Vaccinations for travellers abroad

The following vaccinations are available for people travelling abroad:

• cholera
• diphtheria
• hepatitis A
• hepatitis B
• Japanese encephalitis
• meningococcal meningitis
• MMR (measles, mumps and rubella)
• polio
• rabies
• tetanus
• tick-borne encephalitis
• tuberculosis (TB)
• typhoid
• yellow fever

Cholera vaccination

Vaccination againstcholera isn't routinely needed for most travellers. However, in some cases it may be recommended for aid workers and people likely to have limited access to medical servicesfor example, people working in refugee camps or after natural disasters.

Most cases of cholera are confined to regions of the world with poor sanitation and water hygiene, such as parts of:

• sub-Saharan Africa
• south and southeast Asia
• the Middle East
• centralAmerica and the Caribbean

The vaccine is usually given as a drink in two separate doses, taken one to six weeks apart. Children aged two to six years old should have a third dose taken one to six weeks after the second dose. You should make sure you have the final dose of this vaccine at least a week before you travel.

A single booster dose or full revaccinationis usually recommended if you've previously been vaccinated against cholera and you're planning to travel to an area where the infection is common.

You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

Further booster dosesare usually only recommended if you're going to visit parts of the world where diphtheria is widespread andyour last vaccination dose was more than 10 years ago.

Diphtheria is more common in parts of the world where fewer people are vaccinated, such as:

• Africa
• south Asia
• the former Soviet Union

Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

Hepatitis Avaccination

Vaccination againsthepatitis A is recommended if you're travelling to countries where hepatitisA is widespread, particularly if you're staying for a long period or somewhere with poor levels of sanitation and hygiene.

Areaswith a high risk ofhepatitis A include:

• sub-Saharan and north Africa
• the Indian subcontinent particularly Bangladesh, India, Nepal and Pakistan
• some parts of the Far East excluding Japan
• the Middle East
• south and central America

The vaccination against hepatitis A is usually given as a single initial injection,with an optional booster dose 6 to 12 months later that can protect you for at least 20 years if necessary.

You should preferably have this initial dose at least two weeks before you leave, although it can be given up to the day of your departure if needed.

Jabsthat offer combined protection against hepatitis A and hepatitis B or typhoid are also available if you're likely to also be at risk of these conditions.

Anyone travelling for long periods orwho islikely to need medical care while abroad is also at increased risk.

Hepatitis B is found worldwide, but it's more common in:

• sub-Saharan Africa
• east and southeast Asia
• the Middle East
• southern and eastern Europe

The hepatitis B vaccination generally involves a course of three injections. Depending on how quickly you need protection, these may be spread over a period as long as six months or as short as three weeks.

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.

It's particularly importantif:

• you're visiting during the rainy season
• you're going to visit rural areas suchas rice fields or marshlands
• you'll be taking part in any activities that may increase your risk of becoming infected such ascycling or camping

Japanese encephalitis is found throughout Asia and beyond. The area it's found in stretches from the western Pacific islands in the east, such as Fiji, across to the borders of Pakistan in the west. It's found as far north as Korea and as far south as the north coast of Australia.

Despite its name, Japanese encephalitis is now relatively rare in Japanbecause ofmass immunisation programmes.

See the US Centers for Disease Control and Prevention (CDC) website for a map of Japanese encephalitis risk areas.

Vaccination against Japanese encephalitis usually consists of two injections, with the second dose given 28 days after the first. Ideally, you need to have the second dose a month before you leave.

All travellers to Saudi Arabia for the Hajj or Umrah pilgrimages are required to show proof of vaccination.

If travelling to a high-risk area, you should be vaccinated against meningococcal meningitis with an ACWY vaccine, also known as the quadrivalent meningococcal meningitis vaccine. This is a single injection that should be given two to three weeks before you travel.

You should have the ACWY vaccine before travelling to high-risk areas,even if you had themeningitis C vaccine as a child.

MMR(measles, mumps and rubella) vaccination

The MMR vaccine that protects against measles,mumps andrubella is routinely given to all children in the UK.You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

If you've not been fully vaccinated against these conditions or you're not already immune, the MMR vaccination is recommended before travelling to areas where these conditions are widespread or where there's been a recent outbreak.

The MMR vaccine is given as two injections. These are usually given when a child is 12 to 13 months old and when they start school. However, adults can have the two doses one month apart, and children can have them three months apart if necessary.

You should ideallyhave the final doseat least two weeks before you leave.

You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

Further booster doses are usually only recommended if you're going to visit parts of the world wherepolio is widespread and your last vaccination dose was more than 10 years ago.

Currently, the condition ismost commonin Pakistan, Afghanistan and Nigeria, but it's also a risk in other regions of the world.

Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

The GOV.UK website provides a detailed list of countries that have rabies in domestic animals or wildlife.

Vaccination usually requires a course of three injections. The second dose is given seven days after the first, and the third dose is given 14 to 21 days after the second.

Further doses aren't usually recommended for travellers, unless it's been more than 10 years since you were first vaccinated and you're visiting an area with a high risk of rabies.

You should ensure you and your children are up-to-date with your routine vaccinations before travelling.

Further booster doses are usually only recommended if you're travelling to areas where access to medical services is likely to be limited or your last vaccination dose was more than 10 years ago.

Additional doses of the vaccination are given in a single 3-in-1 Td/IPV (tetanus, diphtheria and polio) injection.

Tick-borneencephalitis vaccination

Vaccination againsttick-borne encephalitis (TBE)is usually recommendedfor anyone who plans to live or work in a high-risk area, or hike and camp in these areas during late spring or summer.

The ticks that cause TBEare mainly found in forested areas of central, eastern and northern Europe, although at-risk areas also include eastern Russia and some countries in east Asia, particularly forested regions of China and Japan.

The vaccination requires a course of three injections for full protection. The second dose is given one to three months after the first and provides immunity for about one year. A third dose, given 5 to 12 months after the second, provides immunity for up to three years.

The course can sometimes be accelerated if necessary. This involves two doses being given two weeks apart.

Booster doses of the vaccine are recommended every three years if necessary.

One is given as a single injection, andthe otheris given as three capsules to take on alternate days. It's also possible to have a combined hepatitis A and typhoid jab.

Ideally, the typhoid vaccine should be given at least one month before you travel, but it can be given closer to your travel date if necessary.

Booster vaccinations are recommended every three yearsif you continue to be at risk of infection.

Some countries require a proof of vaccination certificate before they let you enter the country.

Yellow fever is most common in some areas of tropical Africa and South America.Amap and list of countries where yellow fever is found is available on the NHS fitfortravel website.

A booster dose of the yellow fever vaccine is currently recommended every 10 years if you're still at risk. However, this is likely to change in the future as recent evidence suggests a single dose offers lifelong protection.

You must have a yellow fever vaccination at least 10 days before you travel.

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