To assist NPA Members to collate relevant information that should be obtained prior to suggesting vaccine requirements, the NPA has developed this online resource.
This resource should be used in conjunction with the downloadable vaccination requirements for travellers abroad resources.
Commonly Asked Questions
If a patient is suffering from an acute illness, vaccination should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone receiving their vaccines..
Administering multiple vaccines
Inactivated and/or live vaccines may be given together at the same time, preferably in different limbs, or on a different site on the same limb. Please refer to the individual Summary of Product Characteristics for each vaccine for further information.
Advice on vaccination requirements
The advice given on this website is for a traveller arriving in the country directly from the UK. Where this is not the case, please contact the NPA Pharmacy Services Team.
- Specialist advice should be sought for those intending to live abroad for long periods, those visiting friends and relatives, or for those travelling in rural areas or between countries.
- When advising on vaccination requirements for travellers, consideration needs to be given to the traveller’s itinerary, destination, duration and purpose of travel, planned activities and season of travel.
- It is recommended that all travellers have completed the primary immunisation programme according to the UK schedule. Travellers who have not had a booster dose of a tetanus-containing vaccine within the previous ten years should receive a further booster dose of the tetanus/diphtheria/inactivated polio vaccine (Td/IPV).
- Travellers to the USA (including Bermuda), Canada and New Zealand require no additional vaccines other than completion of the primary immunisation programme (unless there is a risk due to occupation or activities undertaken, then consider, for example, rabies or hepatitis B). Travellers to certain parts of Europe may require tick-borne encephalitis vaccination.
- Ideally travellers need to allow four-to-six weeks before departure to have the required vaccines, although occasionally a course may be accelerated.
- Following the recommended intervals between doses allows time for the antibodies to the disease to be produced and any reaction from the vaccine to subside.
- Travellers should ensure that they are up to date with the UK measles/mumps/rubella (MMR) vaccination schedule, following a worldwide increase in the number of measles cases. There has been a decrease in the uptake of the MMR vaccine in the last decade which means that some adolescents may not have received the MMR vaccine as part of their childhood vaccinations. Measles is now endemic in parts of Africa and Asia, and in addition,certain European countries have reported a rising incidence of cases. Vaccination should, therefore, be considered in non-immune individuals.
For further information, please contact the NPA Pharmacy Services Team on 01727 891800 / 08447 364 201.
Individuals with a confirmed egg allergy may not be able to receive certain vaccines, for example, the yellow fever vaccine. Vaccines that are supplied in vials or syringes containing latex may trigger an allergic response in susceptible individuals.
Most vaccines can be administered safely to breastfeeding women. However, it is important to note that immunity does NOT pass to the child through the mother’s milk. The yellow fever vaccine should only be given during breastfeeding following expert advice.
Mandatory, recommended or considered?
All travellers should have completed the primary immunisation programme according to the UK schedule (including immunisation against measles), irrespective of the country of destination. Travellers who have not had a booster dose of a tetanus-containing vaccine within the previous ten years may require a further booster dose of the tetanus/diphtheria/inactivated polio vaccine (Td/IPV). Ideally, travellers need to allow four-to-six weeks before departure to have the required vaccines, although occasionally a course may be accelerated.
The decision on whether vaccination is required will depend on a number of factors, for example:
- Duration of stay
- Planned activities
- Season or time of year
- Purpose of travel – visiting families/friends, holiday or work
As a guide, the vaccine requirements for each country have been categorised as follows:
Mandatory (M) – vaccination is a requirement for entry into the country (eg. yellow fever).
Recommended (R) – vaccination is recommended because the disease is known to be prevalent in the country, with most travellers being at risk.
Considered (C) – vaccination against disease should be considered depending on the circumstances. Although the disease is known to exist in the country, not all travellers will be at risk.
Whether the traveller needs vaccination depends on a variety of factors (as listed above). Aid workers travelling into remote areas, for example, may be more at risk of diseases such as rabies, whereas someone holidaying in a resort will be at considerably less risk. See the individual disease information for further guidance.
Please note that for countries which have no risk of yellow fever, there may still be a yellow fever certificate requirement if the traveller has been to a country where yellow fever is endemic. However, if the traveller is visiting directly from the UK, then yellow fever vaccination is not required.
Patients with special considerations
Live vaccines are usually contraindicated in severely immunosuppressed individuals because they may cause severe infections in them. Where administration of a live vaccine is necessary, this should be done following official guidance and only on specialist advice – Public Health England’s (PHE) reference book “Immunisation against infectious disease: the green book” can be referred to in these instances. Individuals who have a minor immunodeficiency can receive all vaccines, including live vaccines. Specialist advice should be sought if there is any doubt.
If yellow fever vaccine cannot be given and the individual requires a certificate as a condition of entry to the country, the individual will require a certificate of exemption from a medical practitioner.
PHE has advised that inactivated vaccines – diphtheria, hepatitis A and hepatitis B, Japanese encephalitis, meningitis (ACWY), polio, rabies, tetanus, tick-borne encephalitis and typhoid (not oral typhoid vaccine) – can be given safely to immunosuppressed patients, but their response to the vaccine may be suboptimal.
Live virus vaccines are contraindicated in pregnancy because of possible harm to the unborn child, unless the need for immunisation outweighs any possible harm to the unborn child (for example, yellow fever). Inactivated vaccines are considered to be safe during pregnancy, although should only be administered if immediate protection is required.
Where possible, the recommended intervals between different vaccines or doses should be followed. This allows time for antibodies to the disease to be produced and any reaction to the vaccine to subside.
Ideally, travellers need to allow four-to-six weeks before departure to have the required vaccines, although occasionally, a course may be accelerated. Please contact the NPA Pharmacy Services Team for further information on 01727 891 800 / 08447 364 201.
Yellow fever vaccination centres
Yellow fever vaccine is administered at designated centres only – contact the NPA Pharmacy Services Team for the nearest centre or use the contacts below:
Yellow fever vaccination certificate
Certificates for yellow fever are valid for ten years from the tenth day after primary immunisation. If re-immunisation occurs within the ten year period the certificate will be valid for ten years immediately after re-immunisation.