Vietnam Travel Vaccinations

Vietnam has a low risk of exotic disease.  Some vaccinations are recommended but you don’t need to go over the top.

Most travellers would be advised to have their routine immunisations current and strongly consider Hepatitis A.  You might not consider a flu vaccine under normal circumstances but taking a break in the middle of winter and transiting airports does put you at risk. A true flu can last 5 to 7 days and make you a very undesirable travelling companion, particularly if it’s a special occasion.  Air pollution can be a consideration during the winter months in the northern areas. Unfortunately, you can’t vaccinate for this, but you can use avoidance measures (masks) if you are at risk of chest issues.

The other “food and water vaccine”, typhoid, might be considered for the more adventurous eaters or if staying with friends and relatives in a more rural setting. Cases of typhoid do occur.

Accommodation in Vietnam can range from 5-star resorts to backpacker homestays.  Water and sanitation issues are much more likely in those staying in basic accommodation. Cruising on the Mekong is also popular, and cruise boats come in all sizes.  Time ashore needs to be considered.

There is no vaccination for traveller’s diarrhoea but attention to the rules of eating and drinking safely should help to keep you safe.  Some people seem to be at a higher risk of travellers diarrhoea while others might be on medications which might increase their risk.

Other more exotic vaccines for the prevention of rabies, japanese encephalitis and cholera really depend on what you intend to do, time away and season of travel. Those offered to a long-term resident might be very different to a short-term visitor.

Yes, typhoid fever is a risk in Vietnam. How big a risk depends on what you intend to do regarding eating and drinking during your stay.

Overall, the incidence of typhoid in Vietnam has been declining over many years. This is likely due to improved access to safe water and better sanitation. Vietnam does have a low per capita income, but the government has managed to improve living conditions considerably over the last 20 years.

The risk would be very low if you intend to stay in an upmarket resort with very little in the way of visits to eateries in the local towns or villages. Most resort-based food would be prepared by internationally trained chefs who would ensure the food is prepared in a safe way. Vegetables can be rendered safe with cooking and salads chemically treated. Kitchen hands would be constantly reminded on their own personal hand hygiene. This might be done in high-end accommodation and restaurants but unlikely in markets or with street food.

Certain foods eg seafood (shellfish in particular) is always risky as are uncooked salad vegetables.

It is impossible for anyone to provide a “no risk” scenario. If you want to take some “risks” and you are a bit anxious about what you have read, then it is reasonable to have the typhoid vaccine. There are very few side effects, and the level of protection is reasonable (>70%). It lasts for 2 to 3 years.

Backpackers staying in basic accommodation and those visiting family and friends are more likely to be exposed. These groups have less control over the choice and preparation of food. Business travellers may be in a similar situation with little control over what is ordered when dining out with colleagues. This could be considered an occupational health risk.

Mosquitoes are most active during the wet season in Vietnam. This starts in late April/ May and lasts until October. The seasons are slightly different in the south and the north with the south experiencing 2 seasons, wet and dry, while the north has four distinct seasons like more temperate areas. Mosquito activity is also influenced by temperature with very little activity in the cooler months of the year in the northern areas. Mosquito activity is present most of the year in the south but peaks during the wet season.

Outbreaks of mosquito-borne disease are usually during the wet season. Large outbreaks can be influenced by seasonal variation as well as an increasing number of susceptible individuals within the population (usually children). In one study on the influence of climate, dengue fever showed a gradual increase in cases in northern Vietnam from April to August with peaks in September and October. Transmission was year-round in the south with a higher incidence between August to November.

Australia is a high-income country, and we can assume water from a tap is safe for drinking in major urban areas. It is highly regulated under public health guidelines where safety is determined by its physical, microbial and chemical quality. The same cannot be said for many overseas countries.

When travelling overseas it’s almost impossible to know where the water comes from. Is it locally treated within the property or is it dependent on public infrastructure. Is the infrastructure properly maintained and monitored?

Unless you can be sure of the quality of the water, the safest option is to use factory-sealed bottled water, particularly when travelling in low and low middle-income countries. Water can also be made safe by boiling, chemicals, or UV light. Local filtration systems might be considered by expatriate workers in high-risk locations.

Your attention to water safety is vital if you want to avoid a bout of traveller’s diarrhoea.

The malaria risk is low in Vietnam. According to CDC, there is no need to take prophylaxis if mostly visiting the major centres of Hanoi and Ho Chi Min City, and the coastal plains. Rare cases are reported in the Mekong delta. 

This doesn’t mean there is “no” risk, just that the number of cases is so low that taking medication is hard to justify.

There is risk in some rural areas, including Binh Phuoc province and the central highlands. There is a strong seasonal pattern in areas of risk, with cases increasing from September and a peak in November.

Mosquito avoidance measures are very important whether you are taking or not taking prophylaxis. The medications are not 100% protective and there is a risk of other mosquito- borne diseases such as dengue, chikungunya and zika.

Malaria must always be considered if you experience a fever while in Vietnam or on returning home. A simple blood test can help exclude the diagnosis. It might have to be repeated.