Vaccination involves exposing your body’s immune system to a weakened or harmless version of a bacterium or virus. This helps your body to produce its own antibodies, which will protect against the infection.
Before you put any travel plans into action, find out whether you’ll need vaccinations for the country you’re visiting. You generally don’t need to have any vaccinations if you’re going to the United States, Western Europe, and most parts of Australia or New Zealand. But check before you go. You’ll need to show proof that you’ve had vaccinations for certain diseases to enter some countries.
It’s best to see your GP or go to a travel medicine clinic at least a month or two before you travel. If you’re going away sooner than this, you can still get vaccinated, but you might not be fully protected against some infections.
If you need to have more than one injection for a disease, you’ll usually have them over a number of weeks. This time between injections allows your body to respond to the vaccine, so you develop immunity ready for when you arrive at your destination. You’ll probably have the injections in your upper arm or on the outside of your thigh.
In the UK, we have a routine childhood vaccination programme, which includes vaccinations against diseases like polio, diphtheria, tetanus and measles. If you didn’t have these vaccinations as a child, or missed some of them, you might not be protected. If you’re unsure, ask your GP surgery if there are any records. You might need to have some of the routine childhood vaccinations before you travel.
You’ll need to pay for some travel vaccinations, as not all of them are available from the NHS. Here are some examples of vaccinations.
Cholera is a bowel infection caused by bacteria. It’s usually spread through infected water or food. Cholera is mainly found in places where there’s poor hygiene and sanitation, so where there’s no clean water or sewers. This includes parts of Africa, Asia and South America. Cholera can cause severe diarrhoea and dehydration, which can be particularly serious in babies, children and older people.
You’ll need a cholera vaccination if you’re travelling to an area that has a cholera epidemic. An epidemic is when a large number of people are affected by an infectious disease, which often spreads quickly. It’s also a good idea to have the cholera vaccination if you’re a relief, or disaster aid worker, or are travelling to places where there’s limited access to medical care.
The cholera vaccine comes in the form of a liquid that you drink. Don’t eat or drink anything for an hour before and after you take the vaccine. Adults need two doses between one and six weeks apart. Ideally, have the second dose at least a week before you travel. Children between two and six need a third dose one to six weeks after the second dose. The vaccine isn’t recommended for under twos.
You don’t get lifelong immunity from the cholera vaccine, so you’ll need to have a booster to keep up your protection. Adults and children over six need the booster two years after the first dose, and children aged two to six need it six months after.
Hepatitis A is a liver disease caused by an infection with the hepatitis A virus. People usually get infected through food or water that’s contaminated with sewage. Hepatitis A causes liver inflammation and becomes more serious the older you are when you get it. The virus is found all over the world, but it’s more common in parts of Africa, Asia, and Central and South America.
You can have what’s called a monovalent vaccine, which is just against Hepatitis A, or a combined vaccine, which protects against hepatitis A and B. There’s also a combined vaccine that jointly protects against hepatitis A and typhoid. If you have a vaccine just for hepatitis A, or the hepatitis A and typhoid combination, you’ll need one single dose. If you have the hepatitis A and B combination, you’ll need to have two injections for your body to develop full immunity to the infection. You’ll have a booster dose six months to a year after the first. Ideally, you’ll have the first injection about two weeks before you travel, but it’s possible to have it up to the day before you leave. The vaccine should give you at least 25 years of protection.
Hepatitis B is a liver disease caused by infection with the hepatitis B virus. It can be mild or severe – for some people the infection can be life-threatening. You get it from direct contact with an infected person’s blood or other body fluids, such as semen or vaginal fluid. So you can get it if you have unprotected sex, or have medical or dental treatment in a developing country. You can even get it from needles if you have acupuncture or a tattoo while you’re away.
Hepatitis B is found all over the world but it’s more common in Africa, Asia and the Middle East.
There are different vaccine options, but generally you have three doses. After the first dose, you’ll need the second a month later and a third five months after that. If you need to be vaccinated quickly, you can ask for the vaccinations over a shorter time.
Japanese encephalitis is a serious viral infection and you can get infected from a mosquito bite. It ranges in severity. You might not have any symptoms or it can cause inflammation of the brain and it can be life-threatening. It’s found in Asia and the far north of Australia.
You might need the vaccine if you’re travelling to a place where it’s regularly found for a month or longer – especially if you’re going to rural areas. Ideally, you should get vaccinated at least a month before you travel.
Adults and children have two injections, usually over a month. You’ll need to have a booster a year or two after the initial vaccination if you’re still at risk of being infected.
Meningococcal meningitis is an infection that affects your brain and spinal cord. It’s found all over the world, but is most common in Africa, in countries just below the Sahara desert. You can catch it from close contact with infected people, for example, from those with coughs and sneezes.
If you're backpacking or living in a rural area in an affected country, you’ll need a combined vaccine against several strains of meningitis. If you’re going on pilgrimage to Mecca, you must have the vaccination before you go. The Saudi Arabian authorities will ask for proof of this before you can enter the country.
Arrange to have the vaccine two weeks before you travel. Adults and children over two years old will need one injection. Children under two will need two injections: the first, two months before you travel and the second, one month later.
Poliomyelitis (polio) is caused by a virus. It affects your nervous system and can cause a range of symptoms from fever to paralysis. You catch polio by eating or drinking food or water that has the virus in it. You can also get it if you come into close contact with someone carrying the virus. It’s mainly found in Africa and Central Asia.
If you were born before 1962 in the UK, you probably won’t have been adequately vaccinated against polio, or had a low strength vaccine. The polio vaccine is now given along with the tetanus and diphtheria vaccination in the same injection. In young children the vaccine is given with pertussis (whooping cough) and HIB (Haemophilus Influenzae Type B) as a 5-in-one injection.
If you’re travelling to a high-risk country for polio and you haven’t had a booster within 10 years, you’ll need to have one.
Rabies is a viral infection that can be spread from animals to people. You can catch it if you’re bitten or scratched by an infected animal. Both pets and wild animals can carry rabies. It’s a serious condition and once symptoms develop, there’s no treatment for it and the infection is almost always fatal.
Rabies is found all over the world but it’s more common in Africa and Asia.
You may need a rabies vaccine if:
- you’re travelling for a month or more to an area where the risk of rabies is high
- you can’t easily get medical care
- if your activities put you at risk, for example, if you’re working with animals
You’ll usually be given three injections spread over a month. You may need to have booster vaccinations if you remain in high risk areas.
It’s important to be aware that having the rabies vaccine doesn't mean you're completely immune to the disease. If you’re bitten by an animal that’s possibly infected with rabies, it’s vital you get immediate medical help. You’ll need another dose of the vaccine and a blood product called immunoglobulin (if available), before you get any symptoms, to prevent rabies from developing.
Tetanus is caused by bacteria that live in the soil. It causes muscle spasms and paralysis and can be life-threatening. You can get tetanus if dirt, dust or manure gets into a cut or wound. Tetanus is found all over the world but is more common in developing countries.
In the UK, you’ll usually have had the tetanus vaccine as part of your routine childhood immunisations. But if you were born before 1961, you won’t have as the UK-wide vaccine programme started that year.
If you're travelling to a country with poor medical care, have a booster vaccination if you’ve not had one within the last 10 years.
Tick-borne encephalitis is a viral infection that’s passed on mainly through tick bites. It can cause inflammation of the brain. There are different types of the disease, which are linked to the area they are found in – Europe, the Far East and Siberia. It’s mainly found in the countryside, particularly in woods and forests. You’ll need to have the vaccination if you’re travelling to the countryside in an area where the infection is common during spring and summer.
You have three doses of the vaccine over a year. If you need protection more urgently, you can have two doses, two weeks apart.
Typhoid and paratyphoid fever are both caused by bacteria. You can get infected if you drink water or eat food with the bacteria in it. It causes similar symptoms to food poisoning, but for some people it can cause more serious problems such as pneumonia and a brain infection. Typhoid outbreaks are most common in South Asia, Africa and Latin America.
It’s important to get vaccinated against typhoid if you're planning to stay in areas where it’s common and hygiene is poor. You can have the vaccine as a capsule to swallow in three separate doses. You’ll need to have a booster vaccine every three years if you go back to visit areas where typhoid is common. You may be able to have a combined typhoid and hepatitis A vaccine if it’s available – check with your GP or travel clinic.
Yellow fever is caused by a virus that’s passed on by mosquito bites. It can vary in how serious it is. You may just have flu-like symptoms that get better over a few days. But in some people it can seriously damage your organs and can even be fatal. Yellow fever is found mainly in tropical areas of Africa and South America.
You’ll need to have the yellow fever vaccine if you're going to, or travelling through, a country affected by the disease. And in some of these countries, you’ll need to show certificates to prove you’ve been vaccinated before you can enter. In the UK, you can only get the vaccination at approved yellow fever vaccination centres.
Arrange to have the yellow fever vaccine at least 10 days before you travel. You’ll be given a certificate that lasts for 10 years. You can then have a booster after this if you’re still at risk of getting yellow fever.
If you need to travel, you’ll need to weigh up the risk of getting the disease against the potential risk of harm to your baby.
If possible, it’s best not to travel to an area with a high risk of disease when you’re pregnant. But if you need to, you may need to have vaccinations.
In theory, if you have a live vaccine, there’s a chance your baby will become infected with the disease. But it’s not known how likely this is to happen. You might be able to have some types of vaccines that are considered safe.
It’s probably best to have most of the recommended vaccines if there’s a risk that you might get infected. This is because you and your baby could be at more risk if you get an infection, such as typhoid and hepatitis. Ask your GP or travel clinic for more information and advice if you’re travelling and pregnant.
Some medicines can affect travel vaccinations. So let your GP or travel clinic know if you’re taking any before you have your vaccine.
Tell your GP or travel clinic if you’re taking any medicines and where you plan to travel to. Only some vaccines affect certain medicines. Some of these are listed below.
- The typhoid vaccine that comes as a capsule may be affected by antibiotics, so you can’t take these at the same time. Antibiotics may stop the vaccine from working properly. If you’re taking antibiotics, your GP or travel clinic may offer you a typhoid injection instead.
- The antimalarial medicine chloroquine can affect how your body responds to the rabies vaccine. If you’re taking this, your doctor will need to give you the rabies injection deep into your muscle rather than just into your skin.
Ask your GP or travel clinic if the vaccines you need may interfere with any medicines you take.
No, there isn't a vaccination to prevent malaria but there are tablets you can take to help prevent it. But these don’t always work so the most important thing to do is to prevent being bitten by mosquitos in the first place.
Malaria is a tropical disease that you get if you’re bitten by a mosquito that’s infected with a parasite. It can be a serious condition and even life-threatening.
You can get malaria in tropical and sub-tropical countries all over the world. There are several different tablets available to prevent malaria targeted at certain parts of the world. Ask a GP or travel clinic which tablets are best for the country you’re travelling to. Go and see them about a month before you’re due to travel. You’ll need to start taking malaria tablets before you travel, while you’re away and when you return to the UK. It’s really important to follow the instructions and finish the full course when you come back to the UK to make sure you’re properly protected.
Taking medicines to prevent malaria may not totally protect you, so it’s important to try and prevent mosquito bites.
- Use an insect repellent.
- Use a mosquito net when you sleep if you’re staying in a hotel without air-conditioning or insect netting over the windows.
- Wear long trousers, long-sleeved tops and footwear after dusk to cover up your skin.
Live vaccines contain a weakened virus or bacterium designed to help your body develop an immune response without you developing symptoms of the disease itself. Inactivated vaccines use parts of a dead virus or bacteria to help your body develop an immune response.
Live vaccines include:
- yellow fever
- oral typhoid vaccine
- BCG (tuberculosis vaccine)
- some childhood vaccines, such as the MMR jab
Inactivated vaccines include:
- hepatitis A
- hepatitis B
- meningococcal meningitis
- Japanese encephalitis
If you have a healthy immune system, then it’s safe for you to have live virus vaccines. If you have a weakened immune system (from having HIV/AIDS or chemotherapy treatment, for example), you may not be able to have some live vaccines. Ask your doctor if it’s safe for you to have a vaccine.
- Travel Health Pro
- Immunizations – travel. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2015
- The green book. Immunisation against infectious disease. Public Health England. www.gov.uk, published 17 December 2013
- Yellow fever. BMJ Best Practice. bestpractice.bmj.com, last updated 10 June 2016
- Immunizations – childhood. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised July 2016
- Cholera. World Health Organization. www.who.int, last update 11 February 2015
- The yellow book. CDC health information for international travel. Centers for Disease Control and Prevention. www.cdc.gov, published 2016
- Hepatitis A. Travel Health Pro. travelhealthpro.org.uk, published 15 August 2016
- Hepatitis B. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2014
- Immunizations. Institute for Clinical Systems Improvement. www.icsi.org, update March 2012
- Meningitis – bacterial meningitis and meningococcal disease. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised March 2016
- Poliovirus infection. BMJ Best Practice. bestpractice.bmj.com, last updated 21 June 2016
- Rabies. World Health Organization. www.who.int, published March 2016
- Rabies. Travel Health Pro. travelhealthpro.org.uk, published 15 August 2016
- Tetanus. Travel Health Pro. travelhealthpro.org.uk, published 5 May 2016
- Tick-borne encephalitis. Travel Health Pro. travelhealthpro.org.uk, published 6 July 2015
- Yellow fever. BMJ Best Practice. bestpractice.bmj.com, last updated 10 June 2016
- Malaria infection. BMJ Best Practice. bestpractice.bmj.com, last updated 17 June 2016
- Guidelines for malaria prevention in travellers from the UK 2015. Public Health England. www.gov.uk, published September 2015
- Travel Health Pro
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Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, September 2016.
Expert reviewed by Dr Adrian Raby, General Practitioner and Clinical Lecturer.
Next review due September 2019.
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