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 Yellow
Fever
This
is given as a live vaccine (0.5ml subcutaneously)
at designated yellow fever centres where
an international certificate of vaccination
will be issued and is valid for ten years,
from ten days after vaccination. The certificate
may be required for entry into certain countries
particularly in East Africa. It is recommended
that the traveller carries the certificate
along with his or her passport when travelling
to countries at risk.
Typhoid
Original typhoid vaccine is given
in two doses at intervals of four to six
weeks and gives immunity for up to three
years. 0.5ml is given by subcutaneous or
intramuscular injection or 0.1ml by intradermal
injection. This vaccine induces a mild form
of the illness which can be very unpleasant
in certain cases.
Typhim Vi is a single dose vaccine
where 0.5ml is given by deep subcutaneous
or intramuscular injection. Immunity lasts
for approximately three years.
Vivotif is a live oral vaccine contained
in an enteric coated capsule. The vaccine
is taken as three doses of one capsule on
alternate days. The capsules should be stored
in a refrigerator between doses. Protection
begins seven to ten days after the last
dose.
Tetanus
The Department of Health recommends
administration of reinforcing (booster)
doses at ten year intervals, with the administration
of further doses in the event of injuries
that may give rise to tetanus. 0.5ml is
given by deep subcutaneous or intramuscular
injection.
The Department of Health advised in 2002
that tetanus vaccine is to be replaced by
the combined tetanus/low dose diphtheria
vaccine for adults and adolescents for routine
use and for travel vaccination. Stocks of
single tetanus vaccine are now exhausted
and companies are no longer supplying this
product.
Polio
Poliomyelitis vaccine is recommended
for long term travellers to areas which
have a high incidence of the disease such
as developing countries. Live oral vaccine
is generally used. Three drops of the vaccine
constitutes a single dose. Initially three
doses are given at intervals of at least
four weeks. Those who have been fully immunised
in the past will only need a single booster
dose every ten years if they intend to travel.
Hepatitis
A
Hepatitis A is associated with poor
hygiene and sanitation. Havrix Monodose
is an inactivated vaccine prepared from
the hepatitis A virus. A single 1ml dose
is given intramuscularly to give immunity
up to one year. To obtain immunity up to
ten years a second booster dose is given
between six and twelve months of the original.
Human Normal Immunoglobulin (HNIG) contains
antibodies to Hepatitis A and will give
protection for up to three months. 2ml of
vaccine is administered by deep intramuscular
injection.
Meningitis
(A&C)
Meningitis vaccine is recommended
for travellers to areas where the disease
is endemic such as most of Sub-Saharan Africa.
Saudi Arabia requires vaccination of pilgrims
to Mecca during the Hajj. 0.5ml of inactivated
vaccine is given by deep subcutaneous or
intramuscular injection. Immunity lasts
up to three years.
Japanese
B encephalitis
This is a rare but serious insect
borne disease that occurs in most of the
Far East and South East Asia. Vaccination
is recommended for stays of longer than
one month in rural areas during and just
after the rainy season. The vaccine is issued
on a named patient basis and is given as
1ml subcutaneously for immunity up to four
years.
Diphtheria
Low dose boosters of diphtheria
vaccine are advised for travellers to countries
of the former USSR and for long stay expatriates
in developing countries. A dose of 0.1ml
of the childrens' monovalent diphtheria
vaccine is given by subcutaneous injection
on a named patient basis. Protection begins
ten to fourteen days after administration.
Rabies
Prophylactic immunisation against
rabies is recommended for travellers to
endemic areas on long journeys to remote
locations out of reach of immediate medical
attention. For travellers who are not animal
handlers, two 1ml doses given by deep subcutaneous
injection 28 days apart is regarded as sufficient
cover.
Hepatitis
B
Vaccination is recommended for those
travelling to areas of high prevalence who
plan to remain there for lengthy periods
such as voluntary workers, who may be at
risk from medical or dental procedures carried
out in those countries. Short term travellers
are not generally at risk but may place
themselves at risk by their sexual behaviour.
It is given as a course of three 1ml intra-muscular
injections, the second 28 days after the
first and the third 6 months after the second.
Cholera
The old type cholera vaccine which
was given by injection offers poor protection
against the disease and is no longer recommended
for use by the Department of Health or the
World Health Organisation.
However,
in May 2004 a new vaccine (Dukoral) was
licensed in the UK for immunisation against
cholera for people travelling to highly
endemic or epidemic areas, particularly
emergency relief and health workers in refugee
situations. The vaccine may be considered
for the following:
- People
working in areas where there are known
cholera outbreaks (e.g. aid workers).
- Travellers
staying for long periods in known high
risk areas and/or where close contact
with locals is likely, and who do not
have access to medical care.
- Travellers
to risk areas who have an underlying gastro-intestinal
disease or immune suppression.
The
vaccine is taken as a raspberry flavoured
drink and can be used in adults and children
over 2 years. It is not currently licensed
in the UK for travellers diarrhoea.
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