental problems.
"It is generally recognized by the medical literature that there is no satisfactory typhoid vaccine currently available. Protection afforded by the current strain is negligible."
Again, like cholera, there is an "emperor's new clothes" view about this vaccine. GP recommends that two injections of typhoid separated by one month will give protection for three years, and a child is recommended to get two doses plus a booster. This drug should not be used in children under 1 year, and its harmful effects are worse in people over 35. People who receive the shot have fewer side effects if it is given into the skin (ie, intradermally), rather than under it.
This is one shot you may not be able to avoid if you are travelling to certain part of Africa or South America, since you need a certificate of vaccination upon entry. If you are dead set against the shot, which again is said to require an improved version to be effective, it may be wise to avoid any areas requiring the certificate. This vaccine, which is given live, can cause encephalitis (inflammation of the brain), especially in children under 9 months.
Dr Morris believes that it may be prudent to consider this vaccine if you are travelling to very high risk areas in summer months and haven't had the vaccine before , since polio has largely disappeared from the West and you would not have built up natural immunity. If you have had a vaccine before, (as most of us have) you can request to have a blood test to measure antibody response (serum titre) to avoid having a booster you don't need.
Another way to avoid this vaccine is to simply travel to places like Egypt in the winter, when there is less risk of contracting the disease. If you must get vaccinated consider having the killed vaccine, which carries less risk of spread among unvaccinated individuals than does the current live vaccine taken orally. See WDDTY Vol 2 No 4 (or the Vaccination Handbook) for the considerable dangers of contracting polio from the live polio vaccine.
"There is, to date, no reliable vaccine for malaria and many of the drugs don't work anymore."
Although several drugs developed during World War II to be taken against malaria used to be effective, most strains of the disease have developed active resistance. Last spring the Lancet (14 March 1992) carried an editorial which said that few tropical countries are now unaffected by strains resistant to chloroquine, the first anti malarial pill; resistance to quinine is now increasing. "In South East Asia especially, there is a real possibility that . . . malaria could become untreatable within this decade," said the story. GP (5 July 1991) noted that ". . . experts have found it difficult to be authoritative, and schedules of drugs used in prophylaxis [as preventatives] are changed quite frequently." The general rule of thumb at the moment is to use combinations of drugs in areas where resistance is known to be extremely high. And of course there are a number of known toxic effects with all these drugs, such as nausea, vomiting, severe gastrointestinal disturbances, and even psychotic reactions. Prolonged high doses of chloroquine can lead to damage to the cornea of the eyes or ringing of the ears.