Travel Vaccinations

16th November 2016. Updated 17th November 2024


Vaccinations are a fundamental part of pre-trip planning but, as with all medications, are not to be relied on solely.  Vaccinations may reduce the risk of infection but not all completely eliminate it.  The risk of contracting a water-borne pathogen, for example, is already greatly reduced by diligent personal hygiene and being careful of what you eat and drink (see Diarrhoea & Vomiting for more information).   PPE will reduce the risk of contracting a bloodborne pathogen.  With this in mind a holistic approach should be applied to infection control; being vaccinated does not necessarily mean you are safe and protected.

 

Sources of information

Before you travel, as an absolute minimum, find out about the health and security risks in the area you are travelling to.  The following are reliable sources of current information:

Foreign & Commonwealth Office - First port of call for up-to-date travel, health and safety advice searchable by country.

Travel Health Pro - More detailed country-based travel health information and outbreak surveillance from the National Travel Health Network and Centre (NaTHNaC)

World Health Organisation - Comprehensive health and medical advice for travellers

Travel Aware - UK Home Office basic travel safety advice.


Maintaining records

Keep a record of your vaccinations:  Some will last a lifetime whilst some will last as little as 12 months.  

1. Calendar

At the very least enter the expiration dates to your vaccinations into your cloud-based calendar three months before they expire.   Some vaccinations require a series of doses spread over a set period of time whilst others require an incubation period to develop full efficacy.

Don't leave it to the last minute.


2. Medical Info Screen on your Phone

All iPhones and most Android phones now have the “Medical ID” or “Medical Info” page on the Emergency Call screen.

See how to set this up here.

If you have a secure phone that is not linked to Google or other cloud-based software. Enter your vaccination dates here.



3. Spreadsheet

In addition to your calendar, keep a spreadsheet of your vaccinations, the dates they were administered and when they expire.  This can be useful if:

  • You plan to travel or work abroad for an extended period of time - will your vaccinations expire while you are abroad?

  • You need to provide dates of vaccinations to your employer before deployment.

This is a simple Excel Spreadsheet for you to download.  If you enter the details of your immunisations the rows will change to yellow if they are past their expiration date.  (This form can be edited - instructions supplied.   Save this file to a cloud-based storage service such as Google Drive or DropBox so you can access and maintain it from your phone when you need it.

 

Travel Related Diseases

 
Vaccine Description Schedule Period of protection
Cholera Cholera is a bacterial infection spread through contaminated water, as such it is most often associated where there is poor sanitation such as sub-Saharan Africa, south and south-east Asia, the Middle East, central America and the Caribbean. Symptoms include severe vomiting and diarrhoea and stomach cramps. The Cholera vaccination Dukarol is given as two or three drinks given at six week intervals. 80-85% Effective at 6 months. 63% effective at 3 years.
Additional doses should be repeated every 2 years for frequent travellers.
Diphtheria An upper respiratory tract illness caused by Corynebacterium diphtheriaebacteria. It is characterized by sore throat, low fever, and a greyish adherent membrane on the tonsils, pharynx, and/or nasal cavity. Diphtheria is spread by both direct contact with and air-born contamination from infected individuals. Received in childhood. Booster recommended if travelling to high-risk areas 10 years
Encephalitis - Japanese Japanese encephalitis is a type of viral brain infection that is spread through mosquito bites. It's most common in rural areas throughout South East Asia, the Pacific islands and the Far East, but is very rare in travellers. Domestic pigs and wild birds (herons) are reservoirs of this virus; transmission to humans is most prevalent via mosquitoes Culex tritaeniorhynchus and Culex vishnui. Severe rigors mark the onset of this disease in humans. Fever, headache and malaise are other non-specific symptoms of this disease which may last for a period of between 1 and 6 days. Signs which develop during the acute encephalitic stage include neck rigidity, cachexia, hemiparesis, convulsions and a raised body temperature between 38–41 °C (100.4–105.8 °F). Mental retardation developed from this disease usually leads to coma. 0 and 28 days 1-2 years
Encephalitis - Tick Borne Tick-borne encephalitis is a viral infection. Initial symptoms of TBE are similar to flu and can include a high temperature, headache, tiredness and muscle pain. These symptoms usually last for up to eight days, after which point most people make a full recovery. Some people may go on to develop more serious symptoms caused by the virus spreading to the layer of protective tissue that covers the brain and spinal cord (meningitis) or the brain itself (encephalitis). These ‘second-stage’ symptoms can include altered mental state, seizures, sensitivity to bright light, an inability to speak or paralysis. If TBE reaches this stage, you will usually need to be admitted to hospital. These symptoms tend to get slowly better over a few weeks, but it may take several months or years to make a full recovery and there is a risk you could experience long-term complications. Around one in every 100 cases of TBE is fatal. 3 injections at 0, 1-3 and 5-12 months 3 years
Hepatitis A Hepatitis A is a type of viral liver infection spread by through faeces. Initial symptoms of hepatitis A are similar to flu and include low grade fever, joint pain, nausea and vomiting. This may then be followed by symptoms related to the liver becoming infected, such as jaundice, dark coloured urine and pale faeces, abdominal pain and itchy skin. Single injection ideally given 2 weeks before departure for travel 1 year. A booster received after 6 - 12 months can provide protection for up to 20 years.
Hepatitis B Hepatitis B is a type of virus that can infect the liver. Symptoms can include sickness and nausea, loss of appetite, flu-like symptoms, and jaundice. Hepatitis B is blood borne and through other body fluids. Many people don’t realise they have been infected with the virus, because the symptoms may not develop immediately, or even at all. It takes between 40 and 160 days for any symptoms to develop after exposure to the virus. 0, 1 and 6 months 5 years. A single booster at 5 years is believed to provide 25 years protection but should be renewed at 5 years for those at risk.
Hepatitis C Hepatitis C is a blood borne virus that can infect the liver. If left untreated, it can sometimes cause serious and potentially life-threatening damage to the liver over many years. However, with modern treatments it's often possible to cure the infection and most people with it will have a normal life expectancy. No Vaccine
Hepatitis D Hepatitis D is only present in people already infected with hepatitis B. Chronic hepatitis D can increase the risk of cirrhosis developing. Cirrhosis is more likely to develop in someone with chronic hepatitis B becoming infected with hepatitis D (superinfection). It is much rarer when both infections occur together (co-infection). Requires Hep B Vaccine
Hepatitis E Generally a mild and short-term infection. It is caught by putting something in your mouth that has been contaminated with the faeces of someone with hepatitis E. Person-to-person transmission is rare. No Vaccine
HIV Human Immunodeficiency Virus (HIV) is found in semen, blood, vaginal and anal fluids, and breastmilk. It is mainly passed on through unprotected sex, sharing needles or syringes and during pregnancy, birth or breastfeeding. HIV can’t be transmitted through sweat, saliva or urine.

The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months after being infected, many are unaware of their status until the later stages. In the first few weeks after initial infection people may experience no symptoms or an influenza-like illness including fever, headache, rash or sore throat. As the infection progressively weakens the immune system, they can develop other signs and symptoms, such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis (TB), cryptococcal meningitis, severe bacterial infections, and cancers such as lymphomas and Kaposi's sarcoma.

HIV is global disease but more prevalent in some countries than others, principally in South Africa and Sub-Saharan Africa.

People with HIV can enjoy a long and healthy life by taking antiretroviral treatment (ART) which is effective and available to all. ART can reduce the level of HIV in the body (the viral load) to such low levels that blood tests cannot detect it (known as ‘undetectable’). Having an undetectable viral load means you cannot pass on HIV.

94% of these people are diagnosed, and therefore know that they have HIV. This means that around 1 in 16 people living with HIV in the UK do not know that they have the virus. 98% of people diagnosed with HIV in the UK are on treatment, and 97% of those on treatment are virally suppressed which means they can’t pass the virus on. Of all the people living with HIV in the UK, 89% are virally suppressed. 		No Vaccine
Influenza - Domestic An annual Influenza vaccine is available for those at risk (such as children, elderly or those with weak immune systems). Vaccination could be considered when traveling to areas of high levels of outbreak. The normal influenza vaccine is not effective against Asian Bird Flu (H5N1 or H7N9). 1 injection 1 year
Malaria Malaria is a parasitic infection transmitted from person to person by the bite of infected female Anopheles mosquitoes. Once transferred to the human body, the infection travels to the liver where it multiplies and then enters the red blood cells. Inside the red blood cells, the parasites rapidly multiply until they burst, releasing even more parasites into the bloodstream.

There are four main species of the malaria parasite: Plasmodium falciparum, Plasmodium malariae, Plasmodium vivax and Plasmodium ovale. P. falciparum is the leading cause of severe clinical malaria and death.

Malaria begins as a flu-like illness, with symptoms first occurring 9-14 days after infection. Symptoms include fever (typical cycles of fever, shaking chills, and drenching sweats may develop), joint pain, headaches, frequent vomiting, convulsions and coma. If uncomplicated malaria is left untreated, it can become severe – around eight million cases progress to severe malaria annually. Death from malaria may be due to brain damage (cerebral malaria), or damage to vital organs. The reduction of red blood cells can cause anaemia. 		Prophylactic medication Chloroquine and proguanil hydrochloride ("Malarone") be started 1 week before travel into an endemic area.

Mefloquine should be started 2–3 weeks before travel.

Atovaquone with roguanil hydrochloride or doxycycline 1–2 days before travel.

Prophylaxis should be continued for 4 weeks after leaving the area (except for atovaquone with proguanil hydrochloride prophylaxis which should be stopped 1 week after leaving).
Meningococcus A,B, C W135, X, Y Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis (also termed meningococcus). It carries a high mortality rate if untreated. While best known as a cause of meningitis, widespread blood infection is more damaging and dangerous. Meningitis and meningococcemia are major causes of illness, death, and disability in both developed and underdeveloped countries worldwide. The disease is transmitted through saliva and occasionally through close, prolonged general contact with an infected person. There are several strains of Meningitis including A,B, C W135, X and Y. A combined ACWY Men ACWY Combined Vaccine 3-5 years
Meningitis B at 0 and 1 month for adults Life
Polio Poliomyelitis is an acute, viral, infectious disease spread from person to person, primarily via the faecal-oral route but also through open wounds leading to inflammation of the spinal cord’s grey matter. In about 1% of cases, the virus enters the central nervous system, preferentially infecting and destroying motor neurons, leading to muscle weakness and acute flaccid paralysis. Received in childhood Life
Rabies A viral disease that causes acute encephalitis in warm-blooded animals. The disease is zoonotic, meaning it can be transmitted to humans from another species (such as dogs), commonly by a bite from an infected animal. Rabies is nearly always fatal in humans if postexposure prophylaxis is not administered before the onset of severe symptoms. The rabies virus infects the central nervous system, ultimately causing disease in the brain and death. 0, 7 and 21 days 2-3 years

Those working in high-risk areas or industries should consider Booster vaccinations every 5 years.
Tetanus Tetanus, also known as lockjaw, is a disease caused by the bacterium Clostridium tetani which enters the body through open wounds and releases a poison called tetanospasmin. This is a potentially deadly disease because the poison attacks the nervous system blocking nerve signals from the spinal cord to and from the muscles. Received in childhood 10 Years
Typhoid A common worldwide bacterial disease transmitted by the ingestion of food or water contaminated with the faeces of an infected person. Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. Over the course of these stages, the patient becomes exhausted and emaciated before death. Immunisation is either injected or taken orally, both with a 50%-80% efficacy. One dose 3 years
Yellow Fever The yellow fever virus is transmitted by the bite of female mosquitoes and is found in tropical and subtropical areas in South America and Africa, but not in Asia. The only known hosts of the virus are primates and several species of mosquito. Yellow fever presents in most cases in humans with fever, chills, anorexia, nausea, muscle pain (with prominent backache) and headache, which generally subsides after several days. In some patients, a toxic phase follows, in which liver damage with jaundice can occur and lead to death. Because of the increased bleeding tendency (bleeding diathesis), yellow fever belongs to the group of haemorrhagic fevers. The World Health Organization estimates that yellow fever causes 200,000 illnesses and 30,000 deaths every year in unvaccinated populations; today nearly 90% of the infections occur in Africa. One dose Life
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References

1.       http://www.netdoctor.co.uk/medicines/infections/a8605/dukoral-cholera-vaccine/

2.       http://www.medsafe.govt.nz/profs/datasheet/d/Dukoralsusp.pdf

3.       http://www.nhs.uk/Conditions/Diphtheria/Pages/Prevention.aspx

4.       http://www.nhs.uk/Conditions/Tick-borne-encephalitis/Pages/Beforeyougopage.aspx

5.       http://www.nhs.uk/conditions/vaccinations/pages/hepatitis-b-vaccine.aspx

6.       Joint Committee on Vaccination and Immunisation (2006). "Chapter 18 Hepatitis B". Immunisation Against Infectious Disease 2006 ("The Green Book") (3rd edition (Chapter 18 revised 10 October 2007) ed.). Edinburgh: Stationery Office. p. 468. ISBN 0-11-322528-8.

7.       https://www.medicines.org.uk/emc/PIL.26513.latest.pdf

8.       https://www.medicines.org.uk/emc/PIL.27358.latest.pdf

9.       http://www.medicines.org.uk/emc/PIL.28408.latest.pdf

10.   http://www.nhs.uk/Conditions/Rabies/Pages/Prevention.aspx

11.   http://www.nhs.uk/Conditions/Typhoid-fever/Pages/Prevention.asp