Slovakia

Areas with risk
No risk of malaria

Prophylaxis

Mandatory

Recommended

Diphtheria

All travellers should have completed a primary vaccination course according to the UK schedule.  A booster dose should be given to those who have not received a dose within the previous ten years.

Transmission

Diphtheria is transmitted through respiratory droplets, personal contact and contaminated clothing or bed linen, for example.

Vaccination schedule

Brand Vaccine information Primary course Booster

Revaxis

  • Inactivated, adsorbed
  • Licensed from six years of age
  • Not indicated
  • Single dose; effective after one month if given within ten years of a completed primary immunisation of tetanus, diphtheria and polio
  • Lasts up to ten years

The information below is based on Public Health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands. 

Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines

Diphtheria vaccine can be given at the same time as other vaccines such as MMR, MenC and hepatitis B as long as they are administered at different sites.

Immunocompromised patients

Diphtheria vaccine should be considered in patients who are immunocompromised if they are travelling to an area of risk, however, it may not be as effective. Specialist advice may be required.

Pregnancy and breast-feeding

No harmful effects due to diphtheria vaccination during pregnancy or breast-feeding have been reported so it may be given when clinically indicated.

Polio

All travellers should have completed a primary vaccination course according to the UK schedule. Travellers who receive the tetanus booster in the form of the tetanus/diphtheria/inactivated polio vaccine (Td/IPV) will also be protected against polio.

Transmission

Poliomyelitis (polio) is transmitted by the faecal-oral and from person-to-person.

Vaccination schedule

Brand Vaccine information Primary course Booster

Revaxis

  • Inactivated, adsorbed
  • Licensed from six years of age
  • Not indicated
  • Single dose; effective after one month if given within ten years of a completed primary immunisation of tetanus, diphtheria and polio
  • Lasts up to ten years

The information below is based on Public health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands.

Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines

Inactivated polio vaccine can be given at the same time as other vaccines such as MMR, MenC and hepatitis B as long as they are administered at different sites.

Immunocompromised patients

Inactivated polio vaccine should be given to patients who are immunocompromised if they are travelling to an area of risk, however, it may not be as effective. Specialist advice may be required.

Pregnancy and breast-feeding

No harmful effects due to inactivated polio vaccination during pregnancy or breast-feeding have been reported so it may be given when clinically indicated.

Tetanus

All travellers should have completed the primary vaccination course according to the UK schedule. 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 a tetanus/diphtheria/inactivated polio vaccine (Td/IPV) in accordance with official recommendations. This will depend on the nature of travel and destination.

Transmission 

Tetanus is transmitted through open wounds contaminated by bacteria found in soil and manure.

Vaccination schedule

Brand Vaccine information Primary course Booster

Revaxis

  • Inactivated, adsorbed
  • Licensed from six years of age
  • Not indicated
  • Single dose; effective after one month if given within ten years of a completed primary immunisation of tetanus, diphtheria and polio
  • Lasts up to ten years

The information below is based on Public Health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands.

Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines

Tetanus vaccine can be given at the same time as other vaccines such as MMR, MenC and hepatitis B as long as they are administered at different sites.

Immunocompromised patients

Tetanus vaccine should be given to patients who are immunocompromised if they are travelling to an area of risk, however it may not be as effective. Specialist advice may be required.

Pregnancy and breast-feeding

No harmful effects due to tetanus vaccination during pregnancy or breast-feeding have been reported so it may be given when clinically indicated.

Considered

Hepatitis A

Transmission

Hepatitis A is caused by the virus Hepatovirus and transmitted by the faecal-oral route or person-to-person. This could be through contaminated food or drink, particularly shellfish that feed on waters polluted with sewage, and unwashed salads/ vegetables/fruits — food handlers can contaminate food also, through virus shedding, if good personal hygiene is not observed.

Vaccination schedule — Hepatitis A only

Brand Vaccine information Primary course Booster
Avaxim

 

  • Inactivated, adsorbed
  • Licensed from 16 years of age
  • Single dose
  • Effective after two weeks
  • Single dose — preferably between 6–12 months but can be up to 36 months after primary course
  • Effective immediately — can last over ten years. A further booster may be given after 25 years for on-going risk
Epaxal
  • Inactivated, virosome
  • Licensed from one year of age
  • Single dose
  • Effective immediately if concomitantly given with human gamma globulin
  • Lasts up to 12 months
  • Single dose — preferably between 6–12 months but can be up to ten years after primary course
  • Mathematic modelling estimates the booster to last at least 30 years
Havrix Monodose
  • Inactivated, adsorbed
  • Licensed from 16 years of age
  • Single dose
  • Effective after two-to-four weeks
  • Lasts up to 12 months
  • Single dose — preferably between 6–12 months
  • Some individuals show antibody response if booster is given up to three years after initial vaccination
  • Effective four weeks after booster dose if administered between 6–12 months — lasts over ten years; a further booster may be given after 25 years for on-going risk
Havrix Junior Monodose
  • Inactivated, adsorbed
  • Licensed for 1–15 years of age
VAQTA Adult
  • Inactivated, adsorbed
  • Licensed from 18 years of age
  • Single dose
  • Effective after two-to-four weeks
  • VAQTA Adult lasts up to 18 months
  • Single dose — after 6–18 months
  • Lasts for at least six years for VAQTA Adult and for at least ten years for VAQTA Paediatric — mathematic modelling predictions for both state antibodies may persist up to 25 years
VAQTA Paediatric
  • Inactivated, adsorbed
  • Licensed from 1–17 years of age

Vaccination schedule — Hepatitis A and typhoid combined

Brand Vaccine information Primary course Booster
Hepatyrix

 

  • Inactivated, adsorbed
  • Licensed from 15 years of age
  • Single dose
  • Effective after two weeks
  • Hepatitis A protection lasts up to 12 months
For hepatitis A:

  • Dose of an inactivated hepatitis A vaccine between 6–12 months
  • Lasts for at least 10 years

For typhoid:

  • Dose of Vi polysaccharide vaccine every three years, or, Hepatyrix if hepatitis A revaccination required
ViATIM
  • Inactivated, adsorbed
  • Licensed from 16 years of age
  • Single dose
  • Effective after two weeks
For hepatitis A:

  • Dose of monovalent hepatitis A vaccine between 6–12 months but can be within 36 months, or, ViATIM if typhoid revaccination required

For typhoid:

 

  • Dose of ViATIM at 36 months
  • Lasts for at least ten years

 

The information below is based on Public Health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands.

Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines

Hepatitis A vaccine can be given at the same time as other vaccines such as hepatitis B, MMR, MenC, tetanus/diphtheria/inactivated polio vaccine (TdIPV) and other travel vaccines as long as they are administered at different sites.

Immunocompromised patients

Hepatitis A vaccine can be given to patients who are immunocompromised if they are travelling to an area of risk, however it may not be as effective. Specialist advice may be required and the importance of good personal, food and water hygiene measures while in risk areas should be emphasised.

Pregnancy and breast-feeding

No harmful effects due to hepatitis A vaccination during pregnancy or breast-feeding have been reported so it may be given when clinically indicated.

Hepatitis B

Transmission 

Hepatitis B is transmitted by:

  • Exposure to infected blood/body fluids through contact sport, sharing needles, unprotected sexual intercourse
  • Contaminated medical (or other) equipment that pierces the skin, for example, acupuncture or body piercing/tattoos
  • From mother to foetus

Risk to most travellers is small, unless their behaviour puts them at increased risk. Travellers at risk include:

  • Frequent or long-term travellers who may need medical treatment whilst overseas
  • Those with underlying medical conditions who may require hospitalisation whilst abroad
  • Those travelling abroad to have medical procedures
  • Patients with chronic kidney failure, liver disease and haemophilia
  • Healthcare workers
  • Those planning on adopting a child from overseas

Vaccination schedule Hepatitis B only

Brand Vaccine information Primary course Booster
Engerix B 10mcg/0.5ml
  • Inactivated, adsorbed
  • Licensed up to 15 years of age (including neonates)
Three schedules:

  • Dose at zero, one and six months — effective after seven months
  • Accelerated: dose at zero, one, two and 12 months
  • In children aged 11 – 15 years, dose at zero and six month of Engerix B 20mcg/1ml

Check Summary of Product Characteristics  (SPC) for special group’s schedules

  • Consider after five years if traveller at continuing risk
Engerix B 20mcg/1ml
  • Inactivated, adsorbed
  • Licensed from 16 years of age; can also be given from 11–15 years of age
Fendrix
  • Inactivated, adjuvanted, adsorbed
  • Licensed from 15 years of age
  • Dose at zero, one, two and six months
  • Cannot interchange with other hepatitis B vaccines
  • Consider after five years if traveller at continuing risk
  • Can interchange with other hepatitis B vaccines
HBVAXPRO 5mcg
  • Inactivated, adsorbed
  • Licensed from birth to 15 years of age
Two schedules:

  • Dose at zero, one and six months
  • Accelerated schedule for HBVAXPRO 5mcg and 10mcg: dose at zero, one, two months

If accelerated schedule given to infants at continued risk, a fourth dose at 12 months  should be administered

  • Consider after five years if traveller at continuing risk
HBVAXPRO 10mcg
  • Inactivated, adsorbed
  • Licensed from 16 years of age
HBVAXPRO 40mcg
  • Inactivated, adsorbed
  • Licensed for patients undergoing dialysis and predialysis

 

Vaccination schedule — Hepatitis A and B combined

Brand Vaccine information Primary course Booster
Ambirix
  • Inactivated, adsorbed
  • Licensed from 1–15 years of age
  • Two doses — second dose within 6–12 months
  • Cannot interchange with other vaccines
  • Can interchange with monovalent vaccines — for dose information, refer to SPC
Twinrix Adult
  • Inactivated, adsorbed
  • Licensed from 16 years of age
Two schedules for Twinrix Adult:

  • Single dose at 0, 1 and 6 months
  • Accelerated: dose at 0, 7, 21 days, followed by dose at 12 months

Schedule for Twinrix Paediatric:

  • Single dose at 0, 1 and 6 months
  • Cannot interchange with other vaccinations
  • Twinrix Adult lasts up to 15 years
Twinrix Paediatric
  • Inactivated, adsorbed
  • Licensed from 16 years of age

The information below is based on Public Health England recommendations; individual SPCs should be referred to for manufacturer recommendations regarding individual brands.

Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines

Hepatitis B vaccine can be given at the same time as other vaccines such as DTaP/IPV/Hib, hepatitis A, MMR, MenC, Td/IPV and other travel vaccines as long as they are administered at different sites.

Immunocompromised patients

Hepatitis B vaccine should be given to patients who are immunocompromised if they are at risk; however, it may not be as effective. Specialist advice may be required.

Pregnancy and breast-feeding

No harmful effects due to hepatitis B vaccination during pregnancy or breast feeding have been reported. Hepatitis B infection during pregnancy can lead to severe disease for the mother and chronic infection of the newborn, so where there is a risk of infection immunisation should not be withheld.

Rabies low risk

Rabies may be present in wild and domestic animals but the risk is low. Contact with wild or domestic animals should be avoided; any bites should be thoroughly cleansed and medical advice sought urgently, even if the wound appears trivial.

Vaccination may be considered in at-risk groups.

Tick-borne encephalitis

Transmission

Tick-borne encephalitis is transmitted by the bite of infected ticks or rarely by drinking unpasteurised milk from infected goats, sheep or cows. Infected ticks are found in open country – forests, grassland, meadows and shrubbery, for example – where they are brushed onto clothing as people walk past. Ticks are usually the most prevalent during the spring and summer.

Using insect bite avoidance measures can reduce the risk of transmission of tick-borne encephalitis:

  • Keep limbs covered – wear long-sleeved tops and trousers that can be tucked into socks for added protection. Clothing can be sprayed with a suitable insecticide such as permethrin.
  • Insect repellents should be applied to exposed skin.
  • After walking in risk areas the body should be checked visibly for ticks. If a tick is found, it should be removed as soon as possible by gripping it as close to the skin as possible, preferably using a pair of tweezers, and pulling away slowly. Take care not to squeeze the tick.
  • Travellers should avoid drinking or eating unpasteurised dairy products in risk areas.

Anyone who has been bitten by a tick and who subsequently develops a flu-like illness within 28 days should seek medical advice.

Tick-borne encephalitis vaccine is recommended for travellers to forest and grassland areas of certain European countries, across Russia and eastern parts of Asia, mostly in altitudes lower than 1,500m.

Vaccination schedule

Brand Vaccine information Primary course Booster

TicoVac

  • Inactivated
  • Licensed from 16 years of age
  • First dose on day zero, with second dose given between one-to-three months and third dose given between 5–12 months after second dose
  • Accelerated schedule: second dose may be given two weeks after first dose
  • Lasts up to three years
  • For 1–15 years of age — first booster is given three years after the third dose, then, every five years
  • For 16–60 years of age — every five years for continued risk
  • Over 60 years of age — every three years for continued risk
TicoVac Junior
  • Inactivated
  • Licensed from 1–15years

The information below is based on Public Health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands.

Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines

Tick-borne encephalitis vaccine can be given at the same time as other routine and travel vaccines as long as they are administered at different sites.

Immunocompromised patients

Tick-borne encephalitis vaccine can be given to patients who are immunocompromised if they are travelling to an area of risk; however, it may not be as effective so additional doses may be required following serological tests. Specialist advice may be required.

Pregnancy and breast-feeding

No harmful effects due to tick-borne encephalitis vaccination during pregnancy or breastfeeding have been reported so it should be considered when clinically indicated.

Additional

Precautions

Altitude

Risk

Risk of altitude sickness occurs when travelling  to destinations of 2,500-3,500m (8,200-11,500 feet), although cases have been reported at lower altitudes 1,500-2,500m (5,000-8,200 feet).

Risk factors for altitude sickness include the altitude itself, the rate of ascent and sleeping altitude. Travellers are at a higher risk if they have rapid ascent without a period of acclimatisation.

Risk management

  • Travellers should avoid travelling directly into areas above 3,500m
  • A few days at an altitude below 3,000m prior to ascending should help travellers to acclimatise
  • When ascending above 3,000m, this should take place gradually with no more than a 300-500m increase in sleeping altitude per day, and a rest day every three days
  • Acetazolamide may be used off-label for altitude sickness prevention, although pharmacological prophylaxis is not encouraged
  • Symptoms of altitude sickness include headache, fatigue, loss of appetite, nausea and sleep disturbance; if symptoms develop travellers should avoid further ascent and descend if there is no improvement
  • Symptoms of severe forms of altitude sickness must be treated as a medical emergency and immediate descent is required; such symptoms include high-altitude cerebral oedema (confusion, difficulty with balance and coordination) or high-altitude pulmonary oedema (shortness of breath at rest, cough and chest tightness) 

Biting insects or ticks

Diseases spread via biting insects or ticks

Insect/tick bites can irritate the skin and cause infections and some of the diseases which are spread via the bite include:

  • Chikungunya
  • Crimean-Congo haemorrhagic fever
  • Leishmaniasis
  • West Nile virus

Country-specific details can be found on TravelHealthPro website

Prevention

There is no vaccine to prevent these diseases. Travellers to areas of risk must use bite avoidance measures day and night.