Editor’s Note: This is general travel health advice and is not intended to replace individual advice from your GP, specialist nurse or another qualified travel health professional, that has been tailored to your past medical history, medication or travel plans. This article was reviewed and updated on November 2026. It is routinely reviewed every 3 years unless new clinical evidence emerges.

Working out which vaccinations you need for a gap year or independent trip can feel confusing. You look up your destination and find a list of vaccines, some recommended for most travellers, others suggested only in particular circumstances. But how do you know which ones will apply to you and your trip? Does that mean you need all of them? What makes one relevant to your trip and another unnecessary? And is a vaccine recommended to protect your health the same as one you need to get through immigration?

As a former nurse with a background in emergency and travel health, I’ve helped plenty of travellers make sense of those questions and more in the decade I ran my own online travel clinic. The truth is vaccination recommendations are uniquely applied to you, your past medical history, where you are going and what you will be doing, among other things. Travel health professionals consider all of your plans, existing protection and medical circumstances before making any specific recommendations, but there are general recommendations and clinical guidelines that provide a useful starting point.

This guide explains which vaccines are generally recommended for travellers to risk destinations, which are considered for particular activities or circumstances, and when proof of vaccination may be required. Understanding those distinctions can help you make sense of the advice and have a more informed discussion about the protection appropriate for you.

How Travel Vaccination Recommendations Work

When you look up vaccination advice for a destination, you’ll often find it divided into ‘all travellers’, ‘most travellers’ and ‘some travellers’, with certificate requirements listed separately. These categories explain who the advice applies to. They are a starting point for assessing your needs, rather than a fixed package of injections everyone should book before leaving. There is no one size fits all rule for any vaccination.

All Travellers

All travellers should check that their routine vaccinations are up to date according to UK recommendations for their age, medical history and individual risks. This includes protection against infections such as measles, diphtheria, tetanus and polio.

That doesn’t mean everyone needs more injections before every trip. You may already have the appropriate protection. For example, someone with a documented, completed MMR course may need no further measles vaccination, while someone with missing doses may be advised to complete their course. The point is to check what protection you already have and address any gaps, rather than assume that childhood vaccinations covered everything or that every trip requires a booster.

A recommendation for all travellers doesn’t mean vaccination is mandatory or suitable for everyone. Personal circumstances still apply, and some people may be advised against a particular vaccine for medical reasons.

Most Travellers

Vaccines in this category are recommended for most travellers visiting the particular destination being discussed. It doesn’t mean they are recommended for everyone travelling anywhere, or that you need another dose if you already have adequate protection.

For example, hepatitis A vaccination is recommended for previously unvaccinated travellers to many destinations where the infection presents a risk. It can therefore be relevant to someone taking a short holiday as well as someone backpacking for several months. Your travel health professional will check that general recommendation against your vaccination history and circumstances, including whether the vaccine is suitable for you.

Some Travellers

These vaccines apply to people whose circumstances bring a particular risk into consideration, like those who will incorporate some form of long term volunteering into their trip. That might involve a longer stay, rural travel, animal work, particular outdoor activities, an underlying health condition or difficulty reaching appropriate medical treatment.

Someone taking a short trip spent entirely in cities will generally have a lower risk of Japanese encephalitis, and vaccination may not be recommended for their itinerary. Someone spending longer in rural areas of South, Southeast or East Asia where the infection occurs, particularly with substantial outdoor exposure between dusk and dawn, has a different pattern of exposure. Vaccination may therefore be recommended or considered according to the relevant guidance and their circumstances.

The advice depends on a combination of your medical history, individual risk and likely exposure through the places you visit and the things you do. One traveller’s vaccination recommendations may therefore look very different from another’s. Where vaccination can be considered, the consultation helps establish whether its potential benefits make it worthwhile for you.

Certificate Requirements

A certificate requirement means you must provide recognised proof of vaccination for a particular journey. This may be an International Certificate of Vaccination or Prophylaxis, usually shortened to ICVP, or another accepted vaccination certificate. Requirements can apply when entering or leaving a country and may depend on your previous destinations or transit stops. This is separate from the recommendation to protect your own health, although both may apply.

Check Your Routine Vaccinations

Before looking at vaccinations for particular destinations, it is worth checking the protection you should already have through the UK vaccination programme. Travel vaccines don’t replace routine vaccinations, and infections such as measles can be relevant to your trip even when you aren’t heading somewhere you would normally associate with travel health risks.

Your GP surgery can help check your records and identify any missing doses. What you were offered will depend partly on your age, where you grew up and any medical or occupational circumstances that made you eligible for additional vaccines. Not everyone will have received the same vaccinations, and remembering a few injections at school doesn’t necessarily tell you which courses you completed.

The aim is to establish whether your protection is appropriate, rather than automatically repeat everything. A completed course may provide long-lasting protection without regular boosters, while other vaccinations may need further doses in particular circumstances. There isn’t a universal rule that all vaccinations need renewing every ten years.

If your records are missing or incomplete, tell your GP or travel health professional. They can use UK catch-up guidance to advise you. You don’t need to work out the missing doses yourself, and uncertainty about what you had years ago is something they are used to dealing with.

Travel Vaccines And Who They Are Recommended For

The sections below explain the general recommendations for individual travel vaccines, the circumstances that make vaccination more relevant and why it may not be advised for others. Your destination, activities, length of stay, health and access to treatment can all influence that advice.

Each entry should be read in the context of travel to a country or area where the infection presents a relevant risk. It doesn’t mean that vaccine is recommended everywhere. We’ll explain who is generally advised to have it, when it may be considered and any separate requirement for proof of vaccination.

Unless stated otherwise, these recommendations assume an adult traveller who hasn’t previously been vaccinated against the infection being discussed. Where vaccination is advised, that means completing the appropriate primary course. If you’ve already been vaccinated, you may have suitable protection or need a booster where indicated.

The aim is to help you understand which recommendations may apply to your trip before discussing your individual circumstances with a travel health professional. The Ultimate Guide To Travel Vaccinations covers the vaccines themselves in more detail, including courses, boosters and other clinical considerations, and Bemused Backpackers Destination Guides give a much clearer indication of what is needed for each country.

Hepatitis A

Hepatitis A vaccination is generally recommended for previously unvaccinated travellers visiting countries with intermediate or high rates of infection, particularly where sanitation is poor and access to safe food and drinking water may be limited. This includes many destinations across Africa, Asia, the Middle East and Central and South America. The recommendation can apply to a short holiday as well as a longer backpacking trip.

Hepatitis A is a liver infection spread through the faecal–oral route. For travellers, this usually means consuming food or water contaminated with infected human faeces, including food prepared with contaminated water or handled by someone carrying the infection.

The case for vaccination becomes particularly strong for frequent or long-stay travellers spending time in communities with limited sanitation. That could include volunteering in rural areas or prolonged stays involving shared living and dining facilities where safe water and food hygiene are difficult to maintain. Sharing facilities isn’t itself the problem; the concern is the greater opportunity for exposure when hygiene and sanitation are inadequate.

Vaccination may also be recommended because of specific long-term conditions, particularly chronic liver disease, which can increase the seriousness of hepatitis A infection. This can provide a reason for vaccination independently of the travel itinerary.

Vaccination is not usually recommended solely for travel to countries where hepatitis A rates are low, unless your activities, medical circumstances or an outbreak create an additional reason to consider it.

An initial dose can provide protection for the forthcoming trip, followed by a reinforcing dose for long-term protection. If you have already completed the course, another dose isn’t normally needed for each journey. A booster at 25 years is advised for those who remain at risk.

Hepatitis B

Hepatitis B affects the liver and spreads through infected blood and certain body fluids. Travel-related exposure can involve unprotected sex, getting tattoos or piercings with inadequately sterilised equipment, shared injecting equipment, or medical and dental procedures where infection control is poor. It isn’t spread through sharing meals or ordinary social contact.

Hepatitis B vaccination can be considered for travellers visiting countries with intermediate or high rates of infection and is recommended for those whose activities, length of stay or medical circumstances increase their risk. This includes long-stay travellers, people undertaking healthcare or aid work involving potential contact with blood, and those who may need medical treatment abroad.

The recommendation becomes more relevant for someone spending months backpacking through affected countries, volunteering in a clinical setting, travelling for medical or cosmetic procedures or participating in contact sports where blood exposure may occur. Although nobody plans an accident, any traveller could need emergency treatment, so participation in risky adventure activities and the availability and standard of medical care also form part of the assessment.

Vaccination is particularly important for people with kidney failure, including those who may receive dialysis overseas. Chronic liver disease can also provide a separate medical reason for vaccination. These travellers should discuss protection with their usual specialist as well as their travel health professional.

Vaccination is not usually recommended solely for a short trip to a low-prevalence destination where there are no additional exposure risks. Even in countries where hepatitis B is more common, it isn’t automatically recommended for every short-stay visitor; the advice depends on their circumstances.

If vaccination is advised, complete the appropriate course, including any later dose needed after an accelerated schedule. Most people with a healthy immune system who have completed a standard course don’t need routine boosters. People with kidney failure or occupational exposure may need blood tests and additional doses under the relevant guidance.

Typhoid

Typhoid vaccination is recommended for most travellers to some higher-risk destinations such as south Asia, including India, Pakistan and Bangladesh, and some parts of south east Asia, sub Saharan Africa and central and south America. For other destinations where typhoid occurs, it may be recommended for some travellers according to their plans and likely exposure, particularly where sanitation and food hygiene are poor.

Typhoid is a bacterial infection spread through food or water contaminated with infected human faeces. It can cause a serious illness requiring hospital treatment, and increasing antibiotic resistance can make treatment more difficult.

The recommendation becomes particularly relevant for frequent or long-stay travellers spending time in communities with limited access to safe drinking water and sanitation. That could include extended backpacking trips, rural volunteering or staying for prolonged periods in households where food and water hygiene are difficult to maintain. In higher-risk destinations, however, a short stay doesn’t necessarily remove the recommendation.

Vaccination is not usually recommended solely for travel to destinations where typhoid risk is low. In countries where it is advised only for some travellers, a short visit with reliable access to safe food, drinking water and sanitation may not warrant vaccination. Country-specific guidance helps establish which recommendation applies before your circumstances are considered.

Injectable and oral vaccines are available. If you were previously vaccinated and will be at risk again, revaccination is generally recommended after three years. Neither option provides complete protection, so food, water and hand hygiene remain important. The vaccines are intended to protect against typhoid, rather than provide reliable protection against the related infection paratyphoid.

Tetanus, Diphtheria And Polio

Protection against tetanus, diphtheria and polio is recommended for all travellers as part of their routine vaccinations. If you have never been vaccinated or have an incomplete course, you should seek advice about completing the appropriate UK catch-up schedule. For adults, these vaccines are usually given together as a combined Td/IPV injection.

Additional travel boosters depend on your destination, previous doses and when you last received them. These three infections have different routes of transmission, so the reasons for recommending a booster are not identical.

Tetanus bacteria can enter the body through wounds, including punctures, burns and scratches. A booster is recommended if your last dose was more than ten years ago and you are visiting somewhere with limited medical facilities, even if you previously completed the routine course. This is particularly relevant where treatment following a tetanus-prone injury may be difficult to obtain.

Diphtheria usually spreads through close contact with an infected person and can affect the throat or skin. A booster may be advised for travel to areas where there is a risk, particularly if your last dose was more than ten years ago. Polio vaccination also needs checking when visiting countries with recent poliovirus transmission; a booster is recommended when indicated by country guidance and your last dose was ten or more years ago.

An additional booster is not usually needed solely for a trip to a low-risk destination with accessible medical care if your routine protection is complete and there is no specific travel recommendation. The fact that ten years have passed doesn’t automatically mean everyone needs another dose.

Polio also has separate certificate considerations. Some journeys require recent proof of vaccination for entry or departure, potentially even when a booster would not otherwise be due. Check the requirements for your whole route, particularly if you will spend an extended period in a country affected by poliovirus.

Cholera

Cholera vaccination is not generally recommended for most travellers, even when visiting countries where the infection occurs. It is mainly considered for humanitarian aid workers and people travelling to outbreak-affected areas where safe drinking water, adequate sanitation and medical care may be difficult to access.

Cholera spreads through contaminated food and water and can cause severe diarrhoea and rapid dehydration. The recommendation therefore depends on the conditions you will be living or working in and how easily you could obtain treatment, rather than simply whether cholera has been reported somewhere in the country.

The case for vaccination becomes stronger for someone volunteering in an outbreak-affected community, working in a disaster zone or staying in areas where water and sanitation systems have broken down. These circumstances can make avoiding contaminated food and water much harder, while delays in reaching treatment can increase the consequences of becoming ill.

Vaccination may also be considered where a medical condition or treatment increases susceptibility to infection or makes severe diarrhoea and dehydration more difficult to manage. Reduced stomach acid, including through medicines such as proton pump inhibitors or H2 blockers, can increase susceptibility to cholera. Travellers with inflammatory bowel disease, including Crohn’s disease or ulcerative colitis, should have their condition and medication considered individually alongside their likely exposure.

Vaccination is not usually recommended for gap years or backpacking trips where you have reliable access to safe food and drinking water and could obtain medical treatment if needed. Spending several months travelling, visiting rural areas or staying in basic accommodation doesn’t, by itself, establish a need for the vaccine. What matters is the likely exposure and the conditions you will encounter.

If vaccination is advised, oral vaccines are available. For adults receiving the two-dose inactivated vaccine, a booster is recommended within two years if continued protection is needed. If more than two years have passed, the course needs repeating. Advice differs for the alternative single-dose vaccine, so previous vaccination records should be checked before further doses are arranged.

Rabies

Rabies vaccination is recommended for travellers visiting areas where rabies is considered a risk factor such as parts of Africa, Asia, central and south America and the Middle East, as well as parts of eastern Europe, and whose activities or circumstances increase their risk of exposure. It is particularly relevant for people working or volunteering with animals, long-stay travellers, those undertaking outdoor activities and those staying in rural, remote areas where appropriate treatment may be difficult to obtain.

Rabies spreads through the saliva of infected mammals, usually through a bite or scratch, or saliva entering broken skin, the eyes or mouth. Dogs cause most human infections worldwide, although cats, monkeys, bats and other mammals can also transmit it. Once symptoms develop, rabies is almost always fatal, but prompt treatment after exposure can prevent the disease.

The case for vaccination becomes particularly strong for example, for someone working or volunteering with animals, particularly dogs or cats. Regular animal contact increases the opportunity for exposure, while travelling far from reliable medical facilities can make obtaining treatment more difficult.

Access to treatment is also essential because rabies immunoglobulin, which may be needed after exposure in someone who hasn’t been vaccinated, can be difficult to obtain. Completing vaccination beforehand simplifies subsequent treatment and usually removes the need for immunoglobulin, but further treatment will still be needed.

Vaccination is not usually recommended solely for a trip through countries or areas such as many European cities where terrestrial rabies risk is absent or very low, provided there is no particular animal or bat exposure. For shorter visits to affected countries, the recommendation depends on planned activities and access to treatment; staying in a city doesn’t automatically rule it out.

Most previously vaccinated travellers don’t need routine boosters, but a single booster can be considered after an individual assessment if the completed course was more than a year ago and you are returning to a high-risk area. People with ongoing occupational exposure or volunteering with animals may need different arrangements.

Japanese Encephalitis

The Japanese encephalitis vaccination is recommended for travellers spending long periods in affected areas or travelling frequently through them, particularly during the transmission season. This generally includes stays of a month or more in areas where the infection occurs. Length of exposure is an important consideration, but vaccination can also be considered for shorter trips involving substantial rural or outdoor exposure, or where travel plans are uncertain.

The infection is spread by mosquitoes in parts of Asia and the Western Pacific. These mosquitoes mainly bite between dusk and dawn and are associated with rural environments, particularly rice fields, wetlands and areas where pigs are kept. Infection is rare in travellers, but it can cause serious inflammation of the brain, with potentially fatal or lasting neurological consequences.

The case for vaccination becomes stronger for someone spending several months travelling through rural areas, volunteering on farms or regularly camping outdoors in affected regions. A shorter trip involving fieldwork or evenings outside near rice paddies may also warrant vaccination. The combination of location, season and exposure matters alongside the length of your trip.

A flexible backpacking itinerary can also provide a reason to consider vaccination. If you may extend your stay, move into rural areas or take on volunteering work along the way, discuss those possibilities at your appointment rather than base the assessment only on your first booked destination.

Vaccination is not usually recommended for a short trip confined to urban areas with a low likelihood of exposure. Visiting a country where Japanese encephalitis occurs doesn’t automatically mean you need the vaccine, particularly if transmission is limited to areas you won’t visit.

If vaccination is advised, complete the two-dose course before potential exposure. Previously vaccinated travellers may need a booster before returning to risk areas. For adults under 65, the first booster is recommended 12 months after the primary course where exposure is ongoing, or within 12–24 months after the course before further exposure. Adults aged 65 or over need individual advice, with a booster at 12 months considered if further exposure is expected.

Tick-Borne Encephalitis

Tick-borne encephalitis is usually spread through the bite of an infected tick and can cause inflammation of the brain or the tissues surrounding the brain and spinal cord. The virus occurs in parts of Europe and Asia, but its distribution is uneven. Some regions within an affected country have an established risk, while others have little or no known transmission. Your clinician will therefore look at where you plan to spend time and what you’ll be doing there instead of just the country alone. Hiking through an affected forested region will have a very different risk profile from exploring major cities, for example.

This is why vaccination is generally recommended for travellers visiting affected areas whose activities are likely to expose them to ticks. It is particularly relevant for hiking, camping, cycling, fieldwork and volunteering involving time in woodland or grassy areas.

The case for vaccination becomes stronger if you will spend substantial time outdoors in affected areas, particularly during the spring, summer and autumn when ticks are generally more active. Someone hiking and camping through forested regions or volunteering on a rural conservation project may therefore have a stronger reason to be vaccinated than someone visiting the same country mainly for museums, restaurants and city sightseeing.

A long stay isn’t essential for vaccination to be relevant. A shorter walking or camping holiday can involve considerable exposure, while repeated trips can create further opportunities for tick bites. Parks and gardens can also contain ticks, so exposure isn’t confined to remote wilderness.

Vaccination is not usually recommended solely for a trip with little likelihood of tick exposure, or for travel to areas where the virus is not known to circulate. An urban itinerary generally presents less risk, but regular visits to woodland or grassy parks in an affected area should still be discussed.

The full course consists of three doses, although the first two can provide protection for the forthcoming tick season. If exposure will continue, the first booster is generally due three years after completing the course. Subsequent intervals depend on age and continuing risk.

Meningococcal Disease

Meningococcal disease is a bacterial infection that can cause meningitis and septicaemia. It spreads through close contact with respiratory or throat secretions. Although it occurs worldwide, the main travel concern is visiting areas prone to outbreaks, particularly the African meningitis belt, which stretches from Senegal to Ethiopia. Outbreaks there are more common during the dry season.

MenACWY vaccination is recommended for travellers visiting higher-risk areas whose activities involve increased exposure, particularly prolonged close contact with local communities. This can include extended backpacking trips, volunteering and healthcare work. It is also recommended for Hajj and Umrah, where large numbers of people gather in crowded conditions, and other major events such as Navratri in India may be a consideration too.

The recommendation becomes stronger where an outbreak is occurring or your plans involve sustained close contact in crowded living or working conditions. Someone volunteering for several months in an affected community may therefore have a greater reason for vaccination than someone making a brief visit with limited close contact. An absent or poorly functioning spleen and certain immune deficiencies can also provide a separate, stronger medical reason for vaccination.

Vaccination is not generally recommended solely for ordinary travel to destinations without an identified increased risk. Visiting a country within the meningitis belt still requires consideration of the season, current outbreaks and your planned activities, rather than an assumption that every visitor needs vaccination.

If vaccination is advised, adults generally receive a single MenACWY dose. Previous MenC vaccination alone doesn’t provide equivalent protection. If you have already received MenACWY, your clinician will check whether another dose is indicated.

For Hajj and Umrah, proof of vaccination is also required. Under current rules, a conjugate MenACWY vaccine must have been given at least ten days before arrival and within the previous five years, with an appropriate certificate documenting it.

Yellow Fever

Yellow fever is a mosquito-borne viral infection found in parts of tropical Africa and Central and South America. It can cause severe liver disease, bleeding and death, and there is no specific antiviral treatment. Vaccination is generally recommended for travellers visiting areas with a recognised risk of transmission because it provides highly effective protection against a potentially life-threatening infection.

The strength of that recommendation largely depends on the specific places you will visit. Some countries have risk throughout much of their territory, while others have smaller affected regions alongside areas with no recognised transmission at all. If, for example, the risk is only in heavy jungle areas around a country’s border, but your plans only take you to the cities or inland areas away from that, then mosquito avoidance alone may be advised instead. Your clinician will check your route against current country guidance and vaccination maps to establish whether you are likely to be exposed.

The case for vaccination becomes stronger during an outbreak, during seasons when transmission is higher, or where your plans involve prolonged exposure in affected areas, particularly forest travel and substantial time outdoors. However, a short visit can also warrant vaccination if the area is high risk enough. Unlike some travel vaccines, yellow fever vaccination may be recommended because you are entering a recognised risk area, without needing additional activities or a lengthy stay to justify it.

Medical suitability is particularly important because the vaccine contains a live, weakened virus. People with significant immune suppression, whether caused by an illness or treatments such as chemotherapy or certain biological medicines, may be unable to control that vaccine virus safely. A history of a thymus disorder or removal of the thymus gland is also a contraindication to vaccination. A confirmed anaphylactic reaction to a previous dose or vaccine component is a contraindication; uncertainty about an allergy requires specialist assessment.

People aged 60 or over have a higher risk of very rare but potentially life-threatening vaccine reactions affecting the nervous system or internal organs. Vaccination should therefore be given only where there is a significant and unavoidable risk of yellow fever exposure, rather than simply as a precaution for a low-risk itinerary. Pregnancy and breastfeeding also require particular assessment. Where vaccination is unsuitable, avoiding or postponing travel to the affected area may be advised.

Vaccination is not generally recommended for personal protection when your itinerary is entirely outside recognised transmission areas. Where there is only low potential for exposure, the small risk of a serious vaccine reaction may outweigh the expected benefit. Vaccination may still be considered for some travellers with greater exposure, following an individual assessment.

Certificate requirements are a separate consideration altogether. Some countries require an International Certificate of Vaccination or Prophylaxis, including countries with no yellow fever risk that require proof from travellers arriving from affected countries or following particular transit routes. For many travellers, meeting those requirements is the reason they get vaccinated, regardless of the actual risk in the areas they are visiting. A certificate requirement does not override a medical contraindication. A medical exemption may be issued, but acceptance is not guaranteed, so an alternative route or destination may be necessary.

After a first vaccination, the certificate becomes valid ten days later and remains valid for life. A single dose also provides lifelong protection for most people, so routine boosters are not usually needed. A further dose may be recommended before returning to a risk area if, for example, you were first vaccinated during pregnancy, before the age of two or while living with HIV, or have since had a bone marrow transplant. These are individual clinical decisions about your protection, rather than requirements to renew the certificate.

Dengue

Dengue is a viral infection spread by mosquitoes across many tropical and subtropical destinations, including parts of Asia, Africa, the Caribbean and Central and South America. These mosquitoes mainly bite during the day and commonly live around towns and cities. Most infections cause mild illness or no symptoms. Severe dengue is rare in travellers, but it can cause life-threatening bleeding, shock or organ damage and requires urgent hospital treatment. The low likelihood should be kept in perspective alongside the seriousness of the illness, particularly for someone who has had dengue before.

A vaccine called Qdenga is available in the UK, but it is not a routine recommendation for everyone visiting an affected country. The decision depends particularly on whether you have had dengue before, your likely exposure during the trip and whether the expected benefit outweighs the remaining uncertainties about vaccination.

There are four types of dengue virus. Having been infected previously with one type provides lasting protection against that specific type, but not lasting protection against the other three. A second infection with a different type carries a higher risk of severe dengue. Vaccination can therefore be considered for travellers with a confirmed or likely previous infection who are returning to an area where dengue occurs. The purpose is to reduce the risk of another infection and its potentially more serious consequences.

The case for vaccination becomes stronger with prolonged stays, frequent travel or visits during an outbreak, when exposure is more likely. Someone who previously had dengue and plans several months travelling through affected countries may therefore have a greater reason to consider vaccination than someone making a brief visit where transmission is limited. Previous illness and any test results should be discussed, because a past unexplained fever doesn’t establish that you had dengue.

Vaccination is not usually recommended for travellers who have never had dengue. Although Qdenga can provide protection, evidence remains limited for some virus types in this group. There is a theoretical concern that vaccination could increase the risk of severe illness if someone without previous infection later catches dengue type 3 or 4. The September 2026 UK guidance reports that no such safety signal had emerged, but the uncertainty remains important to the recommendation.

Current guidance nevertheless allows vaccination to be considered for someone without previous dengue after discussion with a travel health clinician experienced in assessing Qdenga’s benefits and risks. A substantial likelihood of exposure may justify that discussion; a low-risk itinerary offers less potential benefit to balance against the uncertainty.

Vaccination is not recommended for destinations where only sporadic local cases have occurred. Qdenga is also unsuitable during pregnancy or breastfeeding, for people with significant immune suppression, or following a confirmed anaphylactic reaction to the vaccine or its components.

If vaccination is agreed, the course consists of two injections three months apart, so it needs planning well before departure. Both doses should be arranged rather than treating the first injection as a completed course. Protection is not guaranteed against every type of dengue, and the vaccine’s effectiveness can differ according to whether someone has previously been infected.

The need for additional booster doses, and when these might be given, has not yet been established. That reflects a remaining gap in the evidence, rather than confirmation that two doses provide lifelong protection. Previously vaccinated travellers should check current advice before further trips.

Mosquito bite precautions remain important throughout your travels, particularly during daylight hours. Vaccination adds protection where appropriate, but it cannot eliminate the risk of dengue or protect against other infections carried by the same mosquitoes.

Chikungunya

Chikungunya is a viral infection spread by mosquitoes in parts of Africa, Asia, the Americas and the Indian Ocean and Pacific regions. It typically causes fever and pronounced joint pain. Most people recover from the initial illness within one or two weeks, but joint pain can persist for months or years. The mosquitoes mainly bite during the day, and exposure can occur in towns and cities as well as rural areas.

Vaccination can be considered for travellers visiting areas with an active outbreak, or for long-term and frequent travellers to regions where transmission has occurred within the previous five years. It is not a routine recommendation for everyone visiting a country that has reported chikungunya.

Recommendations become stronger when substantial exposure is likely, particularly during an outbreak or repeated and prolonged stays in affected areas. Someone spending several months travelling through a region with ongoing transmission may therefore have a greater reason to consider vaccination than someone making a brief visit when little transmission is occurring.

Vaccination is not generally advised solely for a short trip to an area without an active outbreak or another reason to anticipate significant exposure. Your clinician should check the current situation at your destination, because an outbreak can change the advice even for a short visit.

The vaccine currently approved for use in the UK is Vimkunya, available from age 12. It uses non-infectious virus-like particles rather than live chikungunya virus. It is relatively new, and experience of its use remains more limited than for established travel vaccines. Pregnancy, breastfeeding and immune suppression require individual assessment because evidence in these groups is limited; people with immune suppression may also develop a weaker protective response.

A different vaccine, IXCHIQ, had its UK marketing authorisation withdrawn in October 2026 following a safety review. Serious reactions had been reported, and the MHRA concluded that its benefits no longer outweighed its risks for UK travellers. It must no longer be prescribed or administered in the UK. This decision concerns IXCHIQ specifically; it does not mean the same safety findings apply to Vimkunya.

Vimkunya is given as a single injection. The need for boosters has not been established, but travellers should not assume that one dose provides lifelong protection. Mosquito bite precautions remain important after vaccination.

Tuberculosis And BCG

Tuberculosis, usually shortened to TB, is a bacterial infection that mainly affects the lungs, although it can affect other parts of the body. It spreads through the air from someone with infectious pulmonary TB, usually following prolonged close contact. It occurs worldwide, with higher rates in parts of sub-Saharan Africa and Asia, but most travellers remain at low risk even when visiting countries where it is common.

BCG vaccination is not generally recommended for most adult backpackers or holidaymakers. Its clearest benefit is protecting babies and young children against serious forms of TB, including TB meningitis. Evidence of protection when first given in adulthood is more limited, so it isn’t routinely offered simply because someone plans a long trip to an affected country.

Many Gen X travellers such as myself and older adults who grew up in the UK may already have received BCG through the former routine school vaccination programme. If that includes you, another dose isn’t recommended simply because you are travelling or because your vaccination was decades ago. Your clinician can check your vaccination history if you are unsure.

For travel, vaccination is recommended for previously unvaccinated children under 16 who will spend more than three months staying with local communities in countries with high TB rates or a high risk of multidrug-resistant TB. Although this guide mainly concerns adults, that distinction is important for anyone travelling with children.

For adults, the recommendation becomes more relevant where work or volunteering involves direct contact with TB patients or infectious materials. Someone undertaking a clinical placement in a hospital treating TB has a different exposure from someone backpacking through the same region. Healthcare and laboratory placements should therefore include an occupational health assessment, which may involve vaccination, testing and advice on respiratory protection.

Vaccination is not usually recommended for ordinary sightseeing, hostel stays or extended independent travel without a particular exposure risk. Spending months in a country where TB occurs does not, by itself, mean an adult needs BCG.

If vaccination is appropriate, testing may be needed beforehand to check for previous infection. BCG is a live vaccine and is unsuitable during pregnancy or for people with significant immune suppression. It is given as a single dose; repeat vaccination and boosters are not recommended, even if it was received many years ago.

When You Need Proof Of Vaccination

Recommended vaccines and vaccines that are required for entry into certain countries are not the same thing, so don’t confuse them.

Routine vaccinations and recommended travel vaccinations are advised to protect your health. Your travel nurse or doctor considers which infections you could encounter, how serious they could be and whether vaccination would offer a worthwhile benefit for you.

An International Certificate of Vaccination or Prophylaxis, usually shortened to ICVP, serves a different purpose. It is an official document showing that you have received a particular vaccination. Some governments require it when you enter or leave their country as a public health measure to help prevent infections spreading across borders. Other requirements may use a separate vaccination certificate rather than an ICVP booklet.

Having no certificate requirement doesn’t mean there is no health reason to get vaccinated. Equally, being required to show a certificate doesn’t, by itself, mean vaccination is recommended because of your personal exposure risk.

For example, a country with no yellow fever transmission may require a certificate because you have recently visited a country where the infection occurs. Many travellers choose to get vaccinated to comply with those rules and make their journey administratively straightforward, even where the risk along their particular itinerary is low. That is a separate reason from getting vaccinated for personal protection, although both reasons may apply.

The vaccine still needs to be medically suitable for you. A government’s requirement for proof of vaccination does not override a medical reason why you should not receive it, and you should never feel pressured to accept a vaccine that is clinically contraindicated simply to complete your paperwork. Where you cannot receive a required vaccination for medical reasons, a clinician may be able to issue a medical exemption letter explaining this, and this should be considered under International Health Regulation. For yellow fever, this can be arranged through a designated yellow fever vaccination centre. Discuss this early so you have time to check the rules and, if necessary, arrange an alternative route or destination.

Yellow Fever

Some countries require a yellow fever ICVP from all arriving travellers, while others require it only if you have recently been in a country with yellow fever transmission. Certain airport transits can also trigger the requirement, even if you never leave the airport. For a trip through several countries, the order you visit them can therefore affect the paperwork you need.

Tell your vaccination centre about your complete route, including stopovers. After a first vaccination, the certificate becomes valid ten days later, so allow enough time before reaching the border where it is required. It then remains valid for life, including older certificates with a printed ten-year expiry date. You do not need another dose simply to renew that certificate.

Carry the original with your passport and keep a separate photograph or copy as a backup. If you lose it, contact a designated yellow fever vaccination centre; a replacement may be possible if the details of your original vaccination can be verified.

Polio

Polio requirements can concern leaving a country as well as entering one. Under measures intended to prevent international spread, certain affected countries may require residents and visitors staying for more than four weeks to show proof of a recent polio vaccination before departure.

Where this applies, the relevant dose is generally given between four weeks and twelve months before you leave that country and recorded on a polio ICVP. This is a different timescale from the usual advice about travel boosters. You could have adequate protection for your own health but still need a recent documented dose to meet the departure requirement.

For example, if you plan to spend several months in an affected country during your gap year, discuss your expected departure date when arranging vaccination. If you extend your stay, check whether the dose will still fall within the required period. Arrangements exist for urgent departures where there isn’t time to leave four weeks after vaccination, so seek advice rather than assume you cannot travel.

Some destinations also have polio entry requirements based on where you are arriving from. Check both sides of the journey and carry the original documentation when required.

Meningococcal ACWY

For Hajj and Umrah, Saudi Arabia requires proof of meningococcal ACWY vaccination. Under current rules, the conjugate MenACWY vaccine used in the UK must have been given at least ten days before arrival and within the previous five years.

If you received MenACWY at school or for an earlier trip, that dose may satisfy the requirement if it falls within the accepted period and can be properly documented. Previous MenC vaccination alone does not meet the ACWY requirement.

Ask your vaccination provider for a recognised certificate showing your full name, vaccination date, vaccine name and vaccine type. Recording that it is a conjugate vaccine matters as well, under current Saudi rules, a certificate without the vaccine type stated is treated as valid for only three years. The record should be authenticated by the provider, and you should carry the original for inspection. It can be a separate vaccination certificate rather than a yellow ICVP booklet.

Check the requirements for your pilgrimage before booking vaccination, as Saudi authorities review their health rules regularly.

Check The Rules For Your Whole Journey

Check current country guidance and the destination’s official entry requirements for every country on your route, including relevant stopovers. For a longer trip, revisit those requirements before crossing borders, particularly if you change your route or extend your stay.

You retain the choice whether to be vaccinated, but without a specific clinical reason and official exemption, a country may still refuse entry or departure clearance, or impose other public health measures, if you cannot provide the required documentation. Understanding the rules early gives you time to weigh up vaccination, an accepted medical exemption where applicable, or a different itinerary.

Outbreaks And Other Vaccination Considerations

Vaccination recommendations usually reflect the risk you are likely to encounter wherever you are travelling to, and an outbreak can change how strongly a vaccine is advised. Something that would not usually be recommended for your itinerary may become worth considering, while a vaccine already under consideration may become more strongly recommended. That depends on where transmission is occurring, how it spreads and whether your plans bring you into contact with it.

For someone planning a gap year or a longer backpacking trip, that means looking beyond the fact that a country is reporting cases. An outbreak affecting communities far from your route may have little relevance to your journey. One affecting the places where you will spend several months, or people you will be working closely with, may change the advice considerably.

If an outbreak occurs after you have made your plans, or even after you have started travelling, it doesn’t necessarily mean those plans have to change. The precautions you have taken, or now need to take, might. Speak to a qualified travel health professional as soon as reasonably possible so you can review the situation and amend your precautions or the affected part of your itinerary accordingly.

A gap year gives you room to adapt. You may need additional protection, a different activity or a temporary change of route, rather than abandon the adventure you have been looking forward to. The aim is to understand what has changed, respond proportionately and carry on enjoying your travels.

Making The Right Decision For Your Trip

You don’t need to arrive at your travel health appointment knowing exactly which vaccinations to ask for. Hopefully, this guide has made the recommendations easier to understand and helped you recognise which circumstances might apply to your own plans. Your consultation is where those general recommendations become advice tailored to you.

Take any vaccination records you have and an outline of where you hope to go, how long you might stay and what you would like to do. You don’t need every night booked or every border crossing decided. If rural trekking, animal volunteering or an extended stay somewhere is a possibility, mention it. Being honest about the trip you want gives your clinician a better basis for explaining the options.

Ask why a vaccine is being recommended, what benefit it offers for your circumstances and whether you already have suitable protection. You deserve clear answers and the space to make your own informed decision, including choosing not to have a vaccination. We can only provide you with the information. The ultimate choice is yours.

Once you have considered the advice and made your preparations, let yourself look forward to the adventure. The point of understanding these recommendations is to make looking after yourself easier, so you can spend more of your time enjoying the places you have travelled to see.

Sources And Further Information

The recommendations in this guide draw on UK travel health guidance, supported by international sources. Recommendations, vaccine safety advice and certificate requirements can change, so check current guidance for your destinations before travelling.

• NaTHNaC / TravelHealthPro — country-specific vaccination recommendations, disease information, outbreak updates and certificate guidance.
• NHS travel vaccinations — vaccination services, NHS provision and practical preparation.
• UKHSA Green Book — UK clinical guidance on vaccination, eligibility, precautions and contraindications.
• Latest Green Book travel chapters — updated guidance for travel-related vaccines, including dengue.
• MHRA Drug Safety Updates — changes to vaccine safety advice, restrictions and authorisations.
• World Health Organization — international travel health advice and vaccination requirements.
• FCDO foreign travel advice — destination entry requirements and health information.