Which vaccines you need to travel to China

To travel to China from Portugal no vaccine is mandatory. The only one whose certificate can be demanded at the border is yellow fever, and only from anyone arriving from a country with a risk of transmission — which is not the case for Portugal, or for Europe.

The recommended vaccines are two: hepatitis A and typhoid. And there is a third thing that matters more than any vaccine: booking a travel medicine appointment between four and six weeks before departure, because some need two doses and protection is not immediate.

That said, it is worth being honest about what this article is: practical information for preparing a trip, not medical advice. The person who decides is your doctor, and the official reference in Portugal is the Directorate-General of Health (Direção-Geral da Saúde).

The two that are always recommended

Hepatitis A. The most recommended of all, and the reason is simple: it is transmitted through water and food, which is precisely the risk that exists on a trip to China. It is two doses, six to twelve months apart, and protection becomes active about two weeks after the first. One dose already protects for a year; the second protects for decades.

Typhoid. Recommended for stays in which you eat out frequently, which on a trip to China means every meal. It comes as a single-dose injection and as an oral version of three capsules. The protection is not total, but it greatly reduces the risk of serious illness.

Neither is expensive, and neither causes significant complications. They are worth having.

The routine vaccines

Before talking about exotic vaccines, it is worth checking whether the ones on the routine schedule are up to date. And often they are not:

• Tetanus and diphtheria: a booster every ten years. If you do not know when you last had one, you are not up to date.
• Polio: the same logic.
• MMR (measles, mumps and rubella): anyone born after 1970 who does not have a documented second dose should receive it.

This is free at the health centre and sorted in two appointments. For a forty-year-old who has not thought about it since the age of fifteen, it is frequently the most useful part of the preparation.

The ones that depend on the type of trip

China is large, and the recommendations change depending on whether you are going to Beijing or to the mountains of Yunnan.

Hepatitis B. Recommended for long stays, for anyone going to work in a healthcare setting, and for anyone expecting contact with blood or medical procedures. For two weeks of tourism it is not given systematically.

Rabies. Not recommended as a matter of routine. It becomes recommended on long stays in rural areas, in work with animals, and on cycling trips through remote areas. On our classic itineraries it is not justified.

Japanese encephalitis. Transmitted by mosquitoes in rice-growing areas, above all in the south and in summer. It is only recommended for anyone spending weeks in rural areas at that time of year. For anyone going to Guilin for three days, it does not arise.

Malaria. The risk in China is now residual and very localised: in the south of Yunnan, along the borders with Laos and Myanmar, and in parts of Hainan. For the itineraries we sell — Beijing, Xi’an, Shanghai, Chengdu, Guilin — prophylactic medication is not recommended. Protection against bites is enough.

Dengue. Present in the south of the country in the summer months, and there is no vaccine in general use for travellers. Prevention means repellent and long clothing at dawn and at dusk.

What is not a vaccine, and also matters

Three things cause travellers more problems than any tropical disease:

The water. Tap water in China is not for drinking. You boil it, or you drink bottled water. It is a simple rule, and the one most people forget in a hurry.

The air. In the big cities, particularly in Beijing and in the weeks of March and April with the sandstorms, air quality can fall to bad levels. Anyone with asthma or chronic bronchitis should carry their rescue medication and FFP2 masks.

The altitude. Lhasa sits at 3,650 metres and Shangri-La at 3,200. This is not solved with vaccines: it is solved with days of acclimatisation and a gradual ascent. Anyone with heart or respiratory problems should speak to their doctor before including those regions.

What to pack

Put together a small travel pharmacy. That is not excessive: it is what stops you spending a morning looking for a pharmacy that does not stock what you need.

• Regular medication, in a quantity for the trip plus a week, with the prescription on paper.
• Something for diarrhoea, and oral rehydration sachets.
• A painkiller and fever reducer you know.
• An antihistamine, for bites and for pollen.
• Repellent with DEET, for the south in summer.
• Plasters and antiseptic; Chinese pharmacies are good, but the names do not help.
• FFP2 masks, four or five.
• Sunscreen and a hat; the Chinese summer sun is strong.

The insurance

This is not a vaccine, but it is the most important item on this list. Travel insurance for China should have, at a minimum: medical assistance with no excess, medical repatriation and emergency cover in private hospitals.

In the same folder keep the assistance contact, the policy number, and a list of your medications under their generic names — not the brand names, which do not exist in China. And if you take ongoing medication, bring double what you need and split it between two bags: a lost suitcase should not mean an interrupted course of treatment.

Chinese public hospitals are good, but they have long queues and are run in Chinese. The international hospitals in the big cities work in English and are expensive. Cover of 100,000 euros costs between 40 and 120 euros per person for two weeks, and it is the best money spent on the trip.

The practical calendar

Six weeks before: book the travel medicine appointment, taking the itinerary with you. Four weeks before: have the recommended vaccines. Two weeks before: confirm that you have packed the vaccination record. In the week of the trip: buy the insurance, and save the assistance contact on your phone and on paper.

In short

For a classic trip of ten to fourteen days: hepatitis A, typhoid, and routine vaccines up to date. For long, rural or high-altitude trips the list changes, and that is why the appointment exists.

And one last practical note, which we have repeated to our clients from the beginning: the best protection against health problems in China is not in the syringe — it is in drinking bottled water, eating where there is a queue of locals, and washing your hands. The details of how to do that day to day are in our health guide, and those for the suitcase are in the baggage one.