The following vaccinations will provide adequate protection for most travellers. For the most up-to-date advice, you can search by the country that you are visiting on the NHS Fit for Travel website, or the National Travel Health Network and Centre.
This page contains vaccination information about conditions starting with A–M. The next page contains vaccination information about conditions starting with P–Z.
Cholera
Cholera can cause severe diarrhoea and vomiting. This can quickly lead to severe dehydration, and can be fatal. Cholera is spread through contaminated food, particularly shellfish and water.
High-risk areas: cholera is found throughout the world, particularly in areas with poor sanitation, including parts of Africa, India, South East Asia, the Middle East and parts of Central America.
The cholera vaccination is not recommended for most travellers. For most people, normal food and water hygiene precautions will be enough to prevent the infection.
The cholera vaccination is recommended for:
- aid workers helping in disaster areas, or refugee camps, or
- backpackers heading to remote areas of a country where cholera is a risk, and where they will not have access to medical care.
The vaccine
For adults and children over six years of age, two doses of the vaccine are needed to protect against cholera for two years. After this, a booster will be required. The vaccine is taken orally (by mouth), as a small amount of liquid to be swallowed.
Children who are 2-6 years of age will need to have three doses of the vaccine. This will protect them for six months after which time they will need to have a booster.
For all age groups, the doses must be given at least one week apart, but no more than six weeks apart. The vaccinations should be completed at least one week before travelling.
The cholera vaccine cannot be given to children under two years of age.
Diphtheria
Diphtheria is a bacterial infection that is spread through droplets from the coughs and sneezes of people with the condition. It affects the nose, throat, and sometimes the skin, and it can be fatal.
High risk areas: sub-Saharan Africa, and parts of South East Asia and South America.
In the UK, children are vaccinated against diphtheria as part of the childhood vaccination programme. This means that many people in the UK will already be fully vaccinated against diphtheria.
The vaccine is recommended for anyone travelling to a high risk area and who:
- has not been vaccinated before,
- has not been fully vaccinated (in the UK you should receive five doses of the diphtheria vaccine), or
- had their last dose of the diphtheria vaccine 10 years ago, or longer.
The vaccine
Children under 10 years of age will receive their diphtheria vaccine as described in the NHS Choices Vaccination planner.
Children aged 10 years of age, or over, and adults who have never been vaccinated, will need to have three doses of the vaccine, one month apart. You can have a booster dose 5-10 years after this, followed by a second booster dose after another 10 years. You will then be protected for life.
Anyone who has not been fully vaccinated (received five doses of the vaccine), or has not had a booster dose in the last 10 years, will need to have a booster dose of the diphtheria vaccine
The diphtheria vaccine is usually combined with other vaccines, such as tetanus and polio. The diphtheria vaccine cannot be given to infants who are under two months of age.
Hepatitis A
Hepatitis A is an infection of the liver that is caused by the hepatitis A virus. It is caught through contaminated food and water, or through person-to-person contact if there is poor personal hygiene.
High risk areas: the Indian, African, Central American, and South American sub-continents, the Far East, and Eastern Europe.
The Hepatitis A vaccination is recommended for:
- anyone who is travelling to areas of moderate or high risk for prolonged periods, particularly if sanitation and food hygiene are likely to be poor,
- anyone who is going to live, or stay for a long time, in a country where hepatitis A is endemic (constantly present), and
- anyone with chronic liver disease because hepatitis A can be more serious for people with this condition.
Vaccination is not considered necessary if you are travelling to Northern, or Western, Europe, North America, Australia, New Zealand, or Japan.
The vaccine
A single injection of the vaccine should be given two weeks before you leave, although it can be given up to the day of your departure if necessary. This will protect you against hepatitis A for about a year. A booster dose, given 6-12 months after the first, will protect you for up to 20 years.
A combined hepatitis A and B vaccine, and a combined hepatitis A and typhoid vaccine are also available. These vaccines may be useful if you require protection against both diseases.
The hepatitis A vaccine cannot be given to infants who are under one year of age.
Hepatitis B
Hepatitis B is an infection of the liver that can cause flu-like symptoms, liver failure, and can be fatal. It is spread through contact with infected blood, or body fluids - for example, through sexual intercourse or sharing needles.
High risk areas: hepatitis B occurs worldwide but, in particular, it may be found in Eastern Europe, Russia, India, China, South and Central America, Africa, South East Asia, and many of the South Pacific islands.
The risk of hepatitis B for tourists is usually considered to be low. However, some activities will increase your risk - for example, having unprotected sex, injections, or body piercings.
The hepatitis B vaccine is recommended for travellers in high risk areas who:
- may behave in an unsafe way - for example, having unprotected sex, or injecting drugs, working as a relief worker, or working in a medical setting,
- may stay in a high or medium risk area for a long period of time, or
- may require medical care while in a high or medium risk area.
The vaccine
Several different vaccines are available for hepatitis B. Most require a course of three doses in order to provide protection. The second dose is usually given one month after the first dose, and the third dose is then given five months later.
Once you have completed the vaccination course, and a blood test has confirmed that you are immune, you will be protected against hepatitis B for life. Healthcare workers are advised to have a booster dose after five years.
A combined hepatitis A and B vaccine is also available. The hepatitis B vaccine can be given from birth.
Japanese encephalitis
Japanese encephalitis is passed to humans by bites from infected mosquitoes. It is usually mild but in some cases it can cause inflammation (swelling) of the brain (encephalitis), leading to permanent brain damage or death.
High risk areas: tropical north east Australia and East Asia - including China, Myanmar (Burma), Thailand, Vietnam, Cambodia, Laos, Nepal, India, Philippines, Sri Lanka, Korea, Malaysia, Indonesia, and Singapore.
The Japanese encephalitis vaccination is recommended for anyone travelling to a high risk area who will be:
- staying for a month or longer, particularly if visiting rural areas or travelling just after, or during, the monsoon season,
- visiting rice fields or travelling close to pig farming areas, even if only for a short time, or
- cycling, camping, or working in fields, even if only for a short time.
The vaccine
There are two possible vaccines for Japanese encephalitis. Ideally, they need to be completed a month before you leave. One vaccine requires two doses, with the second dose given 28 days after the first. This vaccine is only suitable for people who are over 18 years of age.
The alternative vaccine consists of three doses, and is suitable for people who are over one year of age. The second dose is given after seven days, and the third dose is given 21 days after this. This vaccine needs to be completed at least 10 days before you leave, in case you have an allergic reaction.
Both vaccines will require a booster after one year. The Japanese encephalitis vaccine is not suitable for children who are under one year of age.
If there is not enough time to complete a normal course of the vaccine, you may be able to have an accelerated course. This involves two doses being given one week apart, or three doses with a week in between each dose. This still needs to be completed at least 10 days before you travel. You will need to have a booster three months later.
Meningococcal meningitis
Meningococcal meningitis is a bacterial infection that can be serious, or even fatal, if not treated quickly. It is spread through contact with droplets from the coughs and sneezes of people with the condition.
There are different groups (types or strains) of meningococcal bacteria that cause different meningococcal infections. Groups B and C are the most common in the UK, and vaccination against group C meningitis is now part of the childhood vaccination programme. Groups A, Y, and W135 are more common elsewhere in the world.
High risk areas: parts of Africa and Saudi Arabia.
Vaccination against groups A, C, Y and W135 meningitis is recommended if you are travelling to a high risk area and you will be:
- staying for longer than one month,
- backpacking,
- living with locals in rural areas,
- attending the Hajj or Umrah pilgrimages (religious journeys to Mecca, the centre of the Islamic world) in Saudi Arabia, or
- doing seasonal work in the Hajj area of Saudi Arabia.
Visitors arriving in Saudi Arabia for the Hajj and Umrah pilgrimages, or to undertake seasonal work in the Hajj area, require proof of vaccination against groups A, C, Y and W135 meningitis.
The vaccine
The quadrivalent vaccine will protect you against groups A, C, Y and W135 meningitis. This should be given 2-3 weeks before you travel.
For adults and children who are over five years of age, a single dose of the quadrivalent vaccine provides protection for about five years. For children who are under five years of age when they were first vaccinated, the vaccine gives protection for 2-3 years.
For infants who are between two months and two years of age, the initial dose of the vaccine must be followed by a second dose three months later.
The meningitis vaccine is not suitable for infants who are under two months of age.