The importance of immunisation
Immunisation can protect against many of the more serious diseases which may be encountered during our lives and travel abroad. Many patients have worries about immunisations, especially childhood vaccinations and the media are always presenting further concerns. However, despite all of these concerns, if a child is not immunised they will be at risk from catching the disease and will rely on other people immunising their children to avoid becoming infected.
There will always be some children who are left unprotected because:
- they cannot be immunised for medical reasons
- they are too young to be immunised
- they do not or choose not to access vaccine services
- for some and in rare instances the vaccine does not work
If more people choose not to immunise, then there will be increasing numbers of susceptible children and outbreaks of disease will occur. The effects of large numbers of children not being immunised can and have been seen across the world.
For information about the MMR vaccine and the diseases that it is designed to prevent, visit the comprehensive MMR website at www.mmrthefacts.nhs.uk
This practice does adopt the advice given by the Chief Medical Officer as this represents the best available evidence we have.
The Department of Health are introducing important changes to the childhood immunisation programme.These changes will ensure that young children in this country are offered the best protection against serious vaccine-preventable diseases.
The changes to the routine childhood immunisation programme will come into place on the 4th September 2006 are available in the Chief Medical Officer letter: Important changes to the childhood immunisation programe.
The changes, recommended by the Joint Committee on Vaccination and Immunisation (JCVI) are:
- The introduction of a new vaccine to protect against pneumococcal infection
- A pneumococcal vaccination catch-up programme
- Amending the MenC vaccination schedule to give two doses of vaccine in the first year of life, and a booster dose in the second year
- The addition of a booster dose of Hib vaccine in the second year of life
If possible, seek advice about travel immunisations 6-8 weeks before leaving the UK. Don't leave it until the last minute to prepare for your trip. Please COMPLETE & RETURN the travel risk questionnaire at least 2 weeks before planned travel and post or send via email to Kristyn.whitmore-craw@nhs.net
Please click here to down load the travel risk assessment form which must be completed and returned to the nursing team at least 2 weeks before any planned travel. This form will assist the medical team in indentifying which vaccinations are required on an individual basis and ensures that we have enough stock available for forthcoming vaccinations.
Do not forget to check whether or not anti-malarial prophylaxis is needed in addition to travel vaccinations. Help is available from many online resources (see below) as to which vaccinations to have for a particular destination. As requirements for any particular destination may change it is best to look at the available resources on the internet for the most up to date recommendations.
It is important to bear in mind that immunisations do not protect against many of the more common problems (e.g. travellers' diarrhoea) and it is always wise to ensure high standards of food and water hygiene and to avoid being bitten by mosquitos and other insects (use safe, effective insect repellents, mosquito nets, etc.).
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Suggested links for travel advice and help on required vaccinations |
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Fit for travel - provided by the NHS (Scot) |
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An International Certificate of Vaccination against Yellow Fever may be demanded as a condition of entry when visiting certain countries. This is now the only official, mandatory vaccination (apart from a requirement for a Meningitis Certificate for Hadj or Umra pilgrims to Saudi Arabia) and the regulations are complex. If visiting countries which may require a yellow fever certificate (usually countries in South America, Africa and Asia) it is best to seek expert advice. Despite the fact that yellow fever is the only mandatory immunisation requirement, there are, unfortunately, reports of cholera certificates being demanded by border officials in certain countries. If it is known that such a demand may be made, it is best to ensure that a certificate is obtained prior to departure.
Please note that some of the vaccinations are not available on the NHS (Hepatitis B, Yellow fever, Rabies & Chickenpox ) and a charge has to be made for these (see below).
Anti-malarial drugs will need to be purchased from the chemist but a private prescription from your GP is needed in most instances at a cost of £11.50 per prescription per person plus the cost of the drugs.
Yellow fever vaccination = £62 ; Hepatitis B for travel = £35 x 3 ; Swine flu for travel to Southern Hemisphere = £15 for nurse time + free vaccine; Rabies & Chickenpox = POA. Payment for these must be made in advance of your appointment via cheque, cash or credit/debit card.
The immunisations on this page are those most commonly recommended to travellers. |
Hepatitis A |
Vaccines are available which provide protection for up to ten years (Havrix, Avaxim). These vaccines are recommended for trips to countries where the general standard of hygiene is very poor, eg Asian, South American, and African countries. Ten year protection is only achieved if two injections are given 6 to 12 months apart - one will not do this so please ensure you have the second injection even if you have since forgotton your holiday! The protection provided by the vaccine exceeds 95%. |
Yellow Fever |
A single injection provides protection against yellow fever for ten years. An International Certificate of Vaccination against Yellow Fever is valid ten days after the injection or immediately upon re-vaccination, and is a mandatory requirement for entry into certain countries (see above). |
Typhoid |
Typhoid is a disease contracted from contaminated food and water which leads to high fever and septicaemia. Immunisation is therefore usually advised for those going to areas where the standards of food and water hygiene are very poor. The two vaccines that are now more commonly used are a four-dose oral vaccination (Vivotif) and a single dose injection (Typhim VI). The oral vaccine gives about 70% protection. The injection gives 70-80% protection for at least three years. The injection is the most commonly used vaccine and has fewer side effects than the oral vaccine. Those at risk should be re-immunised every three years.
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Cholera |
Cholera is an uncommon disease in travellers. The injected vaccine was of poor efficacy and is no longer available in the UK. Immunisation against cholera is not appropriate for most travellers, although, where it is known that border officials may demand a cholera certificate, it is wiser to be in possession of such a certificate prior to departure. |
The following vaccines are occasionally suggested to travellers at particular risk or those who may be staying for long periods of time. |
Rabies |
Pre-immunisation against rabies should be considered by travellers going to areas where rabies is endemic, who are staying for considerable periods of time or are at particular risk. The immunisation should not be considered to provide complete protection and medical advice must be sought if bitten by a potentially rabid animal. |
Hepatitis B |
Hepatitis B is a viral disease of the liver that is endemic in many tropical countries. It is transmitted by sexual activity and through contaminated needles and syringes. Travellers at particular risk should consider being in date for this immunisation. The course comprises two injections separated by one month and a further injection at six months. An accelerated schedule is available for those who do not have time to complete the recommended course. |
Japanese encephalitis |
Japanese encephalitis is a serious viral disease transmitted by mosquitoes in certain rural parts of India, Asia and south east Asia. A vaccine is available which should be reserved for those going to risk areas for periods of a month or more. |
Tick borne encephalitis |
Tick borne encephalitis is a viral disease transmitted by ticks. It is prevalent in certain European countries where the ticks are found in the long grass at the edge of forests. The vaccine is recommended for those who will be staying in such areas for prolonged periods of time. |
Meningitis |
Two single dose vaccines are available. One protects against the A and C strains of the disease, the other against the ACW and Y strains. The vaccine would be advised for travellers to areas where there are outbreaks of these strains of meningococcal meningitis. Long-stay travellers to areas where the disease is endemic (e.g. the "meningitis belt" in northern sub-Saharan Africa in the dry season) should also be offered the vaccine. A booster is required every 3-5 years. Pilgrims and seasonal workers visiting Saudi Arabia are required to be in possession of a certificate of immunisation against ACWY strains. A new certificate must be issued every 3 years. |
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Some patients may be at special risk of contracting a disease either because their own immunity against infection is low or because they are at risk through their occupation. Conditions leading to low immunity would include those suffering from immune deficiency syndromes, HIV infection, splenectomy and long term use of steroids. If you feel that you are at risk please make sure that your doctor is aware of this.
Occupational hazards include medical, nursing and laboratory personnel where they regularly come into contact with blood or blood products, the police and emergency services and some other specific groups. The guidance issues on this are complex so please seek the advice of your doctor. However we are unable to provide injections which you may need for occupational health reasons. If you need these, please contact your employer to discuss where you can obtain them.
