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

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

Inactivated strains of Japanese Encephalitis virus.

Those travelling to or residing in areas where the disease is common. The disease is seasonal in some areas, and plans for protection should be considered accordingly. Additional vaccine information: Only IXIARO vaccine is licenced in the UK.

Two doses at 0 and 28 days. Vaccine effective 7 days after 2nd dose.

6 weeks before travel

Patients who have had a serious reaction (”anaphylaxis”) to a previous dose of this vaccine or its constituents.

Subject to medical assessment, vaccine is not recommended for pregnant or breast feeding women.

1 year

Very few. Temporary tenderness at the site of the injection

£105 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

BCG is a Live safe attenuated (weakened form) of Tuberculosis (TB)

BCG vaccination can be given safely to any person of any age, from new born through to old age. This is a once only vaccination in the UK and is highly recommended by the DH to specific groups at higher risk of exposure to TB.

BCG is a single once only injection given by specially trained nurses where there is evidence of a negative tuberculin skin test (mantoux)

3 months before travel

People who have had TB in the past and those with a positive mantoux skin test. This is a live vaccine therefore conditions such as HIV or cancer is contra-indicated. Many people with conditions however can successfully receive BCG with specific nurse management. Those who have received a live vaccination within the last 4 weeks eg MMR or Yellow Fever should delay BCG vaccination by one month. However live vaccines can be given together on the same day.

Although no adverse reports, it is best to avoid BCG in pregnancy. BCG is not contra-indicated in breast feeding therefore can be given after delivery.

25 years – life

A mild local reaction at the BCG injection site is typical. A small blister like response and local reaction is to be expected and this is evidence that the vaccination has been successful, leaving a characteristic small scar.

£70 per dose