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What jabs do I need?

Get informed about your travel injections with our expert information from the NHS.

Confused about what vaccinations you need? Overloaded with injection information?

Good news! Our comprehensive list outlines:

  • Exactly what diseases and infections the vaccinations are protecting against
  • The areas of the world at risk from these problems
  • How many injections you need to ensure immunity

When planning a trip you should visit your GP or a professional at a travel clinic as soon as possible for personalised advice. They will also have the answers to any further questions you may have, as well as information about that organisation’s prices.

For the most up to date and detailed vaccination advice, go to the NHS Fit for Travel website and search by the country you are visiting.

Cholera

Cholera can cause severe diarrhoea and vomiting. This can quickly lead to severe dehydration, and can be fatal. It is spread through contaminated food, particularly shellfish and water.

High risk areas: Found in areas of the world with poor sanitation. In particular, parts of Africa, India, South East Asia, the Middle East, and parts of Central America.

The vaccination is not recommended for the majority of travellers. For most, normal food, water and hygiene precautions will be preventative. 

The vaccine
Two doses are needed to protect for two years. After this, a booster will be required. The vaccine is taken orally (by mouth), as a small amount of liquid to be swallowed. The doses must be given at least one week apart, but no more than six weeks apart and should be completed at least one week before travelling.

Diphtheria

Diphtheria is a bacterial infection that is spread through droplets from the coughs and sneezes of people with the condition. It affects the nose, throat, sometimes the skin, and it can be fatal.

High risk areas: Sub-Saharan Africa, and parts of South East Asia and South America. In the UK, children are vaccinated against diphtheria which means that you may already be protected.

The vaccine
If you have never been vaccinated, you will need three doses, one month apart. You can have a booster 5-10 years after this, followed by a second booster after another 10. You will then be protected for life. Anyone who has not been fully vaccinated (five doses), or has not had a booster dose in the last 10 years, will need to have a booster dose. The vaccine is usually combined with others, such as tetanus and polio.

Hepatitis A

Hepatitis A is an infection of the liver that is caused by the Hepatitis A virus. It is caught through contaminated food and water or through person-to-person contact if there is poor personal hygiene.

High risk areas: The Indian, African, Central American, and South American Subcontinents, the Far East, and Eastern Europe.

The vaccine
A single injection should be given two weeks before you leave, although it can be given up to the day of your departure if necessary. This will protect you for about a year. A booster dose, given 6-12 months after the first, will protect you for up to 20 years. A combined hepatitis A and B vaccine, and a combined hepatitis A and typhoid vaccine are also available.

Hepatitis B

Hepatitis B is an infection of the liver that can cause flu-like symptoms, liver failure, and can be fatal. It is spread through contact with infected blood, or body fluids – for example, through sexual intercourse or sharing needles.

High risk areas: Occurs worldwide but, in particular, Eastern Europe, Russia, India, China, South and Central America, Africa, South East Asia, and many of the South Pacific islands. The risk for tourists is usually considered to be low. However, some activities will increase your risk, such as unprotected sex.

The vaccine
Several different vaccines are available. Most require a course of three doses. The second dose is usually given one month after the first dose, and the third dose is then given five months later. Once you have completed the vaccination course, and a blood test has confirmed that you are immune, you will be protected for life. Healthcare workers are advised to have a booster dose after five years. A combined hepatitis A and B vaccine is also available.

Japanese encephalitis

Japanese encephalitis is passed to humans by bites from infected mosquitoes. It is usually mild but in some cases it can cause inflammation (swelling) of the brain (encephalitis), leading to permanent brain damage or death.

High risk areas: Tropical north east Australia and East Asia – including China, Myanmar (Burma), Thailand, Vietnam, Cambodia, Laos, Nepal, India, Philippines, Sri Lanka, Korea, Malaysia, Indonesia, and Singapore.


The vaccine
There are two options. Ideally, they need to be completed a month before you leave. One vaccine requires two doses, with the second dose given 28 days after the first. The alternative consists of three doses. The second dose is given after seven days, and the third dose is given 21 days after this. This vaccine needs to be completed at least 10 days before you leave, in case you have an allergic reaction.

Both vaccines will require a booster after one year. If there is not enough time to complete a normal course of the vaccine, you may be able to have an accelerated course. This involves two doses being given one week apart, or three doses with a week in between each dose. This still needs to be completed at least 10 days before you travel. You will need to have a booster three months later.

Meningococcal meningitis

Meningococcal meningitis (Groups A, Y, and W135) is a bacterial infection that can be serious, or even fatal, if not treated quickly. It is spread through contact with droplets from the coughs and sneezes of people with the condition. There are different groups (types or strains) that cause different meningococcal infections. Groups A, Y, and W135 are more common elsewhere in the world.

High risk areas: Parts of Africa and Saudi Arabia.

The vaccine
The Quadrivalent vaccine will protect you against groups A, C, Y and W135 meningitis. This should be given 2-3 weeks before you travel. A single dose provides protection for about five years.

Poliomyelitis

Poliomyelitis is a serious infection that is caused by a virus. It is spread through contact with human faeces (stools), contaminated food and water, or person-to-person contact.

High risk areas: Several countries in Africa, and the Indian Subcontinent. In particular, Nigeria, Niger, Egypt, Pakistan, Afghanistan, and India. In the UK, children are vaccinated against polio meaning many people will already be protected.

The vaccine
If you have never been vaccinated – three doses of the vaccine, each one month apart. You can have a booster dose 5-10 years later, followed by a second booster dose after another 10, and you will then be protected for life.

Anyone who has not been fully vaccinated against polio (five doses), or who has not had a booster dose in the last 10 years, will need to have a booster dose of the polio vaccine. The vaccine is usually combined with others, such as diphtheria and tetanus.

Rabies

Rabies causes spasms, extreme thirst, fear of water (hydrophobia), madness, and paralysis, and it is almost always fatal. Rabies is usually spread through the saliva of an animal carrying the virus. Vaccination against rabies is usually carried out as a precautionary measure, in case you are bitten by an animal that might have rabies and medical attention is not available.

High risk areas: Rabies is found in animals almost everywhere, but most human cases occur in Asia, Africa, and South and Latin America.

The vaccine
Vaccination usually requires a course of three doses. The second dose is given seven days after the first. The third dose is given 21 or 28 days after the first, depending on which vaccine is used. A booster dose will be needed every 2-5 years, to ensure continued protection.

Tetanus

Tetanus is a serious infection that affects the body’s nervous system, and it can be fatal. Tetanus bacteria are present in soil and manure and can enter the body through a wound or cut.

High-risk areas: Tetanus is found throughout the world. Any location where medical attention may not be available if you hurt yourself is considered to be a high risk area. In the UK, children are vaccinated against tetanus which means that many people will already be protected.

The vaccine
If you have never been vaccinated – three doses of the vaccine, each one month apart. You can have a booster dose 5-10 years after this, followed by a second booster dose after another 10, and then you will be protected for life. Anyone who has not been fully vaccinated (five doses), or has not had a booster dose in the last 10 years, will need to have a booster. The tetanus vaccine is usually combined with others such as diphtheria and polio.

Tick-borne encephalitis

Tick-borne encephalitis is a serious infection that can cause flu-like symptoms and inflammation of the brain (encephalitis), and can be fatal. It is usually spread through tick bites, but it can also be caught through drinking unpasteurised milk.

High risk areas: The far eastern part of the former Soviet Union, including eastern Russia and Siberia, some parts of China and Japan, western Russia, Austria, Hungary, the Balkans, Czech Republic, Slovakia and Scandinavia. Mainly found in forested areas.

The vaccine
The vaccination requires a course of three doses for full protection. The second dose is given 1-3 monthsaft er the first, and provides immunity for about one year. A third dose, given 5-12 months after the second, provides immunity for up to three years. A booster dose can be given up to three years after the third dose for continued protection. Boosters can continue to be given every 3-5 years if protection is still necessary.

If there is not enough time before you travel to complete a normal course of the vaccination, you may be able to have an accelerated course. This will involve two doses being given two weeks apart. Two weeks after the second dose, 90% of people who receive the accelerated course will have immunity against the condition.

Tuberculosis (TB)

Tuberculosis (TB) is a bacterial infection that is spread through droplets from the coughs and sneezes of people with the condition. It can cause a cough, weight loss, and night sweats, and can usually be cured with antibiotics.

High risk areas: South America, Africa (sub-Saharan and north west) and the tropical Asia-Pacific regions, including the Indian Subcontinent and Indonesia.

The vaccine
The Bacillus Calmette-Guérin (BCG) provides protection against TB. The vaccine used to be given to all children at 15 years of age, but this was stopped in 2005. If you need to be vaccinated, you will first be given a Mantaux skin test. This checks how sensitive you are to the TB vaccine. Your skin reaction will be checked 2-10 days later. A positive reaction suggests that you have already been infected with the bacteria that causes TB and you may already be immune. If so, you will not need to have the vaccine.

If you have a negative result to the Mantaux test, you will be given the vaccine as a single injection. It provides 70-80% protection.

Typhoid

Typhoid fever causes diarrhoea and a high temperature (fever) of 38°C (100.4°F) or over. It is spread through contact with human faeces (stools), usually as a result of poor sanitation and personal hygiene and it is potentially fatal.

High risk areas: Typhoid is found throughout the world, but it is more likely to occur in areas where there is poor sanitation and hygiene. In particular, risk areas include Africa, the Indian Subcontinent, South and South East Asia, the Middle East, and Central and South America.

The vaccine
Ideally, the vaccine should be given at least one month before you travel but, if necessary, it can be given closer to your travel date. The vaccine is not 100% effective, so you will still need to take precautions to avoid contaminated food or water, and pay careful attention to your personal hygiene. A single injection protects against typhoid fever for about three years. A combined typhoid and Hepatitis A vaccine is available.

Yellow fever

Yellow fever can cause headaches, a high temperature (fever) of 38C (100.4F) or over; bleeding, and it can be fatal. It is passed to humans through bites of infected mosquitoes.

High risk areas: Parts of Sub-Saharan Africa and South America. Some countries require you to have an International Certificate of Vaccination or Prophylaxis (ICVP) before they will let you into the country. The certificate proves that you have been vaccinated against yellow fever.

The vaccine
A single dose of the vaccine will provide protection against yellow fever for 10 years. After this time, a booster dose will be required. You will need to have the yellow fever vaccine a minimum of 10 days before you are due to travel. This is because your ICVP is only valid 10 days after your vaccination and then remains valid for 10 years. The vaccination is only available from designated centres. If you cannot be vaccinated against yellow fever for medical reasons GP may be able to issue you with a medical waiver letter. This will explain why you are unable to have the vaccine.

How much will these vaccinations cost and where can I get them?

Not all travel vaccinations are free, and not all will be available from your GP. If you know which vaccinations you need, it is a good idea call your GP surgery to find out whether they are available there and how much they will cost.

If your GP cannot provide the vaccinations that you need, they should be able to refer you to a specialist travel clinic. Alternatively, you can use our useful links to find a travel clinic in your area. Yellow fever vaccines are only available from designated centres. The National Travel Health Network and Centre (NaTHNaC) can help you find where you can get a yellow fever vaccination.

Cost

The following vaccines are provided free of charge, by the NHS, for overseas travel, regardless of the purpose of travel: cholera, diphtheria, poliomyelitis, and tetanus booster, hepatitis A, meningitis C, and typhoid.

The following vaccines are not usually available on the NHS (i.e. you will have to pay) for overseas travel: hepatitis B, Japanese encephalitis, other meningococcal vaccines, rabies, tick-borne encephalitis, tuberculosis, and yellow fever.

Your GP may charge for these vaccines (including an administration fee), although the fee will generally be less than at private clinics. The cost of travel vaccines at private clinics will vary, but could be around £50 for each dose of a vaccine. Therefore, if a vaccine requires three doses, the total cost could be around £150. It is worth taking this into consideration when budgeting for your trip.

Useful links

NHS
For more information on travel vaccines go to the NHS Choices website:

www.nhs.uk

Fit For Travel

www.fitfortravel.nhs.uk

The National Travel Health Network and Centre
For specific country by country vaccination information go to:

www.nathnac.org

Travel Health and vaccine information:

www.traveldoctor.co.uk

Travel Health Clinics:
MASTA: A provider of travel vaccines and travel health advice to the NHS which has national clinics

www.masta-travel-health.com

The Liverpool School of Tropical Medicine Travel Clinic:

www.welltravelledclinics.co.uk

The London School of Tropical Medicine Travel Clinic:

www.thehtd.org

List of clinics:

Travel Health

www.travelhealth.co.uk

If you get ill whilst away look at The International Association for Medical Assistance to Travellers (IAMAT) which provides a free database of English speaking doctors committed to helping travellers. You can register with IAMAT at: www.iamat.org











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