Vaccinations and malaria protection for East Africa

Before anything else: this is not medical advice, and it deliberately names no drug and no dose. It says what to raise and how much lead time you need. The decision belongs to a travel health professional with your history in front of them.

Book the appointment six to eight weeks before departure. Some vaccines need several doses weeks apart, and yellow fever protection is only considered effective ten days after the injection.

Yellow fever: an entry question, not only a health one

This is the one that ends trips.

The yellow fever certificate is written into the requirements of the East Africa Tourist Visa and is checked at land borders. Whether it is demanded depends on which country you arrive from and where you transited — the rules distinguish origin from transit, and interpretation varies between border posts.

In practice: carry the certificate, even arriving direct from Europe or North America. An international certificate weighs nothing. A refused entry costs the trip.

Yellow fever may only be given at designated vaccination centres. Not every family practice is one.

Malaria: the actual risk

Malaria is present across large parts of Tanzania, Kenya, Uganda and Rwanda. The risk is real and unevenly distributed — it depends on altitude, season and region. The Ngorongoro highlands and Nairobi sit high enough for the risk to be low; the coast, Lake Victoria and the lower-lying parks are risk areas.

Raise in the consultation:

• Your exact route, with altitudes and month of travel. "Tanzania" is not enough information.
• Interactions with any medication you take regularly.
• Tolerability — the prophylaxis options differ substantially in side effects, dosing schedule and price.
• How long after you get home you must keep taking it. This is where people stop early, and that is exactly when it is dangerous.

Avoiding bites is not a side issue. Long clothing from dusk, repellent at adequate concentration, a bed net. The mosquito that carries malaria bites in the evening and at night — which is to say, during dinner at the camp.

Other things for the conversation

• Routine vaccinations, particularly tetanus, diphtheria, polio and measles. Frequently overdue.
• Hepatitis A, essentially always a topic for travel in the region.
• Hepatitis B, typhoid and rabies depending on how and how long you travel, and how close you get to animals. Rabies comes up regularly for gorilla and chimpanzee trekking.
• Meningococcal disease depending on route and season.

Altitude, if you are climbing Kilimanjaro

Kilimanjaro is not a medical footnote. Altitude sickness is the commonest reason for turning back and the only serious danger on the mountain. Raise it separately — the altitude question is not the malaria question, and the answer depends on your route and its length.

Gorilla trekking: you are protecting the animals too

Gorillas catch human respiratory infections and have no immunity to them. Anyone visibly ill is not taken along — the rule is enforced, and the permit, at 800 to 1,500 US dollars, is not refunded.

That is one reason to hold travel insurance that covers falling ill on the day.

Before you leave

• Scan your vaccination record and yellow fever certificate and keep the copies separately from the originals.
• Carry medication in its original packaging with the leaflet, in hand luggage.
• Keep a list of your regular medication by generic name, not brand name — brand names differ between countries.

Vaccination guidance and entry rules change. What binds is the advice of your travel health professional and your own government's current guidance for the country you are visiting.