Travel Medicine: Vaccines, Malaria Prophylaxis, and Safe Food Practices for Safe Trips

Every year, over 1.4 billion people cross borders for work, leisure, or family visits. But for many, the biggest threat isn’t lost luggage or language barriers-it’s getting sick from something they could’ve prevented. Travel-related illnesses like hepatitis A, typhoid, and malaria aren’t rare. They’re common. And they’re often avoidable. If you’re planning a trip anywhere outside your home country, especially to parts of Asia, Africa, or Latin America, you need to know the basics: what shots to get, how to avoid malaria, and how to eat without getting sick.

Get the Right Vaccines Before You Go

Most people think they’re covered if they had their childhood shots. That’s not enough. Routine vaccines like MMR, Tdap, and varicella need to be up to date-but they’re just the starting point. The real focus is on destination-specific vaccines.

Hepatitis A is the most common vaccine-preventable disease travelers get. It’s spread through contaminated food or water. One dose gives you 95% protection, and after the second dose (given 6 to 12 months later), you’re protected for life. Yet, 40% of travelers skip it because they think it’s only for risky areas. It’s not. Even in popular tourist spots like Mexico, Thailand, or Egypt, outbreaks happen. In 2024, over 1.4 million cases were reported worldwide.

Typhoid is another big one. There are two types of vaccines: the injectable one (Vi polysaccharide) and the newer conjugate vaccine (TCV). TCV is better-it works longer (up to 3 years), is more effective (87%), and can be given to kids as young as 6 months. Older versions only lasted a year or two and weren’t as reliable. If you’re heading to South Asia or sub-Saharan Africa, don’t skip this. Give it at least 10 days before departure so your body can respond.

Yellow fever vaccine is required by law in 194 countries. If you’re flying into or through a country where it’s present, you’ll need proof-a signed and stamped International Certificate of Vaccination. Without it, you can be denied entry or forced into quarantine for six days. The vaccine lasts for life after one dose, but you must get it at an approved clinic. Not every doctor’s office can give it.

Timing matters. Most vaccines need weeks to build immunity. Yet, the CDC found that 73% of travelers wait until less than two weeks before departure to see a doctor. That’s too late for full protection. Start planning at least 4 to 6 weeks ahead. Even if you’re leaving in a week, it’s still worth a visit. Some vaccines can still help, and you can get advice on other protections like antimalarials or antibiotics.

Choose the Right Malaria Prophylaxis

Malaria isn’t just a tropical disease anymore. Climate change has expanded mosquito habitats. Since 2020, the area where malaria can spread has grown by 15%. That means more travelers are at risk-even in places they didn’t used to worry about.

There are four main drugs for preventing malaria:

• Atovaquone-proguanil (Malarone): Take one pill daily, starting 1-2 days before travel. It’s 95% effective and has fewer side effects. But it’s expensive-around $220 for a 3-week trip.
• Doxycycline: A daily pill, starting 2 days before travel. It’s cheaper ($45 for 3 weeks) but causes sun sensitivity in 30% of users. You’ll need to wear sunscreen and cover up.
• Mefloquine: Taken weekly, starting 2-3 weeks before travel. It’s effective, but some people get severe dizziness, anxiety, or even hallucinations. Reddit users have reported emergency trips to Thai hospitals after taking it. Avoid it if you have a history of mental health issues.
• Tafenoquine (Krintafel): A newer option, approved for kids over 16 in early 2025. Taken weekly, starting 3 days before travel. It’s convenient, but you must be tested for G6PD deficiency first. About 10% of people in malaria zones have this condition, and taking tafenoquine can cause dangerous anemia if you do.

Adherence is the biggest problem. Studies show only 62% of travelers take their malaria pills regularly. Missing doses is the #1 reason people still get malaria after taking prophylaxis. Set phone alarms. Keep pills in a daily pill organizer. Don’t wait until you’re on the plane to remember.

There’s no perfect drug. The best one for you depends on your health, destination, trip length, and budget. Talk to a travel clinic. Don’t just ask your regular doctor-they might not know the latest guidelines. The CDC Yellow Book 2026 is the gold standard, used by 92% of U.S. travel clinics. It’s updated every two years. The 2026 version added new guidance for high-altitude areas and climate-driven changes in mosquito behavior.

Follow the Food Rules That Actually Work

Travelers’ diarrhea affects 30% to 70% of people visiting developing countries. It’s not just a nuisance-it can ruin a trip, land you in a hospital, or even be deadly for kids and older adults. Eighty percent of cases are caused by bacteria, mostly E. coli.

The golden rule? Boil it, cook it, peel it, or forget it.

• Don’t drink tap water-even in hotels. Use bottled water from sealed containers. Check the seal.
• Avoid ice unless you know it’s made from purified water. Many travelers get sick from contaminated ice in drinks.
• Only eat food that’s hot and freshly cooked. Street food isn’t automatically dangerous, but it must be cooked in front of you and served steaming hot.
• Peel fruits yourself. Bananas, oranges, and mangoes are safe if you peel them. Avoid pre-cut fruit.
• Stay away from raw or undercooked meat, seafood, and eggs. Cook poultry to 165°F (74°C), fish to 145°F (63°C), and ground meats to 160°F (71°C). Use a small food thermometer if you’re staying somewhere with a kitchen.

There’s one more tool: bismuth subsalicylate (Pepto-Bismol). Taking two tablets four times a day reduces your risk of diarrhea by 65%. It’s not a substitute for clean food, but it’s a solid backup. Some travelers take it daily during high-risk trips. It can turn your tongue and stool black-that’s normal. It’s safe for short-term use.

Antibiotics like azithromycin are often recommended for treatment. But resistance is rising. In Southeast Asia, over 30% of E. coli strains now resist azithromycin. That means the go-to drug might not work. Carry a backup-ciprofloxacin or rifaximin-but only use them if symptoms are severe. Don’t take them as a preventative. Misuse fuels resistance.

What to Pack and How to Stay Safe

Beyond vaccines and pills, smart packing makes a huge difference:

• Carry all medications in their original bottles with your name on them. This avoids problems at customs.
• Bring a doctor’s note listing generic names of your prescriptions. Some countries restrict common meds like ADHD drugs or painkillers.
• Use hand sanitizer with at least 60% alcohol. Wash hands before eating, even if you’re eating with your hands.
• Bring a small first-aid kit with oral rehydration salts, antidiarrheal meds, and a thermometer.
• Check if your destination requires a digital health passport. As of December 2025, 127 countries use them to verify vaccines and test results.

Don’t forget travel insurance that covers medical evacuation. If you get seriously ill abroad, getting home can cost $50,000 or more. Most standard policies won’t cover it.

Common Mistakes and How to Avoid Them

Here’s what goes wrong-and how to fix it:

• “I don’t need a shot-I’m only going for a week.” Even short trips carry risk. Hepatitis A can strike in 2 days. Malaria can be fatal in under 48 hours.
• “My doctor said I don’t need anything.” Most general practitioners aren’t trained in travel medicine. Look for a clinic certified by the International Society of Travel Medicine (ISTM). There are over 8,500 worldwide.
• “I’ll just take antibiotics if I get sick.” Antibiotics don’t prevent illness. They treat it. And if you take them unnecessarily, they stop working when you really need them.
• “I followed the rules but still got sick.” Sometimes, you can’t avoid it. Contaminated ice, uncooked vegetables, or even bottled water from a bad batch can slip through. That’s why having a treatment plan matters more than perfection.

The bottom line: Travel medicine isn’t about fear. It’s about control. You can’t control everything-but you can control vaccines, pills, and what you eat. Do those three things right, and your odds of staying healthy skyrocket. The CDC says travelers who get proper advice reduce their risk of vaccine-preventable diseases by 78%. That’s not a small win. That’s life-changing.

What’s New in 2026

The CDC Yellow Book 2026, released in April 2025, added new sections on:

• Malaria risk in high-altitude areas (above 2,500 meters), where mosquitoes are now appearing due to warmer temperatures.
• Climate-driven food safety risks: hotter weather means faster bacterial growth in food, even in refrigerated settings.
• Expanded guidance on tafenoquine for teens over 16, now approved by the FDA.
• Recommendations for travelers with weakened immune systems, including those on biologics or chemotherapy.

By 2026, the CDC plans to link the Yellow Book to real-time outbreak alerts via API. That means if a cholera outbreak starts in Haiti next month, your travel clinic will know within hours-and adjust advice accordingly.

Climate change is the silent driver behind all this. By 2030, an extra 200 million travelers could be entering malaria zones. Vaccines, antimalarials, and food safety aren’t optional anymore-they’re essential.

If you’re heading out soon, don’t wait. Book a travel health appointment. Get your vaccines. Pick your antimalarial. Know your food rules. You’ve planned the trip-now make sure your body is ready for it.