Cholera vaccination certificate

The World Health Organisation removed proof of cholera vaccination as a country entry requirement from the International Health Regulations in 1973. the International Certificate of Vaccination no longer contains a specific space for recording proof of cholera vaccination. For further information, refer to the World Health Organisation statement.…

Polio vaccination certificate

Proof of polio vaccination may be required for certain travellers when leaving the country after their visit. Failure to present an International Certificate of Vaccination or Prophylaxis (ICVP) at point of departure, may require the polio vaccination to be given. For further information, refer to: Country-specific pages on the TravelHealthPro website ICVP guidance on the TravelHealthPro website Internation Health Regulation statements on polio on the World Health Organisation website…

Cholera

Transmission Cholera is transmitted through the faecal-oral route through the consumption of contaminated water and sometimes food, including shellfish. Rarely is it transmitted person-to-person. Risk to most travellers is small, even where there is an outbreak. Travellers at risk: Humanitarian aid workers Consuming untreated drinking water, or poorly cooked seafood Travellers living in areas of poor sanitation or poverty Long-term travellers in endemic areas Immunisation against cholera is not required for general travel, however, food and water hygiene measures should be practiced. Immunisation against cholera is usually only recommended for high risk travellers, for example, humanitarian aid workers and those travelling to areas experiencing an outbreak who will have limited access to safe drinking water or medical care. Vaccination schedule Brand Vaccine information Primary course Booster Dukoral Inactivated, oral Licensed from two years of age From six years of age: Two doses 2–6 years of age: Three doses Doses to be administered at least one week apart Restart primary course if more than six weeks have elapsed between doses Effective one week after completing course Single dose From six years of age — within two years 2–6 years of age — within six months If more than two years have elapsed (or more than six months for children 2–6 years of age) — repeat primary course.   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.…

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.…

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.…

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.…

Japanese encephalitis

Transmission Japanese encephalitis is is caused by a flavivirus, present in wading birds and pigs, and transferred to the Culex mosquito. It is transmitted by bites from infected Culex mosquito, which are most active from dusk to dawn. Japanese encephalitis vaccine is recommended for travellers to rural parts of Asia and endemic parts of Australia for stays of one month or more during the main transmission season, however, it may be required for shorter stays if visiting an area of high risk such as rice fields or close to pig farms. Travel should be avoided within 10–14 days of primary course, in case a delayed allergic reaction occurs. Vaccination schedule Brand Vaccine information Primary course Booster IXIARO Inactivated, adsorbed Licensed from 2 months of age Single dose at day zero and 28 Accelerated schedule for adults aged 18-65 years at day 0 and day 7 Effective one week after second dose in adults Recommended not to interchange between different  vaccines (for example, the unlicensed Green Cross vaccine) Check the Summary of Product Characteristics (SPC) for different age group’s schedules   From 18 years of age Third dose between 12–24 months for re-exposure Continuous/repeated exposure — at 12 months   The information below is based on Public Health England recommendations; the SPC should be referred to for manufacturer recommendations.…

Meningococcal Meningitis

Transmission Meningococcal meningitis is caused by Gram-negative bacteria Neisseria meningitides which is frequently carried in the human nasopharynx without progressing to disease. It is transmitted by frequent or prolonged inhalation or direct contact of infected droplets. Contact the NPA Pharmacy Services Team for advice. Vaccination schedule Brand Vaccine information Primary course Booster Menveo Inactivated Licensed from two years of age   Single dose Effective after one month Lasts up to five years Single dose — may be given if primary course with Menveo, other conjugated meningococcal or meningococcal unconjugated polysaccharide vaccines Nimenrix Inactivated Licensed from 12 months of age   Single dose Check Summary of Product Characteristics (SPC) for persistence of immunity in different age groups Single dose — may be given if primary course with polysaccharide meningococcal vaccine NB: The quadrivalent ACWY meningococcal vaccine is the recommended vaccine against meningococcal disease for travel purposes (the MenC conjugate vaccine is not used for travel purposes), according to Public Health England’s book “Immunisation against infectious disease: the green book“. Meningococcal vaccines are available as either a polysaccharide or conjugate version — the Green Book states that the conjugate vaccine is the preferred version for travel purposes in all age groups. Previously, Menveo – manufactured by Novartis Vaccines Ltd – was the only conjugate quadrivalent meningococcal vaccine available for travel purposes, with its use in children under the age of 11 years being unlicensed.…

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.…

Rabies

Transmission  Rabies is caused by members of the virus Lyssavirus genus and is transmitted by bite, scratch or through saliva exposure, for example, to eyes, nose or mouth from domestic and wild and warm-blooded mammals —particularly dogs. The risk of rabies to most travellers is small; those at risk include: Those unable to easily access medical care at their destination, including access to rabies vaccine/immunoglobulin If at continued risk for more than one month Those participating in activities such as running/cycling Handlers of imported animals, bats, or health workers who have direct contact with rabies infected animals or patients Vaccination schedule Brand Vaccine information Primary course Booster Rabies vaccine BP (inactivated) Inactivated No licensed minimum age  Single doses on day zero, seven and 28 — third dose may be given earlier on day 21 Single dose — 12 months after primary course completion and repeated every three-to-five years for continued exposure Rabipur(inactivated) Inactivated For all age groups Three doses, with full immunity after day 28 The booster dose should be administered in line with official recommendations. 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 or contact the NPA Pharmacy Services Team for specific advice.…