Vaccinations for travellers abroad

June 1, 2016 Medical Articles

Vaccinations for travellers abroad

The following vaccinations are available for people travelling abroad:

Cholera vaccination

Vaccination against cholera isn’t routinely needed for most travellers. However, in some cases it may be recommended for aid workers and people likely to have limited access to medical services – for example, people working in refugee camps or after natural disasters.

Most cases of cholera are confined to regions of the world with poor sanitation and water hygiene, such as parts of:

sub-Saharan Africa
south and southeast Asia
the Middle East
central America and the Caribbean

The vaccine is usually given as a drink in two separate doses, taken one to six weeks apart. Children aged two to six years old should have a third dose taken one to six weeks after the second dose. You should make sure you have the final dose of this vaccine at least a week before you travel.

A single booster dose or full revaccination is usually recommended if you’ve previously been vaccinated against cholera and you’re planning to travel to an area where the infection is common.

Diphtheria vaccination

A combined vaccination that protects against diphtheria, polio and tetanus is routinely given to all children in the UK. You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

Further booster doses are usually only recommended if you’re going to visit parts of the world where diphtheria is widespread and your last vaccination dose was more than 10 years ago.

Diphtheria is more common in parts of the world where fewer people are vaccinated, such as:

Africa
south Asia
the former Soviet Union

Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

Read more about the diphtheria travel vaccine.

Hepatitis A vaccination

Vaccination against hepatitis A is recommended if you’re travelling to countries where hepatitis A is widespread, particularly if you’re staying for a long period or somewhere with poor levels of sanitation and hygiene.

Areas with a high risk of hepatitis A include:

sub-Saharan and north Africa
the Indian subcontinent – particularly Bangladesh, India, Nepal and Pakistan
some parts of the Far East – excluding Japan
the Middle East
south and central America

The vaccination against hepatitis A is usually given as a single initial injection, with an optional booster dose 6 to 12 months later that can protect you for at least 20 years if necessary.

You should preferably have this initial dose at least two weeks before you leave, although it can be given up to the day of your departure if needed.

Jabs that offer combined protection against hepatitis A and hepatitis B or typhoid are also available if you’re likely to also be at risk of these conditions.

Read more about the hepatitis A vaccine.

Hepatitis B vaccination

Vaccination against hepatitis B is recommended if you’re travelling in parts of the world where hepatitis B is common, especially if you’ll be doing activities that increase your risk of developing the infection.

As hepatitis B is spread through blood and body fluids, activities such as having sex, injecting drugs or playing contact sports on your travels can increase your risk. Anyone travelling for long periods or who is likely to need medical care while abroad is also at increased risk.

Hepatitis B is found worldwide, but it’s more common in:

sub-Saharan Africa
east and southeast Asia
the Middle East
southern and eastern Europe

The hepatitis B vaccination generally involves a course of three injections. Depending on how quickly you need protection, these may be spread over a period as long as six months or as short as three weeks.

A combined hepatitis A and hepatitis B jab is also available if you’re likely to be at risk of both these conditions while travelling.

Read more about the hepatitis B vaccine.

Japanese encephalitis vaccination

Vaccination against Japanese encephalitis is usually recommended if you’re planning a long stay (usually at least a month) in a country where the condition is widespread. It’s particularly important if:

you’re visiting during the rainy season
you’re going to visit rural areas – such as rice fields or marshlands
you’ll be taking part in any activities that may increase your risk of becoming infected – such as cycling or camping

Japanese encephalitis is found throughout Asia and beyond. The area it’s found in stretches from the western Pacific islands in the east, such as Fiji, across to the borders of Pakistan in the west. It’s found as far north as Korea and as far south as the north coast of Australia.

Despite its name, Japanese encephalitis is now relatively rare in Japan because of mass immunisation programmes.

See the US Centers for Disease Control and Prevention (CDC) website for a map of Japanese encephalitis risk areas.

Vaccination against Japanese encephalitis usually consists of two injections, with the second dose given 28 days after the first. Ideally, you need to have the second dose a month before you leave.

Read more about the Japanese encephalitis vaccine.

Meningococcal meningitis vaccination

Vaccination against meningococcal meningitis is usually recommended if you’re travelling to areas at risk and your planned activities put you at higher risk – for example, if you’re a long-term traveller who has close contact with the local population.

High-risk areas for meningococcal meningitis include parts of Africa and Saudi Arabia. All travellers to Saudi Arabia for the Hajj or Umrah pilgrimages are required to show proof of vaccination.

If travelling to a high-risk area, you should be vaccinated against meningococcal meningitis with an ACWY vaccine, also known as the quadrivalent meningococcal meningitis vaccine. This is a single injection that should be given two to three weeks before you travel.

You should have the ACWY vaccine before travelling to high-risk areas, even if you had the meningitis C vaccine as a child.

Read more about the meningococcal meningitis vaccine.

MMR (measles, mumps and rubella) vaccination

The MMR vaccine that protects against measles, mumps and rubella is routinely given to all children in the UK. You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

If you’ve not been fully vaccinated against these conditions or you’re not already immune, the MMR vaccination is recommended before travelling to areas where these conditions are widespread or where there’s been a recent outbreak.

The MMR vaccine is given as two injections. These are usually given when a child is 12 to 13 months old and when they start school. However, adults can have the two doses one month apart, and children can have them three months apart if necessary.

You should ideally have the final dose at least two weeks before you leave.

Polio vaccination

Further booster doses are usually only recommended if you’re going to visit parts of the world where polio is widespread and your last vaccination dose was more than 10 years ago.

Currently, the condition is most common in Pakistan, Afghanistan and Nigeria, but it’s also a risk in other regions of the world.

Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

Read more about the 3-in-1 Td/IPV vaccine.

Rabies vaccination

Vaccination against rabies is advised if you’re travelling to an area where rabies is common in animals, particularly if:

you’re staying for a month or more
there’s limited access to medical services
you’ll be carrying out activities that could expose you to rabies – such as cycling or running

Rabies can be found in many parts of the world. The GOV.UK website provides a detailed list of countries that have rabies in domestic animals or wildlife.

Vaccination usually requires a course of three injections. The second dose is given seven days after the first, and the third dose is given 14 to 21 days after the second.

Further doses aren’t usually recommended for travellers, unless it’s been more than 10 years since you were first vaccinated and you’re visiting an area with a high risk of rabies.

Tetanus vaccination

A combined vaccination that protects against diphtheria, polio andtetanus is routinely given to all children in the UK. You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

Further booster doses are usually only recommended if you’re travelling to areas where access to medical services is likely to be limited or your last vaccination dose was more than 10 years ago.

Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

Read more about the 3-in-1 Td/IPV vaccine.

Tick-borne encephalitis vaccination

Vaccination against tick-borne encephalitis (TBE) is usually recommended for anyone who plans to live or work in a high-risk area, or hike and camp in these areas during late spring or summer.

The ticks that cause TBE are mainly found in forested areas of central, eastern and northern Europe, although at-risk areas also include eastern Russia and some countries in east Asia, particularly forested regions of China and Japan.

The vaccination requires a course of three injections for full protection. The second dose is given one to three months after the first and provides immunity for about one year. A third dose, given 5 to 12 months after the second, provides immunity for up to three years.

The course can sometimes be accelerated if necessary. This involves two doses being given two weeks apart.

Booster doses of the vaccine are recommended every three years if necessary.

Read more about the tick-borne encephalitis vaccine.

Tuberculosis (TB) vaccination

Vaccination against tuberculosis (TB) is given to some children in the UK who are at increased risk from tuberculosis.

For travellers, the BCG vaccination – which protects against TB – is recommended for people under 16 who:

will be living or working with local people for three months or more
haven’t been previously vaccinated

The BCG vaccine is given as a single injection.

Parts of the world that have high rates of TB include:

Africa – particularly sub-Saharan Africa and west Africa
southeast Asia – including India, Pakistan, Indonesia and Bangladesh
Russia
China
South America
the western Pacific region (to the west of the Pacific Ocean) – including Vietnam and Cambodia

For a world map showing countries with high rates of TB, see theWorld Health Organization (WHO) website.

Typhoid vaccination

Vaccination against typhoid fever is recommended if you’re travelling to parts of the world where the condition is common, particularly if you’ll:

be staying or working with local people
have frequent or prolonged exposure to conditions where sanitation and food hygiene are likely to be poor

High-risk areas include:

the Indian subcontinent
Africa
south and southeast Asia
South America
the Middle East
Europe
Central America

Two main vaccines are available for typhoid fever in the UK. One is given as a single injection, and the other is given as three capsules to take on alternate days. It’s also possible to have a combined hepatitis A and typhoid jab.

Ideally, the typhoid vaccine should be given at least one month before you travel, but it can be given closer to your travel date if necessary.

Booster vaccinations are recommended every three years if you continue to be at risk of infection.

Yellow fever vaccination

Vaccination against yellow fever is advised if you’re travelling to areas where there’s a risk of yellow fever transmission. Some countries require a proof of vaccination certificate before they let you enter the country.

Yellow fever is most common in some areas of tropical Africa and South America. A map and list of countries where yellow fever is foundis available on the NHS fitfortravel website.

A booster dose of the yellow fever vaccine is currently recommended every 10 years if you’re still at risk. However, this is likely to change in the future as recent evidence suggests a single dose offers lifelong protection.

You must have a yellow fever vaccination at least 10 days before you travel.

Read more about the yellow fever vaccine.

Where further advice is required

Speak to your GP before having any vaccinations if:

you’re pregnant
you’re breastfeeding
you have an immune deficiency
you have any allergies

Vaccinations for travellers abroad