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 personal medical history and any recent outbreaks of specific diseases. It is important to get qualified advice
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 website, the Centre of Disease Control and Prevention (CDC) website, or the NHS’ Fit For Travel website. Local physical travel clinics are also excellent resource for travellers. Your GP is also a great resource but remember they are not necessarilly specialists in travel medicine.
Where Can I Get My Travel Vaccinations?
Your GP or local practice nurse can give you all your routine vaccinations and boosters, and some can provide the free vaccinations for travel on the NHS, but not all are signed up to this service. Check with your local practice.
You can get the full range of travel vaccinations at any specialist travel clinic, and these are also the best choice for specific specialist advice. Yellow Fever Vaccinations are only available at specifically designated travel clinics.
Which Travel Vaccinations Are Free?
Polio (given as a combined diptheria/tetanus/polio vaccination), Typhoid, Hepatitis A and Cholera are all technical travel vaccinations that are given for free on the NHS in the UK as they are considered specific risks to public health.
Outside of the UK you may have to pay for these, so check with your local health service.
Which Travel Vaccinations Do I Pay For?
All other vaccinations outside of your routine vaccination programme are not available on the NHS in the UK and will have to be paid for. This includes Hepatitis B, Japanese Encephalitis, Tick Borne Encephalitis, Meningitis, Rabies, Tuberculosis and Yellow Fever.
Types Of Vaccination.
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 in the form of an ICVP, or International Certificate of Vaccine Prophylaxis. There are exceptions to this where exemptions are given if the vaccine cannot be given for clinical reasons.
Routine Vaccinations.
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 (HIB), 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 your specialist nurse or doctor will first confirm that you have had all of these and are up to date on any boosters. Any written advice may generally assume you already have these and concentrate on the non routine vaccinations. That is why the recommended vaccination lists for any given destination do not list these.
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.
Recommended Vaccinations.
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, you are not vaccinated and can’t get treatment in time. It is up to you whether you want to take that chance.
Hepatitis A.
This is a virus present in faeces and is usually caught by consuming contaminated food or water. It is common throughout Asia, Africa, the Middle East and Central and South America. The vaccination is recommended for most travel if you haven’t received it as part of your routine schedule, but is particularly recommended to those travelling to any developing country or region where sanitation is poor and there is a noted risk of the disease. Good personal hygiene is also important to prevent the disease as it is spread through the feca oral route and yes, that means hand washing and is exactly how it sounds.
This vaccination should be administered at least 2 weeks before travel although can be administered up to the day before in an emergency but this is not ideal. A further reinforcing dose will be required 6 to 12 months later and if you can plan ahead and get this second dose before you travel that is the best option. Once you have the second dose the duration of immunity can be up to 20 years. You can also get this as combined vaccination with hepatitis B or Typhoid.
Hepatitis B.
Hepatitis B is spread through blood and body fluids, so any action such as unprotected sex, injecting drugs or contact sports are a risk factor. This vaccine should be given as part of your routine schedule but if not it is recommended for most travellers who are travelling for long periods and will be engaging in activities that raise their risk factor.
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.
The hepatitis B vaccination is given over a course of 3 injections taken 3 weeks to 6 months apart, depending on how quickly you need protection. 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.
Polio.
Poliomyelitis is an infectious disease that can in rare cases affect the central nervous system and cause temporary or sometimes permanent paralysis. It is very rare now because of vaccination efforts and the vaccinne is part of the routine vaccination programme for children in the UK. It is always highly recommended that you are up to date with your routine vaccinations and boosters.
Despite common misconceptions that it has been eradicated, Polio does still exist and in the small pockets where it is still present such as in Pakistan, Afghanistan and Nigeria, it can be recommended that travellers get a further booster. Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.
Cholera.
Cholera is a bacterial infection that is spread by contaminated food and water in areas with poor sanitation such as sub Sharan Africa, South and Southeast Asia, the Middle East and Central America and the Caribbean.
Cholera is generally not recommended for the vast majority of travellers unless they are in a specific at risk group or an aid or medical worker.
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 and the final dose should be completed a week before you travel. 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.
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). Most commonly a dog but other animals such as cats, monkeys and bats can carry it too. There is no treatment or cure for rabies once it becomes symptomatic, and at this stage it is almost always fatal, but treatment and vaccination before this is extremely effective.
For many countries it is not recommended for travellers to get the vaccine at all because of the low risk and chance of contracting it. However, the vaccine becomes much more strongly recommended for any traveller who falls into an at risk group, including those who are travelling for extended periods in countries where Rabies is present and problematic, or conducting activities that may expose them to the disease such as volunteering or working with animals and will have limited access to immediate post exposure medical facilities.
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 or there is a chance you may have done.
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.
Japanese encephalitis is a viral brain infection causing a severe flu like illness spread by mosquitoes throughout South and Southeast Asia and beyond. Despite it’s name it is not only found in Japan (where it is rare thanks to mass immunisation).
It is recommended for any traveller travelling for longer than a month in any given region, particularly in rural areas such as rice and paddy fields, and can be more prevalent in wetlands and during the rainy seasons. Anyone with increased exposure to mosquito bites (ie extended time camping or working in rural areas) is at higher risk.
Chances of contracting the disease are low, very rare in fact, but the consequences if you do get it can be fatal. That is why it is important to discuss your personaal risk factor with a professional.
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.
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 and other countries as far as Russia.
If travelling to a high-risk area, you should be vaccinated against meningococcal meningitis A, C, W and Y with a MenACWY vaccine, also known as the quadrivalent meningococcal meningitis vaccine. This includes those who have already had the meningitis C vaccine as a child.
This is a single injection that should be given 2 to 3 weeks before you travel and immunity lasts for 5 years.
Pilgrims travelling to Saudi Arabia for Hajj are required to have a valid certificate of vaccination against the disease for visa purposes
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 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.
Typhoid Fever.
Typhoid fever is a potentially serious bacterial infection that can affect multiple organs with severe complications and in some cases be fatal.
It is caused by a bacteria called Salmonella Typhi (not to be confused with the Salmonella that causes food poisoning) and can contaminate food or drink in areas of poor sanitation or through infected fecal matter or urine on the hands of anyone who doesn’t wash their hands properly after going to the toilet.
The vaccination is recommended for all travellers going 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, after which a booster is required, 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.
Yellow Fever.
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 but is actually very rare in travellers. There have been less than 50 cases since 1970, but it is at constant high risk of outbreaks and has a significant fatality rate, which is why ICVP procedures are enforced. 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 and can take at least 10 days to become effective. You should be issued with an International Certificate of Vaccination or Prophylaxis when you have the vaccine. This certificate is valid for life. 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, a booster is no longer required for the majority of people as it has been found the single dose gives lifelong immunity. A booster may still be given for very specific at risk groups but this is not common.
Required Vaccinations.
This term is slightly misleading as the term required doesn’t refer to the health risk or vaccine recommendation, but the necessity of an ICVP, or International Certificate of Vaccination or Prophylaxis for visa and border entry purposes.
The reason for the ICVP is to control the spread of very specific diseases that pose a significant public health risk. They do not apply to all recommended vaccinations, in fact they are only currently required for Yellow Fever, Meningococcal disease and Polio, and are only required in some countries or under very specific circumstances. If you are heading to or from a country that has disease control restrictions in place you will need to show this proof of vaccination before entry.
Yellow Fever 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 for some countries in Africa and South America for entry, and 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.
There are exemptions to this condition of entry for those who cannot get the vaccine for clinical reasons such as those with a risk of anaphylactic reactions to the vaccine or any of the components of it such as egg or chicken enzyme, those who have a weakened immune system due to disease or treatment, those with Thymus disorder or a wide range of other clinical contraindications.
Meningococcal Meningitis ICVP.
Proof of vaccination is required for visitors to Saudi Arabia who visit Mecca and Medina during Hajj or Umrah, and is sometimes required by other countries such as Libya or Gambia during outbreaks. This is because with the sheer amount of pilgrims in such a small area (over 2.5 million Muslims attended Hajj in 2019 for example), there is a significant rise in public health risk.
This ICVP may look slightly different to the normal yellow booklet. If you have the yellow booklet when you recieve this vaccine it may be recorded in their, but if you don’t you may be issued with a seperate certificate that will be officially stamped by the prescribing nurse.
Polio ICVP.
For the exact same reason as the Meningococcal Meningitis ICVP, proof of vaccination in your yellow book may be required by certain countries if you are travelling from somewhere wehere there is a significant risk or outbreak, or for travel to certain events such as Hajj or Umrah.
Related Articles.
Common Backpacker Illnesses And Diseases.
Sexual Health Advice For Backpackers.
The Ultimate Guide To Travel Vaccinations.
What Vaccinations Do You Need?
Why Travel Vaccinations Are Important.
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 20 years travel experience, I am also a qualified nurse who specialises in emergency nursing and travel medicine.
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
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