Vaccinations for Kilimanjaro

CDC image for travel vaccines with needles and luggage and a hat

Be sure to visit your doctor several months before your trip to Tanzania.  This is important first to ensure that you are in good enough health for the climb (and especially important if you haven’t been to the doctor in a long time).  Most emergency evacuations and fatalities on Kilimanjaro are people that did not know they had a health condition before they came to Tanzania.

The other reason you want to visit your doctor is to be sure you are up to date on your routine immunizations and have a discussion on which additional immunizations you should have before coming to Africa.  Be sure to take the following:

  • Travel Itinerary – Particularly important if you plan on visiting any other countries other than Tanzania.
  • Immunization Record – If you have a record of past immunizations, take this with you.
  • Medication List – Be sure to tell your doctor about any medications you take (both prescriptions and OTCs you take regularly)

This article discusses some of the most common immunizations that climbers get before attempting Kilimanjaro.  If you live in the United States, the CDC is a good source for recommended immunizations. Or you can check your own country’s national health system for recommendations.  Above all, always follow your doctor’s guidance as she/he will know what medications you take and you health history which can affect your decisions on particular immunizations.

Hepatitis A and Hepatitis B

Series of 3 injections over the course of 6 months
Lasts 20 years

It is strongly advised to get vaccinated for Hepatitis A and usually advised for Hepatitis B.  It is quite easy to contract Hepatitis A since it is spread by contaminated food and water.  Hepatitis B is more difficult to contract, but it is very dangerous.  And it is estimated that approximately 8% of the population in Tanzania have the disease.  Since you can often get both vaccines in the same shot, we recommend getting both just to be safe. 

In order to ensure you will be immunized for the full 20 years, you must remember to take all three doses.  The second dose is to be taken one month after the first dose.  The third dose must be taken 6 months after the first dose (i.e. 5 months after the second dose).   If you don’t have a full 6 months before your trip to Tanzania, do not be alarmed.  You can take the first 2 doses before you go and take that third dose after you return.  You will be fully immunized for your trip with those first 2 doses.  The third dose is only given to give you the full 20 years of protection.

The medication Twinrix is a single injection that will vaccinate you for both Hep A and Hep B.  Otherwise you may get two separate shots at the same visit:  Havrix for Hep A and Engerix-B for Hep B.

Typhoid

Oral Medication taken every other day for course of 6 days
Lasts 5 years

Typhoid is primarily spread through contaminated food or water and is highly recommended for visitors to Tanzania. The most common medication is called Vivotif.  It is important to note that this medication must be refrigerated once you get home!  If you don’t it will not properly immunize you.

It is very easy to take because it is simply a prescription of 4 pills.  Simply swallow one capsule every other  day with room temperature water on an empty stomach (about an hour before a meal).  Avoid alcohol for several hours before or after taking the medication. 

Malaria

Oral medication taken before, during and after your trip to Tanzania
Effective only while taking medication

Malaria is a serious and sometimes fatal disease that is spread through mosquito bites.  The best way to avoid Malaria is to not get bitten, thus it is highly recommended to use proper bug spray with DEET while at the foothills of Kilimanjaro (this will also help avoid diseases like Zika and Dengue).  However, because no bug spray is 100% effective, it is also generally recommended to take malaria medication while in Tanzania where the parasite is commonly found in mosquitos.

Fortunately, there are no mosquitos that live above 1,800 meters (5,900 feet), so you actually do not need to take malaria medication while you are hiking.  Thus, you need to be taking the medication before you arrive in Tanzania, continue taking it while you are in the foothill towns (Arusha/Moshi/etc.), then you can stop taking while you hike.  Then you’ll want to take it again after you summit since you will be heading back to the foothills.  Your guide will probably remind you to start taking it again on the evening of your summit day. Importantly, you need to keep taking the medication everyday for 7 days after leaving Africa.

The common medication is called Malarone (generic name Atovaquone-Proguanil).  You just need to swallow the pill each day and take with food. 

Yellow Fever – Likely Not Needed

There are some differing views on whether travelers to Tanzania should be vaccinated for Yellow Fever.  For Americans, the current CDC guidance is that you do not need to be vaccinated if you are only traveling to Tanzania.

However, if you plan to go another African country you may not only need the vaccination, but you also may need to prove you’ve been vaccinated when you arrive in Tanzania.  The authorities in Tanzania will check to see if you are flying in from one of several countries that has widespread Yellow Fever and may demand to see your proof of immunization before letting you out of the airport.  This includes the country of Kenya (which is right next to Tanzania).  The exception to the rule is if you only have a layover and do not leave the airport in one of these countries.  If that is the case,  you will not need the vaccination.

This can be confusing to understand, so we will give some examples.  For instance, if you fly to Tanzania and your flight stops in Kenya but you do not leave the airport, you will not need a Yellow Fever vaccination.  However, if you fly there and leave the airport for other activities, you will need to show proof of your Yellow Fever vaccination as soon as you land in Tanzania.  

Rabies – Not Needed

The CDC guidance on whether a Rabies vaccination is necessary in Tanzania can be somewhat confusing to climbers. Specifically the guidance says:

Travelers involved in outdoor and other activities (such as camping, hiking, biking, adventure travel, and caving) that put them at risk for animal bites.

Many Kilimanjaro climbers read this and naturally assume they need to get vaccinated for rabies.  Clearly your Kilimanjaro climb will involve camping and hiking, so it seems like you need it, right?  However, you most likely do not need the vaccination (although you should always check with your doctor).  The reason is that all of your hiking and camping will be at high elevations far away from animals that generally carry the disease such as bats, rats and feral dogs.  Since these animals don’t live on the mountain, the risk of being bitten is extremely low.

Routine Immunizations & Titer Testing

If you live in the United States (regardless of whether or not you travel internationally), there are several vaccinations that are recommended for you.  You likely received many of these vaccinations as a child and some were required if you went to college.  However, now is a good time to check and see if you are immunized to the diseases.

If you are like most of us, you simply can’t remember if you’ve had your routine vaccinations, which ones you had and when you last had them.  In general, if you don’t know your doctor may just have you re-vaccinated which means you have to get more shots (sometimes with a complex series of boosters on a calendar schedule).  But – there is a way to know if you have immunity to particular diseases.  That is through what is called Titer Testing.

Image of a titer test blood results showing immunity to certain diseases
The results of a titer test showing immunity common diseases

Remember that most vaccinations work by putting a weakened form of a virus into your body so that your body creates anti-bodies that fight that particular virus.  That way when you get a full-strength virus that attacks your body, your blood already has antibodies that kill the virus almost immediately.  So as long as you have antibodies to each type of virus, you are protected.  This is why if you had chickenpox as a child, you likely don’t need to be vaccinated (your body fought off the chickenpox virus and has antibodies ready to fight it again if you are exposed).

A titer test is simply a laboratory test that checks for a certain amount of antibodies in your blood stream.  If you have enough antibodies present in your blood, you are immunized and don’t need to be vaccinated (yay!).  While it does require a small blood draw, you can get many titer tests performed from a single vial of blood.  Currently you can get a titer test for: Hepatitis A & B, chickenpox, rabies, measles, mumps, rubella and tuberculosis.  

Measles/Mumps/Rubella (MMR)

If you were born in the US, you likely received your MMR as a child.  And if you went to college you had to either prove you had the vaccine as a child, or they required you to get a vaccination.  If you simply can’t remember if you did or not, we recommend you get a titer test to check.

Tetanus, Diphtheria and Pertussis (Tdap)

In the US, the CDC recommends this vaccination whether or not you travel abroad.   However, the vaccine only lasts for 10 years.  So there are many Americans that are past due for this vaccination.  It is a single injection that provides you protection for a full 10 years, so it is highly recommended to get if you are climbing Kilimanjaro.  If you can’t remember if you’ve had it, it is recommended you get it (there is no issue if you get it twice within 10 years).

Chickenpox (Varicella Zoster)

This is another immunization that can be hard to remember if you had.  Most likely you got the vaccination as a child.  Also, if you were diagnosed with the disease “varicella” or “herpes zoster”, you likely have antibodies and do not need to be vaccinated.  A simple titer test can show whether you are immune.  Another option is to get the vaccination again.