How Travel Vaccinations are Delivered 

If you are planning a trip abroad, it is important to check if there are some vaccines you need to have. Some travel vaccinations are available on the NHS. These include: 

• polio (given as a combined diphtheria/tetanus/polio vaccine), 

• typhoid 

• hepatitis A 

• cholera 

But not all travel vaccinations are available on the NHS, even if they're recommended for travel to a certain area. Those which are not available on the NHS are: 

• hepatitis B 

• Japanese encephalitis 

• meningococcal meningitis vaccines 

• rabies 

• tick-borne encephalitis 

• tuberculosis (TB) 

• yellow fever 

From 1 April 2021, all general practices are expected to offer specific NHS travel vaccinations. Some offer vaccines not available on the NHS as a private service. Other settings which may offer travel vaccinations include pharmacies, private clinics and occupational health services. In England, Wales and Northern Ireland yellow fever vaccination can only be administered at designated Yellow Fever Vaccination Centres. 

The National Travel Health Network and Centre (NaTHNaC) was set up by the Department of Health in 2002 and is commissioned by the UK Health Security Agency (formerly Public Health England) to provide up-to-date and reliable travel health guidance for health professionals and people travelling overseas. This includes a programme of registration, training, standards and audit for all Yellow Fever Vaccination Centres in England, Wales and Northern Ireland. However, other areas of travel health delivery are not specifically regulated, and although specialist training is available, it is not a requirement. 

Travel vaccinations are important because travel to certain parts of the world can expose travellers to infectious diseases like yellow fever, hepatitis B that the routine NHS immunisation schedule doesn’t provide protection against. This can put their individual health at risk, but also cause localised outbreaks on their return.  

This is the case for travel made for visiting friends and relatives (VFR travel): surveillance data show that the majority of cases of malaria reported in the UK occur in people who have visited friends and relatives in Africa while the majority of cases of enteric fever (typhoid and paratyphoid) reported in the UK have been acquired in countries in the Indian subcontinent by people travelling for the same reason. It does not matter how familiar people are with their destination, it is important to seek health advice before travelling abroad. 

How Local Public Health Teams Can Support Travel Vaccinations 

Directors of Public Health are not mandated to gain assurance of local travel vaccination services. But from a health protection and health inequalities perspective, local public health teams should work with other system leaders to promote travel vaccinations. This is especially important if there have been any recent outbreaks of vaccine-preventable diseases associated with travel in the area (e.g. cholera, hepatitis a & b, and yellow fever). It would be interesting for public health teams to:

1. Develop an understanding of the local rate of travel to countries where vaccinations are recommended or required. Speak to local universities, schools, airports, GPs and travel health clinics about common destinations of travel for holidays, visiting friends and relatives (VFR travel), gap years, working and volunteering abroad, and international students. Find out how they promote the need for travel vaccinations amongst these groups. 

2. Ask LPCs, ICSs, and Commissioners: 

• How are travel vaccinations promoted and signposted? 

• Are all vaccinators specially trained in delivering travel vaccinations? 

3. Explore the level of awareness in the local area about the importance of travel vaccinations, where they are offered locally, and when they are needed. You could explore this using a community survey disseminated to key stakeholders and community groups, focus groups and engagement events, making sure you engage with all demographic groups in the area.  

4. If you identify a need for more information about travel vaccinations, you can explore developing a communications campaign aimed at raising awareness and promoting travel vaccinations (see our resource on Developing Communications). 

5. Think about how you could involve travel agents, local faith groups, universities, and visa services in signposting to travel vaccinations. 

Information and Resources 

NaTHNaC provides travel advice for health professionals and the public including:   

• Health information for overseas travel (TravelHealthPro) 

• Specialist advice line for health professionals advising travellers who have a complex medical history or itinerary 

• Conditions of designation and code of practice for Yellow Fever Vaccination Centres  

• Yellow fever vaccination centre registration and training 

• Courses, conferences and training days for professionals working in travel health and vaccination 

Other useful resources include: 

• The Royal College of Nursing’s guidance: Competencies: travel health nursing: career and competence development 

• National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners (in partnership with Public Health England, Public Health Wales, and Scotland’s Public Health Agency)  

• The Royal College of Physicians and Surgeons of Glasgow, Faculty of Travel Medicine: Good practice guidance for providing a travel health service 

• Recommendations for the practice of travel medicine 

Health Protection Scotland provides travel advice on the following websites: 

• TRAVAX for health professionals 

• Fit for travel for the public 

UK Health Security Agency offers specific advice for healthcare workers with patients who moved to the UK and are now planning on travelling to visit friends and relatives: Migrant Health Guide: Immunisation 

  Migrant Health Guide: travel to visit friends and relatives