This essential resource is a list of all the vaccinations you may need when travelling around the world, including which ones you should have as routine regardless of travel, which ones are strongly recommended by health care professionals no matter where you travel, which ones are advised for certain criteria only and finally which ones are necessary for travel in specific countries. It will also tell you why you need them and how they are administered.
Different destinations will have different vaccination requirements, and some of these do change from time to time. For specific recommendations on what vaccinations are recommended based on which country or region you are heading to you can look at the Bemused Backpacker destination guides for each individual country, see the Travel Health Pro (formerly NaTHNaC) website, the Centre of Disease Control and Prevention (CDC) website, or the NHS’ Fit For Travel website. Local travel clinics are also excellent resource for travellers.
Vaccinations are basically split into three categories. Routine vaccinations, which are the ones everyone should already have regardless of any travel or not, (most people will get these throughout childhood and their teens and they are offered for free in the UK on the NHS). Recommended vaccinations are the ones most backpackers need to think about. They are not offered routinely on the NHS and some will cost you, and the severity of the recommendation depends on what countries you are visiting and a few other factors. Required vaccinations are a little bit misleading, the vaccinations themselves are the same as the recommended vaccinations, the requirement part refers to the fact that proof of immunization is needed for entry into the country, but there are not many of these.
These are the basic vaccinations that most people should have as routine and are often routinely administered in childhood or throughout adult life for at risk groups such as the elderly or health workers.
These routine vaccinations include the BCG, diptheria, tetanus and pertusis (DTP), Hepatitis B, Hepatitis A (for at risk groups) heamophilus Influenzae type b, pneumococcal conjugate, rotavirus, measles, mumps and rubella (MMR) and Human papillomavirus HPV (for young girls only to prevent cervical precancers and cancers)
When giving any advice on recommended vaccinations for travel, it is often assumed by health professionals that you will already have these routine vaccinations and are up to date on any boosters. If you don’t have these vaccinations or boosters, then it should be assumed that it is always recommended to get them. They are available on the NHS in the UK, so if you do not have them for whatever reason or if you had them more than 10 years ago and may need a booster (dependent on the vaccine), go and get them now. If you are unsure, check with your GP or practice nurse who will have access to your past medical history and notes.
These vaccinations are not always required in every country, and recommendations do change from time to time as the spread and nature of certain diseases change. Dependent on the country or countries you are visiting, any or all of these vaccinations may be classed as not required at all, sometimes recommended, strongly recommended or recommended (which is to be read as essential).
Some vaccinations are very specific to certain countries and are technically only recommended if you are visiting that region. However it is wise to get inoculated against these diseases regardless, especially if you are travelling long term and extensively throughout different regions and will be heading to more rural parts of certain countries.
It is up to you to assess the risk for yourselves and decide whether you want the recommended vaccines or not, no one can force you to get them after all, but from a health professional point of view it simply isn’t worth taking risks when it comes to your health. So despite the fact that certain vaccinations may not be required in certain countries, and obviously you should pay attention to the vaccinations that are recommended first, as a health professional I would still strongly recommend you get all of them if you can. The chances of getting rabies on your travels for example may be extremely low, and you will still need to seek treatment, but it can be fatal if you are one of the few who do get it and you are not vaccinated. It is up to you whether you want to take that chance.
Cholera is rare in backpackers, but is spread by contaminated food and water in areas with poor sanitation. It is recommended to travellers heading to rural areas in particular, slum or refugee areas or conflict zones where access to medical facilities is limited. Outbreaks occur sporadically throughout the world.
The vaccination is administered over a period of 2 to 3 months. Once you have the vaccination, you will be immune for up to 2 years, after which you will need another vaccination.
This is a virus present in faeces and is usually caught by consuming contaminated food or water. It is common throughout Asia, Africa and Central and South America. The vaccination is recommended for any travel, but is particularly recommended to those travelling to any developing country where sanitation is poor. Good personal hygiene is also important to prevent the disease.
This vaccination should be administered at least 2 weeks before travel, and a further reinforcing dose will be required 6 to 12 months later. Once you have it the duration of immunity can be up to 20 years. You can also get this as combined vaccination with hepatitis B or Typhoid.
Japanese encephalitis is a viral disease causing a severe flu like illness spread by mosquitoes throughout South East Asia, particularly in rural areas such as rice and paddy fields, and can be more prevalent in wetlands. Chances of contracting the disease are low, but the consequences if you do get it can be fatal. It is recommended to all travellers to the region, but particularly those travelling to rural areas for extended periods or those travelling during the monsoon seasons.
You will need two doses of this vaccine spaced 28 to 30 days apart, so you should get your first dose at least a month before travelling. The immunity period is approximately 1 year.
There are two types of meningitis vaccine for the four different strains of meningitis, A, C, W and Y. The meningitis C vaccine is a routine vaccination for all UK children, and most travellers will have had this during their childhood. Vaccination against the other strains are sometimes recommended on top of this routine protection. Outbreaks have occurred in many regions throughout the world and in many cases the chances of contracting the disease are significantly higher than in the UK.
The vaccines are administered as a single dose and immunity lasts for 5 years.
Rabies is spread through the bite or saliva of an infected animal (especially if you have open wounds such as a cut or graze). For many countries it is not recommended at all, and it is only a sometimes recommended vaccine for most travellers. However, the vaccine becomes strongly recommended for any traveller who falls into an at risk group, including those who are travelling for extended periods or conducting activities that may expose them to the disease in areas with rabies and will have limited access to immediate post exposure medical facilities. It is also recommended for those volunteering or working with animals. Vaccination usually requires three doses for full protection, and you may still need to be treated with post exposure prophylaxis (PEP) if you contract it.
If you get bitten or suspect the saliva of an infected animal has entered your bloodstream (such as through an open cut), then seek help immediately even if you have the vaccine, as cases are almost always fatal once you become symptomatic.
The vaccine is administered in three doses, spaced a week, then a month after the first dose, and will last for 3 to 5 years.
Tick borne encephalitis.
This is a potentially serious virus spread by the bite of infected ticks found in wooded or forested areas of Central, Northern and Eastern Europe, with sub types found in Russia, Siberia and parts of China and Japan. Backpackers who travel to these areas and spend extended periods outdoors, especially in forested areas, are at risk.
The vaccine is administered in three doses, spaced 1 month then 6 months after the initial dose, so will need to be started at least 6 to 7 months before travel, and is effective for approximately 3 years.
Typhoid is called by bacteria called Salmonella and can contaminate food or drink in areas of poor sanitation. It can be very serious and even potentially fatal and the vaccination is recommended for all travellers to affected regions, especially the Indian subcontinent, Asia, South America and Africa, and particularly if they will be spending extended periods exposed to poor sanitation or hygiene conditions.
There are two types of vaccine, an oral and injectable variety, but the injectable variety is recommended. It is administered in a single dose and lasts for up to 3 years. It can also be administered in a combined injection with hepatitis A.
This is a serious disease that is spread through the bite of infected mosquitoes that tend to feed during daylight hours. It is prevalent throughout tropical Africa and South America. Symptoms can range from flu like fever to vomiting, jaundice or bleeding which can be fatal. The vaccination can only been given at accredited Yellow Fever Vaccination centres such as most GP practices and can take at least 10 days to become effective. The certificate is only valid 10 days after your injection too, so leave enough time to get your vaccination before you fly.
The vaccine is administered as a single dose injection, and up until very recently a booster dose used to be required every ten years. Now the yellow fever ‘booster’ vaccination given ten years after the initial vaccination is not necessary. The World Health Organisation (WHO) has stated that the Strategic Advisory Group of Experts on immunization (SAGE) has reviewed the latest evidence and concluded that a single dose of vaccination is sufficient to confer life-long immunity against yellow fever disease.
This term is slightly misleading as the vaccination itself is recommended on the same level as other recommended vaccinations depending on the prevalence of the disease in certain destinations. It is the visa restrictions by the governments of particular countries have made proof of these vaccinations mandatory for approved entry, which is what makes them ‘required’. If you are heading to or from a country that has disease control restrictions in place you will need to show proof of vaccination before entry known as an international certificate of vaccination or prophylaxis (ICVP).
If you are heading to any country where yellow fever is present, it is strongly recommended that you are vaccinated against it. Proof of vaccination is required by many countries throughout South America and Africa as a condition of entry if you are coming from a country where yellow fever is present. Failure to provide a valid certificate may lead to you being denied entry and turned away, or even quarantined and immunised.
Although it is strongly recommended that you get the vaccination before you travel you can get the Yellow Fever vaccination abroad whilst travelling if you need to, but do your research and ensure that it is a reputable clinic, and also ensure that you get the actual vaccination certificate at the airport by exchanging the note you got whilst getting the vaccination. It is this ICVP that is really important.
Meningococcal disease and polio.
Proof of vaccination is required for visitors to Saudi Arabia who visit Mecca and Medina during Hajj or Umrah.
Have you read all the information but still need a little more specific advice? Is there a travel health issue that you are worried about and need a little reassurance on? Need some information on malaria, or which vaccinations you will need? Is there a travel health issue you would like to ask about in complete confidence?
Well I am here to help.
Apart from being an experienced backpacker with over 10 years travel experience, I am also a qualified nurse with an interest in emergency nursing and travel medicine and practical experience volunteering as an expedition medic.
The Bemused Backpacker Travel Clinic is an indispensable online resource for you to gain a one on one consultation with a medical professional giving you personal reassurance, expert information and qualified advice for any and all of your travel health related questions. To head into the Travel Clinic, click here.