Travel vaccinations

Overview

Travel vaccinations
Travel vaccinations

If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fever, typhoid and hepatitis A.

In the UK, the NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

When should I start thinking about the vaccines I need?

If possible, see the GP or a private travel clinic at least 8 weeks before you're due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you're:

  • travelling in rural areas
  • backpacking
  • staying in hostels or camping
  • on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

Which travel vaccines do I need?

You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these websites:

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it's still a good idea to take a record of the vaccinations you have had with you.

Where do I get my travel vaccines?

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

You should also ask if the GP practice is signed up to provide free NHS vaccinations for travel, as not all GP practices are.

If the GP practice does not provide NHS vaccinations for travel, you can try a:

  • private travel vaccination clinic
  • pharmacy offering travel healthcare services

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area.

If the GP practice is signed up to provide NHS travel vaccines, these can be provided to you free of charge.

Other non-NHS travel vaccines may be charged for by the GP.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

  • written information on what vaccines are needed
  • the cost of each dose or course
  • any other charges you may have to pay, such as for some certificates of vaccination

Which travel vaccines are free?

The following travel vaccines are available free on the NHS if your GP practice is signed up to provide vaccination (immunisation) services.

  • polio (given as a combined diphtheria/tetanus/polio jab)
  • typhoid
  • hepatitis A
  • cholera

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?

You'll have to pay for travel vaccinations against:

  • hepatitis B
  • Japanese encephalitis
  • meningitis vaccines
  • rabies
  • tick-borne encephalitis
  • tuberculosis (TB)
  • yellow fever

Yellow fever vaccines are only available from designated centres.

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.

Other things to consider

There are other things to consider when planning your travel vaccinations, including:

  • your age and health – you may be more vulnerable to infection than others; some vaccines cannot be given to people with certain medical conditions
  • working as an aid worker – you may come into contact with more diseases in a refugee camp or helping after a natural disaster
  • working in a medical setting – a doctor, nurse or another healthcare worker may require additional vaccinations
  • contact with animals – you may be more at risk of getting diseases spread by animals, such as rabies

If you're only travelling to countries in northern and central Europe, North America or Australia, you're unlikely to need any vaccinations.

But it's important to check that you're up-to-date with routine vaccinations available on the NHS.

Pregnancy and breastfeeding

Speak to a GP before having any vaccinations if:

  • you're pregnant
  • you think you might be pregnant
  • you're breastfeeding

In many cases, it's unlikely a vaccine given while you're pregnant or breastfeeding will cause problems for the baby.

But the GP will be able to give you further advice about this.

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised.

This may be the case if:

  • you have a condition that affects your body's immune system, such as HIV or AIDS
  • you're receiving treatment that affects your immune system, such as chemotherapy
  • you have recently had a bone marrow or organ transplant

A GP can give you further advice about this.

Non-travel vaccines

As well as getting any travel vaccinations you need, it's also a good opportunity to make sure your other UK vaccinations are up-to-date and have booster vaccines if necessary.

If you have any records of your vaccinations, let the GP know what you have had previously.

People in certain risk groups may be offered extra vaccines.

These include vaccinations against diseases such as:

  • hepatitis B
  • tuberculosis (TB)
  • flu
  • chickenpox

 

Available vaccines

The following vaccinations are available for people travelling abroad.

Cholera vaccination

Vaccination against cholera isn't routinely needed for most travellers.

But 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 2 separate doses, taken 1 to 6 weeks apart.

Children aged 2 to 6 years old should have a third dose taken 1 to 6 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 have 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 make sure 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.

Hepatitis A vaccination

Vaccination against hepatitis A is recommended if you're travelling to countries where there are poor levels of sanitation and hygiene, and hepatitis A is common.

Ask your GP, pharmacy or travel clinic if you should have the hepatitis A vaccine if you're travelling to:

  • sub-Saharan Africa
  • Asia
  • the Middle East
  • South and Central America

The vaccination against hepatitis A is usually given as a single initial injection, with a second dose 6 to 12 months later. Two doses should protect you for at least 20 years.

You should preferably have the initial dose at least 2 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.

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.

Hepatitis B is spread through blood and body fluids. Things like having sex, injecting drugs or playing contact sports on your travels can increase your risk.

Anyone travelling for long periods or who's likely to need medical care while abroad is also at increased risk.

Hepatitis B is found worldwide, but it's more common in parts of:

  • Africa
  • Asia
  • the Middle East
  • southern and eastern Europe

The hepatitis B vaccination generally involves a course of 3 injections. Depending on how quickly you need protection, these may be spread over a period as long as 6 months or as short as 3 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.

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 you could get the condition.

It's particularly important if:

  • you're visiting during the rainy season or there's a year-round risk because of a tropical climate
  • 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, across to the borders of Pakistan in the west.

It's found as far north as northeastern China and as far south as the islands of the Torres Strait and Cape York in northeastern Australia.

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

Find out more about risk areas on the Travel Health Pro website

Vaccination against Japanese encephalitis usually consists of 2 injections, with the second dose given 28 days after the first.

Ideally, you need to have the second dose a week before you leave.

Meningococcal meningitis vaccination

Vaccination against some types of 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 during the mass gatherings of Hajj or Umrah.

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 a MenACWY vaccine, also known as the quadrivalent meningococcal meningitis vaccine.

This is a single injection that should be given 2 to 3 weeks before you travel. Babies under a year old need 2 injections.

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

Measles, mumps and rubella (MMR) vaccination

The MMR vaccine that protects against measles, mumps and rubella is routinely given to all children in the UK. 

You should make sure you and your children are up-to-date with routine vaccinations, including MMR, before travelling.

If you haven't been fully vaccinated against these conditions or you're not already immune, you should ask about MMR vaccination before you travel.

The MMR vaccine is given as 2 injections. These are usually given when a child is 12 to 13 months old and when they start school.

But if vaccination has been missed previously, adults can have the doses 1 month apart, and children can have them 3 months apart if necessary.

You should ideally have the final dose at least 2 weeks before you leave.

Polio vaccination

A combined vaccination that protects against diphtheria, polio and tetanus is routinely given to all children in the UK.

You should make sure 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 polio is, or has recently been, present 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.

Rabies vaccination

Vaccination against rabies is advised if you're travelling to an area where you could get rabies, particularly if:

  • you're staying for a month or more
  • there's unlikely to be quick access to appropriate medical care
  • you plan to do activities that could put you at increased risk of exposure to rabies, such as cycling or running

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

Vaccination involves a course of 3 injections before you travel, usually given over a period of 28 days.

If you're bitten, licked or scratched by an animal in a country where rabies is a problem, further doses of rabies vaccine (with or without a special anti-rabies injection given around the wound) may be required as emergency treatment.

Tetanus vaccination

A combined vaccination that protects against diphtheria, polio and tetanus is routinely given to all children in the UK.

You should make sure 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.

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, including some regions of China and Japan.

The vaccination requires a course of 3 injections for full protection. The second dose is given 1 to 3 months after the first and provides immunity for about a year.

A third dose, given 5 to 12 months after the second, provides immunity for up to 3 years.

The course can sometimes be accelerated if necessary. This involves 2 doses being given 2 weeks apart.

Booster doses of the vaccine are recommended every 3 years, if necessary.

Tuberculosis (TB) vaccination

The BCG vaccine (which stands for Bacillus Calmette-Guérin vaccine) protects against tuberculosis, which is also known as TB.

The BCG vaccine isn't given as part of the routine NHS vaccination schedule. It's given on the NHS only when a child or adult is thought to have an increased risk of coming into contact with TB.

When preparing for travel abroad, the BCG vaccine is recommended for any unvaccinated people under 16 who'll be living or working with friends, family or local people for more than 3 months in a country where TB is common or the risk of multi-drug resistant TB is high.

The BCG vaccine is given as a single injection.

Areas of the world where the risk of TB is high enough to recommend BCG vaccination for previously unvaccinated travellers include:

  • the Indian subcontinent (Bangladesh, Pakistan, India)
  • Africa
  • parts of south and southeast Asia
  • parts of South and Central America
  • parts of the Middle East

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: 

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

High-risk areas include:

  • the Indian subcontinent (Bangladesh, Pakistan, India)
  • Africa
  • parts of south and southeast Asia
  • parts of South and Central America
  • parts of the Middle East

Two main vaccines are available for typhoid fever in the UK. One is given as a single injection, and the other is given as 3 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 1 month before you travel, but it can be given closer to your travel date if necessary.

Booster vaccinations are recommended every 3 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 getting yellow fever.

Some countries require a proof of vaccination certificate before they let you enter the country.

Yellow fever occurs in some areas of tropical Africa and Central and South America. More information about yellow fever and areas where it's found is available on Travel Health Pro.

A single dose of the yellow fever vaccine is thought to provide lifelong protection. For most people, a booster dose is no longer recommended.

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

You should be issued with an International Certificate of Vaccination or Prophylaxis when you have the vaccine. This certificate is valid for life.

When to get further advice

Speak to your GP before having any vaccinations if:

  • you're pregnant
  • you're breastfeeding
  • you have an immune deficiency
  • you have any allergies

Leaflets

Welsh Government Leaflets

Am I at risk of Hepatitis B? pdf

Travel immunisation poster pdf



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 25/05/2021 10:09:18