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.
What vaccinations you need for your travels will depend on where you are going, as well as other individual factors such as your own medical history and any recent outbreaks of specific diseases.
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: These are the ones everyone should already have regardless of any travel or not and are necessary parts of a healthy daily life, (most people will get these throughout childhood and their teens and they are offered for free in the UK on the NHS).
- Recommended vaccinations: These are usually destination specific and are the ones most backpackers need to think about. They are not offered routinely on the NHS and some may cost you. The severity of the recommendation depends on what countries you are visiting and a variety of other individual risk factors.
- Required vaccinations: These are a little bit misleading, the vaccinations themselves are the same as the recommended vaccinations in terms of the severity of the recommendation to get them for health purposes, the requirement part refers to the fact that proof of immunization is needed for entry into specific countries.
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 to a specific destination it is often assumed by health professionals that you will already have these routine vaccinations and are up to date on any boosters. That is why the recommended vaccinations for any given destination do not list these as routine.
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 have not had a booster (for those ones that require it) 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 and a variety of other individual risk factors, 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 may be 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 more strongly 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 and can’t get treatment in time. It is up to you whether you want to take that chance.
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.
Cholera is a bacterial infection that is spread by contaminated food and water in areas with poor sanitation. It is rare in backpackers and is not often recommended as a vaccine with a few exceptions, but is more often recommended to volunteers in disaster zones or those heading to rural areas where the disease is present for long periods of time, in particular, slum or refugee areas or conflict zones where access to medical facilities is limited. Outbreaks occur sporadically throughout the world.
The cholera vaccine is mixed with water and given orally as a drink. You should avoid eating, drinking or taking oral medication for an hour before and after having the vaccination. Two doses of the vaccine taken 1 to 6 weeks apart are needed to protect against cholera for two years. After this, a booster is required if you continue to be at risk.
Rabies is a viral infection that is present worldwide and is spread through the bite or saliva of an infected animal (especially if you have open wounds such as a cut or graze).There is no treatment or cure for rabies, and if you become symptomatic it is almost always fatal.
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.
The pre exposure vaccine is administered in three doses via an intramuscular injection. You need to start these injections at least one full month before travelling. The second dose will be given 1 week after the first, and then the final dose will be given 21 – 28 days after the first. The vaccination once administered will last for for up to ten years, after which time a booster should be considered.
You may still need to be treated with post exposure prophylaxis (PEP) if you contract it.
The vaccine does have some rare side effects in some people including fever, headache, muscle pain and vomiting. Not everyone will get these symptoms and they are temporary.
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 and during the rainy seasons.
Chances of contracting the disease are low, but the consequences if you do get it can be fatal. It is sometimes recommended to travellers to the region who may be in an at risk category, such as 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, and the final dose should be given at least a week before your departure date to ensure you are fully protected from any exposure. The immunity period is approximately 1 – 2 years after which time a booster will be required.
Meningococcal meningitis is an acute bacterial disease that can cause a severe flu like disease and is transmitted by sneezing, coughing or direct contact with respiratory secretions. There are 13 different serogroups of meningitis of which groups B and C are most common in the UK, and vaccinations for various strains of meningitis form part of the routine vaccinations for life in the UK and other Western countries.
Epidemics of the disease predominantly occur in the African meningitis belt from Senegal in the west to Ethiopia in the east. These serotypes have also been responsible for outbreaks in Saudi Arabia during the Hajj pilgrimages and in the city of Moscow in Russia.
Travellers are sometimes recommended to get vaccinated against meningitis A, C, W and Y on top of the routine vaccinations they should already have if they are in a high risk category such as those travelling to countries where those strains are present for prolonged periods.
Pilgrims travelling to Saudi Arabia for Hajj are required to have a valid certificate of vaccination against the disease for visa purposes
The vaccines are administered as a single dose and immunity lasts for 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.
It is a viral infection that can cause flu like symptoms. Many travellers will recover from this initial phase, however there is a risk that the virus can spread to the protective layer of tissue that covers the brain and spinal cord (meningitis) or the brain itself (encephalitis). This can lead to some serious complications including paralysis and even in rare cases, death.
The vaccination is given as an injection and three doses are needed for full protection. The second dose is given one to three months after the first, or in some circumstances at an accelerated dosage two weeks after the initial dose, and the third dose is given five to 12 months after the second.
The vaccine is effective for three years, after which a booster will be required which is effective for up to 5 years. Boosters should be given every 5 years after the first booster to maintain effectiveness.
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.
In the UK, there are two types of licensed vaccine, an injecatble vaccine and an oral one.
- Vi vaccine – given as a single injection
- Ty21a vaccine – given as three capsules to take on alternate days
Both are effective for up to three years but the injection is often preferable due to simple convenience. Combined typhoid and hepatitis A injections are also available for people aged 15 or older.
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 via an International Certificate of Vaccination or Prophylaxis (or ICVP) is required by many countries throughout the world 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.
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.