The vaccine is administered by orally (dissolved in a glass of water), and contains killed cholera cells and toxin.

Travellers with journeys to remote areas where cholera epidemics are occurring and there is limited access to medical care. Additional vaccine information: Food and drink should be avoided for one hour before and one hour after vaccination. Oral administration of other medicinal products should be avoided within one hour before and after administration of the vaccine.

The primary course of the immunisation must be restarted if more than six weeks have elapsed between the first and second doses or if more than two years have elapsed since the last vaccination. These recommendations are unique to this vaccine.

2 weeks before travel

General issues: The vaccine is not recommended for prevention of the syndrome of travellers’ diarrhoea since it is only one of the many bacteria, viruses and protozoa that cause this syndrome. Specific issues: A confirmed anaphylactic reaction to a previous dose of oral cholera vaccine, or a confirmed anaphylactic reaction to formaldehyde or any of the components of the vaccine.

No data are available on the safety of oral cholera vaccine in pregnant or breast-feeding women. There is no evidence of risk from vaccinating pregnant women or those who are breast-feeding. If the risk of cholera is high then the vaccine should be considered.

2 years

Serious adverse events, including a flu-like syndrome, rash, arthralgia and paraesthesiae are rare, occurring in fewer than one per 10,000 doses distributed

£40 per dose

Travellers will receive an active vaccine. This is a purified, inactivated preparation of hepatitis A virus.

Those travelling to or who will be residing in areas where the disease is common, particularly if sanitation and food hygiene is likely to be poor. Additional vaccine information: The vaccine is also available combined with hepatitis B or typhoid.

A single injection 2 weeks prior to travel. Then a reinforcing dose 6-12 months later.

2 weeks before travel

General issues: Patients who have had a serious reaction (”anaphylaxis”) to a previous dose of this vaccine or its constituents. Specific issues: One brand of vaccine ”Epaxal” should not be given to those who have had anaphylaxis to hens’ eggs.

There is no evidence of risk.

25 years

Very few. Temporary tenderness at the site of the injection.

Very few. Temporary tenderness at the site of the injection.

£82 per dose

Travellers to areas of high or intermediate prevalence who place themselves at risk when abroad should be offered immunisation. The behaviours that place them at risk will include sexual activity, injecting drug use, undertaking relief aid work and/or participating in contact sports. Travellers are also at risk of acquiring infection as a result of medical or dental procedures carried out in countries where unsafe therapeutic injections are a possibility.

Additional vaccine information: The vaccine is available combined with hepatitis A vaccine.

Those travelling to an area with poor access to medical attention who have not had a booster in the last 10 years. Additional vaccine information: If your childhood schedule was incomplete, seek guidance about additional doses. In the UK, tetanus vaccine is combined with polio and diphtheria.

There are several different schedules of vaccination. Usually we advise three doses at 0, 1 and 6 months.

2 months before travel

General issues: Patients who have had a serious reaction (”anaphylaxis”) to a previous dose of this vaccine or its constituents. Specific issues: Vaccination should not replace other protective measures against infection, for example the use of condoms.

There is no evidence of risk.

Life cover after a full 3 dose course

Very few. Temporary tenderness at the site of the injection

£62 per dose

Given as a combined vaccine with polio, tetanus and diphtheria.

Those travelling to an area with poor access to medical attention who have not had a booster in the last 10 years. Additional vaccine information: If your childhood schedule was incomplete, seek guidance about additional doses. In the UK, tetanus vaccine is combined with polio and diphtheria.

A single injection.

2 weeks before travel

General issues: Patients who have had a serious reaction (”anaphylaxis”) to a previous dose of this vaccine or its constituents. Specific issues: Unstable epilepsy.

There is no evidence of risk.

10 years

Very few. Temporary tenderness at the site of the injection

£50 per dose

Inactivated rabies virus particles

Travellers for more than one month to areas with rabies, unless there is reliable access to prompt, safe medical care, or who may be exposed to rabies because of their travel activities, or those who would have limited access to post-exposure medical care. Additional vaccine information: Even if vaccinated, travellers who have sustained an animal bite must obtain urgent medical advice.

Three doses at 0, 7 and 28 days.

1 month before travel

General issues: The single site, intradermal 0.1ml pre-exposure vaccine regimen should not be used in those taking chloroquine for malaria prophylaxis, as this suppresses the response. Specific issues: A confirmed anaphylactic reaction to a previous dose of rabies vaccine, or a confirmed anaphylactic reaction to any component of the vaccine.

Pregnant women and breast-feeding mothers should only be given pre-exposure vaccination if the risk of exposure to rabies is high and rapid access to treatment would be limited.

10 years

Rabies vaccine may cause local reactions such as redness, swelling or pain at the site of injection within 24 to 48 hours of administration. Reactions such as headache, fever, muscle aches, vomiting and nettlerash are rare.

£87 per dose

For travellers, there are available two quadrivalent vaccines – (protecting against four strains, A, C, W and Y): “polysaccharide” and “conjugate”. UK authorities recommend the use of the conjugate vaccine, and we can advise you about the choice.