travel vaccinations with gp

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Vaccines for Travelers

Vaccines protect travelers from serious diseases. Depending on where you travel, you may come into contact with diseases that are rare in the United States, like yellow fever. Some vaccines may also be required for you to travel to certain places.

Getting vaccinated will help keep you safe and healthy while you’re traveling. It will also help make sure that you don’t bring any serious diseases home to your family, friends, and community.

On this page, you'll find answers to common questions about vaccines for travelers.

Which vaccines do I need before traveling?

The vaccines you need to get before traveling will depend on few things, including:

• Where you plan to travel . Some countries require proof of vaccination for certain diseases, like yellow fever or polio. And traveling in developing countries and rural areas may bring you into contact with more diseases, which means you might need more vaccines before you visit.
• Your health . If you’re pregnant or have an ongoing illness or weakened immune system, you may need additional vaccines.
• The vaccinations you’ve already had . It’s important to be up to date on your routine vaccinations. While diseases like measles are rare in the United States, they are more common in other countries. Learn more about routine vaccines for specific age groups .

How far in advance should I get vaccinated before traveling?

It’s important to get vaccinated at least 4 to 6 weeks before you travel. This will give the vaccines time to start working, so you’re protected while you’re traveling. It will also usually make sure there’s enough time for you to get vaccines that require more than 1 dose.

Where can I go to get travel vaccines?

Start by finding a:

• Travel clinic
• Health department
• Yellow fever vaccination clinic

Learn more about where you can get vaccines .

What resources can I use to prepare for my trip?

Here are some resources that may come in handy as you’re planning your trip:

• Visit CDC’s travel website to find out which vaccines you may need based on where you plan to travel, what you’ll be doing, and any health conditions you have.
• Download CDC's TravWell app to get recommended vaccines, a checklist to help prepare for travel, and a personalized packing list. You can also use it to store travel documents and keep a record of your medicines and vaccinations.
• Read the current travel notices to learn about any new disease outbreaks in or vaccine recommendations for the areas where you plan to travel.
• Visit the State Department’s website to learn about vaccinations, insurance, and medical emergencies while traveling.

Traveling with a child? Make sure they get the measles vaccine.

Measles is still common in some countries. Getting your child vaccinated will protect them from getting measles — and from bringing it back to the United States where it can spread to others. Learn more about the measles vaccine.

Find out which vaccines you need

CDC’s Adult Vaccine Quiz helps you create a list of vaccines you may need based on your age, health conditions, and more.

Take the quiz now !

Get Immunized

Getting immunized is easy. Vaccines and preventive antibodies are available at the doctor’s office or pharmacies — and are usually covered by insurance.

Find out how to get protected .

Get Vaccinated Before You Travel

It’s important to plan ahead to get the shots required for all countries you and your family plan to visit.

Protect your child and family when traveling in the United States or abroad by:

• Getting the shots required for all countries you and your family plan to visit during your trip
• Making sure you and your family are up-to-date on all routine U.S. vaccines
• Staying informed about travel notices and alerts and how they can affect your family’s travel plans

Avoid getting sick or coming back home and spreading the disease to others.

Vaccinate at least a month before you travel

See your doctor when you start to plan your trip abroad. It’s important to do this well in advance.

• Your body needs time to build up immunity.
• You may need several weeks to get all the doses of the vaccine.
• Your primary doctor may not stock travel vaccines. Visit a travel medical clinic .
• You’ll need time to prepare for your pre-travel appointment .
• If the country you visit requires a yellow fever vaccine , only a limited number of clinics have the vaccine and will probably be some distance from where you live. You must get it at least 10 days before travel.

Find out which vaccines are recommended or required for the countries you plan to visit .

TIP : Save time by getting routine vaccines during the same doctor visit. Use the Vaccine Self-Assessment Tool and discuss the results with your doctor. It tells you which U.S. recommended vaccines you (19 years and older) or your child (birth – 18 years) might need.

Last-minute travelers

When traveling to another country be aware your doctor may not carry a travel vaccine and you may have to visit a medical clinic.

Many travel vaccines require multiple shots or take time to become fully effective. But some multiple-dose vaccines (like hepatitis A) can still give you partial protection after just one dose. Some can also be given on an “accelerated schedule,” meaning doses are given in a shorter period of time.

• Discover and learn about specific diseases that can affect you while traveling
• What to do if you get sick after traveling
• Vaccines & Immunizations

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Health advice for travel abroad

Peer reviewed by Dr Colin Tidy, MRCGP Last updated by Dr Toni Hazell Last updated 10 Feb 2023

Meets Patient’s editorial guidelines

In this series: Travelling to remote locations Ears and flying Jet lag Motion sickness Altitude sickness

Travelling abroad means encountering unfamiliar places and situations which may carry unexpected risks. Good planning and risk assessment allow us to anticipate and avoid many possible difficulties. This leaflet considers preparation for travel, aspects of personal safety, and health when travelling. It points to sources of information and advice to help in planning.

In this article :

Research and planning, personal safety when travelling abroad, special groups of travellers, and finally.

Continue reading below

Country information

In these days of adventure travel, when it can seem as though travelling to somewhere unusual, remote or simply very different is a commonplace event, it is easy to forget the dangers and importance of being informed and prepared.

Read more about travelling to remote locations .

It is always advisable to know about the places you are travelling to, particularly if they are unfamiliar and even more so if you have never travelled there before. There are many sources of specific advice on the countries you are visiting.

Consider checking the UK government's Foreign Travel Advice by Country, which will update you if there are specific issues which might affect your safety in the countries you are visiting. Watch the news, pay attention and give yourself the opportunity to be aware of the things which might affect your decision to travel. Remember that if the UK government issues a travel warning regarding a particular country or area of the world, this may invalidate your travel insurance. Check, additionally, the CIA's World Factbook, which offers a slightly different view with information on history, people, government and transportation.

Travel insurance is an important part of your trip. Insurance protects your possessions and travel arrangements, but also your health. Accidents and illnesses happen everywhere, including overseas. The cost of medical treatment can be very high. An uninsured patient may struggle to find treatment without paying upfront. The cost of medical repatriation, if needed, can be extremely high.

Adventure tourism and sports

Make sure that your insurance covers the type of holiday you are taking. Make sure that you understand the limitations of your policy.

Some insurers will not cover high-altitude trekking holidays, for example. These travellers are strongly advised to obtain specialist insurance which includes helicopter evacuation.

Most insurers charge an extra premium for dangerous activities, including winter sports.

Many insurers will not cover travellers to any area if the Foreign Office has advised against travel there.

Your insurer may also decline to cover you if you deliberately put yourself in harm's way by taking unusual risks without informing them. For example, a policy which covers scuba diving may only cover you to a certain depth and not below.

Medical conditions

Your insurer must be fully informed of any pre-existing medical issues which might invalidate your policy if not notified:

Remember that if your doctor advises you against travelling on medical grounds then it is likely that your insurance, even if already in place, will become invalid.

Global Health Insurance Card (formerly European Health Insurance Card)

If travelling to Europe make sure you have a GHIC card. These may be applied for through the GOV.UK website (see 'Further Reading and References' below), and are free. The GHIC card is the post-Brexit version of the European Health Insurance Card (EHIC), which itself replaced the E111 form.

It will not cover any private medical healthcare or costs, such as mountain rescue in ski resorts, repatriation to the UK, or lost property.

It is also not valid on cruises.

It is therefore important to have both a GHIC and a valid travel insurance policy in place before you travel.

Some insurers now insist you hold a GHIC and many will waive the excess if you have one.

If you need urgent health help during a visit to Europe, dial 112. The European emergency number is valid in all EU/EEA member states and is free of charge.

Reciprocal health agreements

Some non-European countries also offer 'reciprocal' health treatment for UK visitors. This means that if you're visiting any of these countries and need urgent or immediate medical treatment, it will be provided at a reduced cost or, in some cases, free. The range of medical services may be more restricted than under the NHS.

A list of reciprocal agreements, by country, is available on the GOV.UK website (see 'Further Reading and References' below).

Personal documents

Obtain passports and visas well in advance. You may be refused permission to travel at the airport if you don't have the right documentation and visas. Keep a copy of the front page of your passport at home in case of loss. Check the requirements of the country that you are visiting - some will not accept a passport which is more than 10 years old, even if it has not yet expired, and some need you to have a passport which is valid for at least six months after you leave the country.

It can be useful to take some passport photographs with you for unexpected visas and other permits. Some national parks, for example, will require a photo permit for entry.

Consider how you will obtain cash at your destination. Advise your bank of your travel plans and keep access to more than one way of accessing money overseas, in case you lose a card or a card fails to work. Keep a record of your credit card numbers, passport number, driving licence number and the 'stop' numbers for lost credit cards and phones.

Patient picks for Travel advice

Travelling to remote locations

Accidental injury.

The greatest risk to travellers is not of tropical diseases, dangerous animals or high-risk sport, but of death on the road. Worldwide, road accidents are the most frequent cause of death amongst travellers. Less-developed countries typically have much higher rates of road deaths and injuries compared with their richer counterparts. Therefore, the more adventurous your travel plans, the more danger you are likely to face on the roads. This problem is compounded by the fact that poorer countries usually have less quantity and quality in their hospital and ambulance services too. Any badly injured person who cannot be transported rapidly to an adequate hospital is more likely to die. You can minimise the risks of driving abroad in several ways:

Always wear a seatbelt (or a helmet if on a bike).

Never drive under the influence of alcohol. In many countries driving with any blood alcohol present at all is illegal.

Rent cars from reputable car companies which regularly service their vehicles.

Check the tyres, lights and brakes yourself.

Make yourself aware of the rules of the road in the country you are in.

Consider whether there is an alternative to driving yourself, particularly if conditions are very unfamiliar.

Avoid hiring motorbikes and mopeds, which are statistically associated with a higher incidence of personal injury and death.

Lock the doors of your car when driving, particularly after dark.

Alcohol and drugs

Consider your personal safety when using substances that can impair your judgement and common sense.

Use alcohol in moderation only and never use it when driving.

Remember that the effects of alcohol may be more marked if you are lacking in fluid in the body (dehydrated) and you may drink more than you intended to.

Drink water, rather than alcohol, for thirst.

Don't swim if you've been drinking alcohol.

Avoid illicit drugs. Even if you are not breaking the law, you may be stepping outside your comfort zone and ability to take care of yourself. Don't make yourself vulnerable.

Most crime is minor and opportunistic; however, it occurs worldwide. Some destinations have a higher risk of violent crime and sexual assault than others. Be sensible and plan ahead. Be vigilant regarding personal security.

Try not to stand out as a potential target.

Consider whether wearing valuable or visible jewellery may be inappropriate for your destination.

Keep your cash hidden and try to carry some low-denomination notes.

Use only licensed taxis and don't share them with strangers.

Be cautious with alcohol and don't leave drinks where they can be tampered with.

Look as though you know where you're going.

Keep your credit card in sight when using it to pay and ask for the printed receipt.

Stay aware of your surroundings.

Don't commit a crime yourself, either deliberately or through ignorance of the law. Obey the law in countries that you visit; respect dress codes and traditions.

Don't buy or use illegal drugs. Most countries take a very strong view on travellers carrying illegal drugs.

Don't carry packages through customs for other people; pack your own luggage and don't leave it unattended.

Be aware that some countries prohibit the consumption of alcohol.

Be aware that flouting dress codes may break the law in some countries..

Climate and environmental hazards

Understand your destination and what you plan to do there. What risks will you face? There may be several aspects of your destination that are not only unfamiliar to you in everyday life but which also pose a risk. These include:

Remember that the sun can damage your skin at altitude, even in the absence of heat, in the shade and even when wearing sunscreen. See the separate leaflet called Sun and Sunburn for more details .

Observe sensible precautions when swimming:

Pay attention to local signs alerting you to dangerous tides or currents, or to dangerous marine animals, including jellyfish, snails and biting fish.

Watch children carefully: the sea is not like a swimming pool and it can be very easy to lose track of them.

Don't swim beyond your capabilities.

Don't swim when alone - particularly not in the sea.

Take care when diving - consider hidden rocks. Don't dive in harbours and off jetties. Beware of swimming where there are jet skiers or other vessels.

Don't swim immediately after a heavy meal.

Heat and humidity

These can cause a number of adverse effects, including prickly heat, fainting, cramps, swelling of hands and feet and heatstroke.

Risks are greater if undertaking strenuous activity in the heat of the day.

Heat exhaustion and heatstroke cause headache, dizziness, feeling sick (nauseated) and sweating and, as the condition gets worse, dry skin, collapse and confusion. Heatstroke is a life-threatening condition and needs urgent medical help. Patients need to be rested, given sufficient fluids (hydrated) and cooled.

Small children may just become quiet and listless.

Take suitable clothing to stay cool; avoid overexertion in the heat of the day. Remember to stay hydrated. Be aware of the dangers of overheating and don't overdo it. If trekking or backpacking, be particularly aware of the need for water, salt and energy replenishment. Whatever you are doing, stay hydrated and seek attention if you become unwell. See the separate leaflet called Sun and Sunburn for more details.

Sea - boats and boards Make sure that you know the rules of navigation and the waters that you are in. Understand the hazards, including dangers from marine animals and from other boats. If in charge of a motorboat, always wear the kill cord and make sure your crew members have the right flotation aids. Know how to use the radio and your flares.

Lakes and rivers Understand your environment. Some lakes and rivers may not be safe for swimming, due to the presence of freshwater parasites which can cause serious infections in human beings. Parasites are living things (organisms) that live within, or on, another organism.

Snow and ice Insurance is essential when taking part in winter sports, as mountain rescue services and helicopter evacuations in most countries are not free of charge. See the separate leaflet called Dealing with the Effects of Cold and the section providing advice for travelling to remote locations.

Altitude sickness If you are travelling to altitude, see separate sections dealing with altitude sickness and advice for travelling to remote locations for more details. Follow the guidance on how quickly to ascend and when to stop or go back down. In some cases it may be appropriate to consult a private travel clinic (not your GP) for an altitude sickness medication prescription to take with you.

Building standards Building construction in holiday destinations is not always as reliable as we expect it to be at home. Fire regulations may not be adhered to. Recent accidents abroad have highlighted risks of poorly maintained boilers, of dangerous balconies and of cloudy swimming pools:

If you have concerns about where you are staying, move to different accommodation.

Sleep with windows open and don't lean on balcony parapets.

Don't swim in cloudy swimming pools or trust poorly constructed safety barriers.

Check fire escapes and make sure that there is a way out and that you know what it is.

Extreme activities Many holidaymakers now seek the thrill of 'extreme' adventures, such as bungee jumping, swimming with sharks or paragliding. If taking part in these activities make sure that you feel happy with the way the operation is being run - ask yourself:

Do the guides seem sensible and experienced?

Are they paying attention to safety?

Do you feel comfortable that the activity is well organised?

If in doubt, go elsewhere.

Wildlife Make yourself aware of the wildlife hazards in the places you are visiting.

Large predatory animals may need particular precautions. Attacks are uncommon compared to other travel dangers and most are avoidable. In parts of the Northern USA, trekkers and campers should carry bear spray to ward off bear attacks. In parts of Australia, beaches are not safe for swimming, due to the presence of sharks and crocodiles. Large predators on African safari trips are a threat to life and limb if proper precautions are not observed.

Biting animals (including dogs, cats, bats, foxes and monkeys) may carry rabies (see below). If you are bitten, seek help. Consider whether you need rabies vaccination (generally recommended for those more likely to come into contact with local animals, including those travelling 'off the beaten track' for prolonged periods).

Venomous animals such as snakes and scorpions may pose a risk to health. Be aware of what you may encounter and know how to identify it. Never touch insects, caterpillars, spiders, snails or other animals you find on your path. It is best to assume that all snakes are both aggressive and venomous.

Whilst large or venomous animals pose the most dramatic wildlife risk to travellers, mosquitoes are a much greater threat to travellers' health. Take all possible precautions to minimise insect bites, including covering your skin and using insect repellent and mosquito nets. Use prevention (prophylaxis) against malaria and vaccination against yellow fever where appropriate (see under 'Health', below).

Remember also the dangers posed by marine life such as corals, jellyfish and octopuses.

Terrorism and civil unrest

Country-specific travel sites advise of specific dangers. However, in 2017 the range of countries where terrorism could possibly take place includes many places that UK travellers visit regularly (and of course terrorist attacks also occur in the UK). Also, the types of attacks we have seen were often impossible to predict.

Be alert to what is going on around you. Watch the news before you leave. Learn what you can about the country you are visiting.

The NHS Fit for Travel website (see under 'Further Reading and References' below) offers updated information, by country, on specific and general health issues which you might expect there.

Vaccinations

Make sure that you have all the vaccinations you need. Book an appointment with your GP or practice nurse three to six months ahead of your holiday in order to plan a programme of vaccination. Some vaccinations are given as a course of separate jabs and some cannot be given together. See the separate leaflet called Travel Vaccinations for more details . If your GP does not have the resources to offer the appointments that you need then you may need to attend a private travel clinic instead. These costs should be seen as a necessary part of the cost of travel.

Be aware of the risks of deep vein thrombosis and pulmonary embolism associated with air travel. Speak to a private travel doctor if you feel you may be at particular risk. Protective travel socks may be recommended and some patients are advised to take aspirin for travel.

If you have any doubts about whether you are fit to travel by air then speak to a private travel doctor. Your GP is very unlikely to be trained or insured to write a letter to say that you are fit to fly, and consultant assessment for this purpose is generally not available on the NHS. l. Some groups of people should not travel by air. These include:

Women more than 36 weeks pregnant.

Those with active communicable diseases, including tuberculosis, although the risk of transmission is generally low.

Those who have angina or chest pain at rest, or have had a recent heart attack (myocardial infarction) or stroke.

People with ear infections, or infection of the sinuses, nose and Eustachian tubes.

Those who have had recent surgery or injury where trapped air or gas may be present. For example, gastrointestinal surgery, face and eye injuries, brain surgery or eye operations.

People with severe chronic respiratory disease, or breathlessness at rest.

People with air trapped between the chest wall and the lung ( pneumothorax ).

Those who have sickle cell anaemia.

Those who have psychotic illness, except where fully controlled.

Try to minimise jet lag: get maximum sleep on the flight and drink all the water you can. Read more about jet lag .

if you are affected by travel sickness, take the precautions which usually help you. If using medication, make sure that you tolerate your medication well. Remember, however, that medicine that makes you appear sleepy or drunk may result in you not being allowed to travel. See separate section on dealing with motion (travel) sickness for more details.

Malaria prevention

Take all necessary precautions against malaria. It is a serious disease which can, at the very least, spoil your holiday and, at the very worst, be fatal. This includes medication to prevent malaria and protection against biting mosquitoes. It is very important to protect yourself, even if returning to a country where you have family or where you have previously lived. Immunity is not inherited and is only partially acquired by living there for a long time.

Garlic and citronella do not prevent mosquitoes from biting you. Cover your skin to avoid bites, especially after sunset when malarial mosquitoes bite. Use mosquito nets and insect repellent devices such as candles and coil burners.

Consult the NHS Fit for Travel website for up-to-date advice on the malaria regimen recommended for the countries you will be visiting. There is normally a choice of medication. Make sure that you can tolerate the medication you choose before you go. Remember that malaria prophylaxis does not offer absolute protection: minimising exposure to mosquito bites is also important. The risks of mosquito-borne disease are always greater where there is disease in the human population.

See the separate leaflet called Malaria Prevention for more details .

Water, and traveller's diarrhoea

In the UK we are accustomed to trusting the water that comes out of the tap. However, this isn't possible all over the world. Stream water and river water are not usually clean enough to drink, unless you are so high up a hill that it is certain that no people, cattle or other animals have been in the water above you.

Travellers who drink the contaminated water may find themselves exposed to the organisms that cause travellers' diarrhoea.

If you are not sure that you can trust the water in the countries you are visiting, obtain bottled water. Only drink this from a bottle if it was sealed when you purchased it. Alternatively, purify water yourself. Where bottled water is readily available, it may be a good idea to have a back-up system for purification. Purification is also more environmentally friendly than bottled water since the same bottle can be refilled.

If water needs to be purified for drinking then it should also be purified for brushing teeth.

The best ways to purify water are boiling, water purification tablets, ultraviolet devices or filtration using purpose-designed filters:

If boiling, a rolling boil for one minute is sufficient at normal altitudes (three minutes at altitudes above 2000 metres).

Water purification tablets are not palatable to everyone but are fast and effective.

Filtration is very effective, even for brackish or sandy water. Filters for sterilising water are usually sold by travel equipment shops. These filters must not be confused with those designed only to remove smells and chlorine from domestic water.

Battery-operated pen devices are easy to carry and can destroy bacteria, viruses and cryptosporidium parasite in clear water.

Diet and traveller's diarrhoea

It is important to find a middle ground between sampling local cuisine and avoiding 'traveller's tummy'. Be aware of the risks and apply commonsense when eating out. The most common causes of infection from food are salmonella , Escherichia coli ( E. coli ) and norovirus . Others, including campylobacter and giardia are also common, particularly in the developing world.

Whilst these illnesses are acquired from contaminated food, cutlery or plates, they may also be acquired from elsewhere. For example, your fellow travellers, from local people and even from touching contaminated lavatory flushers or taps.

Take precautions around drinking water (see above). Don't have ice or ice cream in places where you wouldn't drink the tap water.

Cook it, wash it, peel it or forget it. Eat freshly cooked food and fruit that you can peel.

Avoid cold cooked meats, salad (which may have been washed in contaminated water), runny eggs and unpasteurised dairy products.

Think about fish. Do you trust the source? Is it really fresh? Shellfish can accumulate contaminants whilst in the sea. Shellfish may be better avoided in many places. Smaller fish tend to be safer than larger fish where there is any doubt.

Make sure hot food is thoroughly cooked and, ideally, not reheated. Be particularly wary of undercooked chicken or pork. In some developing countries food may not have been refrigerated. If you see evidence that food is left lying around uncovered where you are, take care.

Avoid unsealed mayonnaise, although sealed condiments are fine.

If purchasing from street vendors consider how the food has been kept and cooked.

Generally, busier restaurants have a better throughput of food and so it's more likely to be fresh.

it is easier, these days, for vegetarians and vegans to travel. However, the concept of what you are happy - or not happy - to eat may not be familiar wherever you go. This, combined with potential barriers of language, may make it difficult to obtain exactly what you want.

If you have special dietary needs, particularly food allergies, consider in advance whether the countries you are visiting will be able to meet them. If you are uncertain, you may need to take energy bars and other supplements with you, or purchase food at a local store.

It is difficult to avoid all hazards completely, particularly if you are travelling off the beaten track. Therefore, it is best, whilst taking the necessary precautions, to travel prepared. Take treatments for traveller's diarrhoea in your medical kit. See the separate leaflet called Traveller's Diarrhoea .

Infections and diseases

See individual leaflets on this website for specific illnesses and conditions. Some of these may be illnesses to which you are not normally exposed when at home, such as malaria and typhoid . Others are conditions which you can acquire anywhere, such as the common cold.

It is important to remind yourself that most travellers do not acquire serious illnesses abroad and that with sensible precautions you are also unlikely to do so. These include:

Make yourself aware of the risks of disease in the countries you are visiting: read the news, check country advice.

Have the recommended vaccinations.

Take the advised protective measures against malaria.

Protect yourself against insect bites.

Be careful where you swim, take local advice before swimming in fresh water.

Take care with diet and hygiene.

Take care when exposed to those who are infected (this is particularly important for aid workers - see below).

Avoid areas where there are disease outbreaks, civil unrest and natural disaster.

If the worst happens and you develop symptoms, seek medical advice early. Avoid self-medication unless there is really no alternative. Local experts are more likely than you are to know what your symptoms are most likely to represent.

If you develop an unexplained temperature within six months of returning home from a malarial region, tell your doctor or health professional. The risk of this being malaria or another 'tropical' disease declines considerably after the first month. However, it does not drop to almost zero until six months.

Bites and stings

Most bites and stings are a nuisance rather than a serious threat to health. However, there are exceptions to this. See the separate leaflet called Insect Bites and Stings . Protect yourself against insects: take an effective insect repellent (at least 20% DEET) and cover your arms and legs as much as possible to minimise biting.

Venomous bites . Make yourself aware of the biting animals that you could encounter on your travels. Find out what you should do if you are bitten. Don't panic - seek help urgently, as you may need antivenom or other supportive treatment. Remember that most venomous bites and stings are not lethal, as most are designed to disable smaller animals than you.

Infected bites . A bite is a 'dirty' puncture wound and even a tiny insect bite can become infected. If redness around a bite continues to increase on the second and third day then it may be infected. Remember in particular to check boots for insects in the morning.

Diseases acquired from insect bites . In addition to malaria there are many other insect and arthropod-borne diseases. These include yellow fever , dengue, Zika virus, chikungunya fever, West Nile virus and Japanese encephalitis . Be aware of what the risks are where you are travelling and seek advice if you develop symptoms. The best prevention for the avoidance of mosquito-borne diseases against which there is no vaccine is the avoidance of bites.

Rabies is endemic in wild animal populations in many parts of the world. It can be acquired from the bites or scratches of various mammals, including dogs, cats, bats, monkeys and foxes. Rabies can, less commonly, be acquired through inhalation of bat droppings. Don't touch animals and if bitten seek medical advice (and if it is possible to isolate the animal for testing, do so.) If you think you are at increased risk of animal contact, consider rabies vaccination.

The risk of acquiring a sexually transmitted infection (STI) from casual sex when travelling is high. Condoms provide good but not complete protection. STIs like gonorrhoea , chlamydia and syphilis may cause serious long-term disability. Hepatitis B and HIV are also spread sexually.

High proportions of sex workers are infected with STIs. Large numbers of the population in many parts of Africa are infected with HIV, and AIDS is common. Infection is widespread in many countries in Asia and South America.

It is safest to avoid casual sex when travelling. You are taking a risk which, if you were not on holiday, you might find unacceptable. If you do have sex with a stranger, always use a condom.

Needing emergency treatment abroad

In some developing countries medical supplies, including needles and syringes, are cleaned and re-used. Travel packs are available from some chemists and travel clinics. Packs contain sterile equipment for use in an emergency. A needle kit should be supplied with a certificate showing contents and the reason for its purchase - useful for clearance at customs.

In most of Western Europe, North America, Japan and Australasia all donated blood is now screened for HIV antibodies. However, in most developing countries much of the blood donated is unscreened. The risks from blood transfusion may be high. Points to consider are:

Accidents are the most common reason for needing a blood transfusion.

Blood transfusion should only be accepted when essential.

Pregnancy or any medical condition which may lead to heavy blood loss should be taken into account before travelling to destinations where good medical facilities will not be available.

Knowing your blood group in advance may make it easier to find a blood donor in an emergency.

Travelling with children

This presents different challenges, depending on the age of your child or children. Of course travel broadens the mind and can teach children a great deal. It may, however, be easier for adults to tolerate or forget the difficulties of travelling than it is for children. When making any journey with children consider what special risks, if any, your journey and destination may mean for them. Ask yourself, are the benefits of your trip worth this, or should you delay or go elsewhere? Children will need special consideration - in particular, in areas of:

Vaccination.

Malaria prevention.

Motion (travel) sickness.

Managing long journeys.

Air travel, including ear pain.

Diet and hygiene.

Water purification.

Adventure tourism.

Environmental hazards, including sun, sea and altitude.

Understanding risk (clearly this will vary with the age of the child).

Safety in motor vehicles (for example, child seats).

Planning ahead

Allow plenty of time for journeys with young children.

Book ahead to be sure of your accommodation.

Arrange vaccinations well in advance and explain the purpose to children old enough to understand.

Take something to occupy your child on the journey.

Avoid sweets. Use savoury snacks instead.

Consider investing in a child location device for your journey. The child wears a small device fixed to their clothes and you keep the transmitter. When you have a small wandering child in a busy airport consider writing your mobile number on their arm in case they wander off and become lost.

Take the child's usual painkilling medicine (nothing else will taste the same).

Keep them involved in your plans and experiences.

Take appropriate clothing for them.

Children generally find antimalarial medication difficult. Chewable tablets taste bitter, and liquid preparations are often even worse. Make sure your children can cope with the recommended medication before you arrive in the malarial zone. The Further Reading resources section contains information on how to teach children to swallow tablets.

Travelling with medication

Permission to carry drugs Travellers carrying prescribed controlled drugs carry a letter of confirmation from their doctor. This includes personal details, travel dates and the drug/s and amount to be carried.

The Home Office allows you to take up to 90 days of controlled drug medication abroad. However, you must also comply with the entry requirements of the countries you are visiting, which may be different. It is also advisable to contact the embassy/consulate/high commission of the destination country to check regulations. Some countries have specific lists of restricted medicines and may confiscate your supply.

A copy of a recent prescription should be carried for any prescribed psychotropic including antidepressants.

For other prescribed medicines it is unlikely that any restrictions will be imposed although carrying a copy of the prescription is advisable.

For suspected restricted medication check the International Narcotics Control Board (INCB) website (see 'Further Reading and References' below) for the requirements. In many cases the regulations allow you to take up to 30 days' supply as long as you are carrying a prescription or doctor's certificate. Carrying greater than 30 days' supply may require special importation licences.

Travelling with medication Always keep medicines in packaging together with the patient information leaflet. If taking liquid medication through an airport try to take volumes of less than 100 ml, with your name and dose clearly indicated on the bottle.

Crossing time zones Travel may significantly lengthen or shorten your day through the crossing of time zones. If you are taking regular medication then seek advice from your health professional regarding whether you need an extra dose or a reduced dose to address this. For many medications this won't be necessary. However, for some, such as patients with diabetes who are taking insulin, a change of four hours or more to the length of the day is likely to need addressing. Keep sufficient medication in your hand luggage for your journey, allowing for delays.

Relief workers

Relief workers are at greater risk than other travellers. They may face greater hazards and health risks because of flooding, unstable buildings, debris, lack of electricity, water, sanitation, health facilities and law enforcement. They are in close contact with local people and may share their exposure to infectious disease and lack of access to clean water for washing and drinking.

Those undertaking this work should consult with a travel health advisor as soon as practicable for advice on vaccine and malaria recommendations and other advice on protecting their health. Relief workers should ideally be in good physical and mental health, well briefed, and equipped as necessary to deal with the challenges of their environment.

Travelling when pregnant

Travelling when pregnant needs special consideration and planning. You should research your intended destination and consider whether it is right for you. Consider the medical facilities in the country you are visiting and any outbreaks or travel warnings. Advise your doctor or a doctor specialising in pregnancy and childbirth (an obstetrician) of your intention to travel. In particular:

There are restrictions on the vaccinations pregnant women can receive.

Pregnant women and their babies are at increased risk if they contract malaria.

Pregnant women can take some kinds of malaria prophylaxis, although others are not safe in pregnancy.

Pregnancy carries an increased risk of deep vein thrombosis.

Some diseases such as Zika virus are a particular threat to pregnancy.

Most commercial airlines accept a pregnant traveller up to 36 weeks of gestation (up to 32 weeks for multiple pregnancies). Some airlines require documentation from your doctor or midwife to confirm you are in good health, and the due date. Your GP will not be trained or insured to write a letter to say that you are 'fit to fly' - they will only be able to give you a letter stating the facts of your pregnancy. If the letter needs to contain the words 'fit to fly' then you will need to visit a private travel doctor.

Travelling to visit relatives abroad

If you are normally resident in the UK but are travelling to visit relatives abroad, it's easy not to think of this as a 'holiday' and not to think of it as needing the same level of planning.

Remember that if you travel abroad to visit relatives - even if this is to a country in which you yourself were formerly resident - you need to do much of the same planning. In particular:

Insurance: your residence in the UK may mean that you have no more entitlement to healthcare on your trip than any other traveller.

Vaccinations: protect yourself against disease with a normal travel vaccine schedule - you are as vulnerable as the next person. Consider rabies vaccination if you are likely to encounter stray dogs, and educate your children about the risks of petting stray animals.

Malaria: don't be tempted to ignore the recommended precautions because your relatives say they never get malaria. They may be immune or partially immune due to repeated infections. However, you will not be, even if you once were.

Food and water: the food and water in the country you are visiting is now as foreign to your digestive system as it is to anyone else's, so you have the same vulnerability to traveller's diarrhoea as any other traveller. Take the usual precautions.

Cultural and social differences can be a challenge to you and to your children, even if your ethnic origin is in the country you are visiting. You and they will be adjusting to a different climate and possibly to other situations:

Seeing different religious practices.

Separation from family and friends at home.

Changes in living standards.

Different social amenities.

Language differences.

Economic inequalities.

Many problems can be overcome through experience and sympathetic support from family and friends.

The key to a successful holiday is careful, thorough preparation. This is true even if you are off on a carefree, backpacking, 'go where the mood takes me' trip. The NHS Fit for Travel website offers the following 'Ten Tips' to help you remain safe and healthy:

Before your trip

See a health professional specialist several months before travel.

Ask about vaccinations that are recommended for your specific destinations.

Make up a first aid and medical kit containing regular and special medication for the trip - carry it in your hand luggage.

Make sure you have evacuation and travel insurance.

During your trip

Take precautions against malaria when needed. Prevent mosquito bites and take malaria pills as advised.

Road safety is important - wear safety belts in cars, helmets on bikes and avoid night-time driving and driving under the influence of alcohol.

Abstain from casual sex or practise safe sex with condoms to prevent HIV and other STIs.

Verify and consume safe water and food. Have a supply of medicine for self-treatment of diarrhoea.

Use sunscreen. Sun can be more intense over water, over snow and at altitude.

Leave animals alone, as they may transmit rabies. Seek help if bitten.

If fever develops during or after a trip, seek medical help immediately .

Dr Mary Lowth is an author or the original author of this leaflet.

Further reading and references

• Lackner JR ; Motion sickness: more than nausea and vomiting. Exp Brain Res. 2014 Aug;232(8):2493-510. doi: 10.1007/s00221-014-4008-8. Epub 2014 Jun 25.
• Foreign Travel Advice by Country ; GOV.UK
• The World Factbook ; Central Intelligence Agency
• NHS Fit For Travel: Travel health information for people travelling abroad from the UK ; Health Protection Scotland
• Information on carrying medication overseas ; International Narcotics Control Board
• Wright T ; Middle-ear pain and trauma during air travel. BMJ Clin Evid. 2015 Jan 19;2015. pii: 0501.
• Sleep disorders - shift work and jet lag ; NICE CKS, November 2019 (UK access only)
• Apply for a UK Global Health Insurance Card (GHIC) ; GOV.UK
• Helping your child to swallow tablets ; Medicines for children, 2017

Article History

The information on this page is written and peer reviewed by qualified clinicians.

Next review due: 9 Feb 2028

10 feb 2023 | latest version.

Last updated by

Peer reviewed by

8 Jul 2016 | Originally published

Authored by:

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Travel health advice and travel vaccinations

You should make an appointment for a travel health risk assessment if you’re travelling abroad and think you need:

• a malaria risk assessment
• further advice

A travel health professional will take you through your travel health risk assessment.

Your GP is no longer your point of contact for a travel health risk assessment, including travel vaccines.

NHS travel health service

NHS Scotland provides a travel health service that includes some free vaccines.

To find information on how to make an appointment for a travel health risk assessment in Scotland, contact the NHS health board where you live.

Private travel clinics

You can also visit an independent (private) travel clinic for:

• a travel health risk assessment
• travel advice
• other travel vaccines

You should arrange a travel health risk assessment 6 to 8 weeks before you travel. This gives time for any vaccines you need to become fully effective.

If your trip is sooner, remember it’s never too late to get advice.

Travel health risk assessment

If you’re planning to travel outside the UK, your travel health needs will depend on your individual situation. This includes:

• your destination
• how long you’ll stay
• what you’ll be doing
• your general health

The fitfortravel website provides country-specific advice on:

• recommended vaccines
• other risk prevention advice

If you think you need vaccines and/or a malaria risk assessment, you should make an appointment with a travel health professional.

A travel health risk assessment is also recommended for some people, even when vaccines or malaria tablets aren’t required. This includes:

• older people
• those with a weakened immune system
• those with long-term conditions that need medications
• pregnant women

Travel vaccines

The following travel vaccines are free on the NHS in Scotland:

• diphtheria, polio and tetanus (combined booster)
• hepatitis A

It’s likely that you’ll have to pay for vaccines against:

• yellow fever
• Japanese encephalitis
• tick-borne encephalitis

You may also have to pay for the following vaccines if they’re only needed for travel purposes:

• hepatitis B
• tuberculosis (TB)

Proof of vaccination

To enter some countries you may need proof that you have had particular vaccines. This includes the yellow fever vaccine.

Yellow fever vaccines are only available from designated centres. To find out if you need a yellow fever vaccine or proof of the vaccine, you should contact a yellow fever clinic.

To request a list of any other vaccines held on your GP record, contact your GP practice. GP practices cannot provide proof of COVID vaccine.

Preventing risk while travelling

Vaccines or anti-malarial tablets will not protect against all travel health risks. This means you’ll need to take extra steps to protect your health whilst travelling abroad.

The fitfortravel website has further advice on preventing health risks whilst travelling. This includes information on:

• general travel advice
• disease prevention

Travelling abroad to visit friends and relatives

If you’re travelling abroad to visit friends or relatives, you may be at higher risk of developing travel-related illnesses. For example, malaria or typhoid. This could be because:

• you may be living with the local community
• your trip might be longer than the average holiday
• you might be visiting more rural areas where it’s difficult to take precautions that reduce your risk

The fitfortravel website provides information and advice on visiting friends and family abroad .

Travel safety advice

You can find country-specific safety and security advice through the UK government website .

Travel insurance advice

Many countries don’t have the same access to medical treatments as the UK and can be expensive.

It’s recommended that all travellers get comprehensive travel insurance before travelling.

When you return home

If you become unwell and/or develop a fever when you return home, it’s important to get medical advice as soon as possible. You should seek medical help even if it’s up to 1 month after you’ve been travelling.

Always make sure you tell the health professional that you’ve recently travelled abroad. This is especially important if you have been to a country where malaria is a risk.

Donating blood after travelling abroad

Travel outside the UK can affect whether you can give blood donations. This is because some infections may be caught abroad. This is usually through mosquito or other insect bites.

There are conditions for donating blood if you’ve been to certain countries. This can depend on your length of stay and some other factors.

Further information on donating blood after travelling abroad

Source: Public Health Scotland - Opens in new browser window

Last updated: 01 March 2024

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Travel vaccinations

Advice about getting vaccinated before travelling abroad and information about common travel vaccines.

• Travel vaccination advice
• Available travel vaccines

Country-by-country advice

• Travel Health Pro: country information travelhealthpro.org.uk
• GOV.UK: foreign travel advice www.gov.uk

Travel immunisation

Actions for this page.

• Find out from your doctor or travel health clinic which vaccinations you need for your specific travel arrangements.
• The World Health Organization recommends some routine vaccinations for all travellers as well as specific vaccinations for travellers to regions with a high risk of specific diseases.
• For some infectious diseases, some countries require proof of immunisation to enter the country.
• Many illnesses can be prevented with vaccinations and a little caution.

On this page

About travel immunisation, immunisation for travellers, immunisation for specific diseases, infectious diseases for which there are no vaccines, immunisation and halo, where to get help.

Some illnesses you can catch overseas can be prevented with immunisation . Anyone travelling overseas should visit their doctor or travel health clinic to find out what vaccinations they need. Even if you think your travel destination is safe, keep in mind that disease outbreaks can and do happen. Vaccination offers good protection against many diseases. Anyone planning to travel should check with their doctor, the World Health Organization (WHO) External Link and Smartraveller External Link for the latest information on international infection outbreaks and available vaccines. In addition to immunisations against new infectious diseases, you might need 'booster shots' to catch-up on missed vaccines or doses of vaccines that you have received before. There is no set immunisation schedule that will suit all travellers, so you must see a doctor. It is important that you don’t wait until the last minute to visit your doctor to discuss the immunisation needs for your trip. You might need a number of doses and you might need time after immunisation for your body to develop full immunity.

The WHO recommends that all travellers be up to date with routine vaccinations. In Australia, this refers to vaccinations available through the National Immunisation Program External Link . Additional immunisations might be required for people with specific needs or for people travelling to certain areas with a high risk of specific infectious diseases.

Most destinations require travellers to have completed a course of vaccination for COVID-19 to be permitted entry. Travellers should check the requirements of their destination for COVID-19 vaccination requirements, including approved vaccines, time since completing the vaccination course, evidence requirements and quarantine requirements depending on vaccination status.

Routine immunisations

You should check whether you (and your children) are up to date with or need routine immunisations for diseases including:

• pertussis (whooping cough)
• hepatitis B
• Haemophilus influenzae type b (Hib)
• human papillomavirus (HPV)
• influenza (flu)
• varicella (chicken pox)
• pneumococcal disease

The common diseases of childhood occur more frequently in countries without widespread immunisation programs, but they can also occur in countries that do have immunisation programs. If you are travelling with children, it is important that you speak with your doctor about the risks.

Have you been vaccinated against measles?

Measles is one of the most important childhood vaccines that needs to be considered for travel also. Many young people and adults have either missed out on the required 2 doses for full immunity or aren't sure if they received it as a child. If you are not sure of your measles vaccination status or know you've had fewer than 2 doses, then make sure you get vaccinated before travel because there are lots of countries where measles is still commonly transmitted. See our video External Link for more information on measles and travelling.

Free measles vaccines are available for many under the national immunisation program. Check with your local immunisation provider or ask your GP (doctor) to see if you’re eligible. Children normally receive their first measles vaccine at 12 months of age, but if you are travelling internationally with younger children make sure you tell your GP (doctor) as they can receive their first measles vaccine from 6 months of age if travelling to an area of high risk. Some of these routine immunisations, such as for flu, are important for people with medical conditions such as asthma , respiratory and cardiac conditions, metabolic conditions (such as diabetes ) or anyone over 65 years of age .

Selective immunisation for travellers

For travellers to areas with a high risk of specific infections, speak with your doctor about immunisations that you might need for diseases including:

• cholera External Link
• hepatitis A

Japanese encephalitis

• meningococcal disease
• rabies External Link
• tick-borne encephalitis
• typhoid fever
• tuberculosis
• yellow fever .

Proof of immunisation

Some countries require proof of immunisation for some infectious diseases before you enter. Check with your doctor. Diseases that might require proof of immunisation include:

• yellow fever
• meningococcal disease – specifically immunisation against serogroups A, C, W and Y
• polio – required by some countries.

Listed below is a brief overview about some infectious diseases, but you should check for more detailed information and speak with your doctor about your travel immunisation needs.

Hepatitis A

Hepatitis A is the most common vaccine-preventable disease in travellers. Information for hepatitis A includes:

• It is spread by contact with contaminated food or water.
• Hepatitis A is caused by a virus.
• Symptoms include fever, lack of energy (malaise) and jaundice (yellow skin colour).
• Hepatitis A is rarely fatal.
• Treatment for the symptoms is the only treatment available.
• Immunisation is safe and extremely effective.

Hepatitis B

Information for hepatitis B includes:

• Hepatitis B is spread by body fluid – commonly through sexual intercourse or shared syringes, but also by accident.
• The cause is a virus.
• Around half of all cases worldwide result in death.

Typhoid is common in developing countries. Information for typhoid includes:

• The cause is a bacterium.
• Symptoms include fever, weakness, headache and sometimes a rash.
• Typhoid can be treated successfully with antibiotics.
• Immunisation must be completed at least one week before travelling.

Rabies External Link is common to Central and South America, Eastern Europe, Africa and Asia. Information for rabies includes:

• The cause is a virus passed on by a bite or scratch from an infected dog or any mammal that carries the virus.
• Symptoms include headache and fever, then convulsions (fits) and death.
• All animal bites and scratches should be immediately and thoroughly washed with soap and water for at least 10 minutes.
• A three-dose immunisation is given over 3 to 4 weeks before travel.
• Treatment after a bite from a possibly rabid animal involves a course of 5 vaccines and, if previously unvaccinated, an injection of immunoglobulin.

Meningococcal meningitis

Meningococcal meningitis is common in sub-Saharan Africa. Information for meningococcal meningitis includes:

• The cause is a virus spread by close contact with infected secretions from the nose and throat.
• Symptoms include headache, fever, confusion and a stiff neck.
• Treatment can only ease the symptoms.
• Immunisation is a legal requirement for some countries.

Tuberculosis

Tuberculosis is common in developing countries. Information for tuberculosis includes:

• The cause is a bacterium spread by aerosol droplets when someone with ‘active’ tuberculosis sings, laughs or sneezes.
• Symptoms include persistent cough and fever.
• Treatment involves a prolonged course of antibiotics.
• Immunisation is recommended only for some travellers to high-risk areas for prolonged periods and must be preceded by a skin (Mantoux) test.

Japanese encephalitis is present throughout Asia (and in the Torres Strait region of Australia). Information for Japanese encephalitis includes:

• The cause is a virus spread from animals to humans by infected mosquitoes.
• Symptoms include headache, fever, confusion and nervous system problems.
• Three doses of vaccine are required so speak to your doctor about when to begin immunisations.

Yellow fever

Yellow fever is present in tropical South America and sub-Saharan Africa. Information for yellow fever includes:

• The cause is a virus spread by infected mosquitoes.
• Symptoms include fever, headache, bloody vomiting, jaundice and death.
• The vaccine gives immunity for life for most people.
• Immunisation is a legal requirement for some countries and certification can only be given by an authorised travel health clinic.

Infectious diseases are generally transmitted by food, water or a lack of hygiene (for example, ‘ gastro ’, traveller’s diarrhoea , giardiasis and amoebic dysentery ) or by insects (for example, malaria and dengue fever ). These diseases can be life threatening. Your doctor will advise you on measures and medications that you can take to help prevent these diseases.

The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO. Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary.

The Immunisation for Life infographic can help you determine which immunisations you may need.

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 (24 hours, 7 days) – for expert health information and advice
• Immunisation Unit, Department of Health External Link , Victorian Government Email: [email protected]
• Smartraveller.gov.au External Link , Australian Government
• Travel Clinics Australia External Link Tel. 1300 369 359
• SAEFVIC External Link Tel. 1300 882 924
• Coronavirus (COVID-19) Victoria
• Community Pharmacist Pilot – receive some treatments at a local pharmacy without needing to see a doctor for a prescription in Victoria
• Vaccines External Link , World Health Organization.
• Australian Immunisation Handbook External Link , Department of Health, Australian Government.
• Smartraveller.gov.au External Link , Department of Foreign Affairs and Trade, Australian Government.
• Vaccinations External Link , Travel Clinics Australia.
• Vaccine side effects External Link , Department of Health, Victorian Government.
• Travellers' Health External Link , CDC Centers for Disease Control and Prevention, United States of America.

This page has been produced in consultation with and approved by:

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More information, related information.

Being young and fit doesn't reduce your risk of altitude sickness.

Anthrax is a rare but potentially fatal bacterial disease that occasionally infects humans.

The Western obsession with cleanliness may be partly responsible for the increase in allergic asthma and conditions such as rhinitis.

Careful prescribing of antibiotics will minimise the emergence of antimicrobial resistant strains of bacteria.

Aspergillus is a fungus that commonly grows on rotting vegetation. It can cause asthma symptoms.

From other websites

• External Link Department of Foreign Affairs and Trade, Australian Government – Countries, economies and regions
• External Link Department of Health, Australian Government – Travel Health Information

Content disclaimer

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

• Immunisation
• Public Information
• Healthcare Worker Information
• History of Vaccines
• Information Materials
• Immunisation websites
• Travel Vaccines

Travel Vaccines: Public Information

You may need extra vaccinations when going abroad. Certain parts of the world are associated with specific diseases. For specific travel advice, including vaccinations and malarial prophylaxis you should contact your G.P. or travel clinic.

For specific travel advice, including vaccinations and malarial prophylaxis you should contact your G.P. or travel clinic.

Read the NIAC - Immunisation Guidelines for Ireland (www.rcpi.ie) for the most up to date advice.  

Other Useful Websites include

• Health information provided by the NHS(Scotland). Available at www.fitfortravel.scot.nhs.uk
• International travel and health is a WHO publication is a reference book for doctors and nurses, giving health advice. Available at http://www.who.int/ith/en/

This page was updated on 30 October 2019

GP mythbuster 107: Pre-travel health services

Guidance updated April 2023

We have fully revised and reissued this information to incorporate up-to-date resources and advice.

Travel health services are available from a range of NHS and independent healthcare services.

These include:

• NHS GP practices
• private travel clinics
• some specialist clinics providing post-tropical screening services
• occupational health settings
• military healthcare settings
• independent schools and universities.

In England, a provider needs to be registered with CQC if it provides travel health services that are delivered by a doctor or a nurse. This comes under the regulated activity of treatment of disease, disorder or injury .

Travel health services are exempt from CQC registration if they are provided in:

• occupational or military settings - these work under their own standards of practice
• pharmacies - where the service is not delivered by a doctor or nurse.

NHS GP practices are required to offer certain vaccinations for the purposes of travel, free of charge. The travel vaccines available on the NHS are provided because they protect against the diseases thought to be the greatest risk to public health, if brought into this country. These are:

• polio (given as a combined diphtheria/tetanus/polio jab ).
• hepatitis A

Not all travel vaccines are provided on the NHS. See the BMA's Travel medication and vaccinations guidance for further information.

A pre-travel risk assessment must be performed by the healthcare practitioner either:

• giving the travel vaccine under a Patient Group Direction (PGD), or
• delegating the administration of the travel vaccine under a Patient Specific Direction (PSD).

See information about Patient Group Directions (PGDs) / Patient Specific Directions (PSDs)

For more details see:

• Royal College of Physicians and Surgeons of Glasgow Good Practice Guidance for Providing a Travel Health Service
• National Travel Health Network and Centre
• RCN Travel Health Nursing: career and competence development

GP practices that provide travel health services can also offer:

• advice, including preventing malaria. See Malaria prevention guidelines for travellers from the UK
• advice on the vaccines available on the NHS and information on where to go for those that are not.

Governance structures and individual travel medicine practitioners influence the quality and safety of services. In NHS general practice, this duty of care is often delegated to general practice nurses (GPNs), pharmacists and paramedics.

The GP delegating must be satisfied that the person providing care has:

• the appropriate qualifications, skills and experience to provide safe care for the patient
• access to appropriate training, supervision and oversight.

See the General Medical Council’s  Good Medical Practice guidance.

Registered nurses delivering travel health services are professionally accountable to the Nursing and Midwifery Council (NMC). They work within the NMC Code (2015) .

Regardless of their profession, the minimum standard of practice for practitioners who deliver travel health services is the same. Pre-travel consultations are complex. Practitioners need a wide knowledge that covers:

• geography and epidemiology of infectious disease
• vaccine-preventable diseases
• infections transmitted by insect bites
• non-vaccine preventable risks
• the ability to risk assess and communicate this to the traveller.

Initial training for travel health should be in line with:

• Good Practice Guidance for Providing a Travel Health Service (Royal College of Physicians and Surgeons of Glasgow)
• RCN Travel Health Nursing: career and competence development . This includes using the competency assessment tools before carrying out clinical practice.

There should be evidence of formal training in immunisation and ongoing evidence of competence. Practitioners should also achieve safeguarding competence at the appropriate level. This includes awareness of female genital mutilation and forced marriage. See the RCN Travel Health Subject Guide .

Practitioners administering yellow fever vaccines must meet the standard required to register as a Yellow Fever Vaccination Centre. This is administered by the National Travel Health Network and Centre.

When we inspect

We may not look at every regulation at every assessment. Where we identify concerns regarding travel services, we assess against:

• Regulation 12 (Safe care and treatment)
• Regulation 17 (Good governance)
• Regulation 18 (Staffing)  

We will look for evidence that providers have systems to ensure that staff:

• are recruited appropriately
• operate within the limits of their capability, scope of practice and competency
• receive appropriate information, support and supervision to enable them to carry out their role.

Training and development should include, but is not limited to:

• reviewing pre-travel consultations until the practitioner has reached the minimum standard of proficiency
• communicating patient safety alerts and guidance
• opportunities for continuing professional development
• complaints and significant event arrangements.

We expect to see processes to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients. Examples include:

• Using a recognised online tool to identify country-specific risks to help make recommendations. Country-specific risks include vaccine-preventable and mosquito-borne diseases. See the travelhealthpro website
• A comprehensive travel health risk assessment completed for each person using the service.
• all vaccines given
• medicine prescribed or advised
• vaccines declined.
• Risk assessment of the emergency equipment and medicines required. As a minimum, this must include adrenaline.
• patient group directions (PGDs)and patient-specific directions (PSDs)
• use of unlicensed and off-label medicines.
• Safe storage of medicines, including vaccines.

Further information

• Non-medical prescribing
• Resuscitation in GP surgeries
• General Medical Council ethical guidance for prescribing unlicensed medicines

GP mythbusters

Snippet gp mythbusters rh.

Clearing up some common myths about our inspections of GP and out-of-hours services and sharing agreed guidance to best practice.

See all issues:

• GP mythbusters: listed by key question
• GP mythbusters: full list
• GP mythbusters: recently updated

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Travel vaccinations

How to find out what vaccinations you’ll need when travelling abroad.

• Vaccination (Sub-topic)

In the UK, the  NHS routine vaccination schedule   protects you against a number of diseases. However, this does not cover all infectious diseases found overseas.

If you are planning to travel outside the UK, you should consider whether you need additional vaccinations. These will depend on the areas you will be visiting. You can find out which vaccinations are necessary or recommended on these websites:

• Travel Health Pro
• NHS Fit for Travel

From the 1 st October 2023, you can get the following travel vaccinations for free with the NHS. Ask your GP practice for details:

• hepatitis A

Some travel vaccinations are only available privately. Your healthcare professional will be able to advise you on the cost for these. If your GP practice does not provide the travel vaccinations you need, contact a:

• private travel vaccination clinic 
• pharmacy offering travel healthcare services

You can find further information on  NHS 111 Wales .

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• Travel Insurance

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Travel Insurance For South Africa: Everything You Need To Know

Updated: Apr 30, 2024, 1:13pm

Table of Contents

Featured Partners

Do I Need Travel Insurance for South Africa?

What does travel insurance for south africa cover, frequently asked questions (faqs).

Tourism is on the rise in South Africa according to the local government , with more than four million tourists visiting the nation in the first half of 2023 alone. Australians form a sizable chunk of those numbers, with an estimated 125,000 Australians touring the country each year pre-pandemic.

With travel still high on the agenda for many Australians, that figure is expected to rise in the coming years.

If you’re considering a trip to South Africa, you’ll want to purchase travel insurance. Our guide explains everything you need to know.

Fast Cover Travel Insurance

On Fast Cover’s Secure Website

Medical cover

Unlimited, 24/7 Emergency Assistance

Cancellations

Unlimited, (Trip Disruption $50,000)

Key Features

25-Day Cooling Off Period, Australian Based Call Centre, 4.6 Star Product Review Rating

Cover-More Travel Insurance

On Cover-more’s secure website

Unlimited, with a $2000 limit to dental

Yes, amount chosen by customer

Southern Cross Travel Insurance

Medical Cover

Including medical treatment, doctors’ visits, prescribed medication, specialist treatment & medical transport costs

$2,500 with option to increase to unlimited

Yes, Australians should purchase travel insurance for South Africa. While not a legal requirement to enter the country, it is highly recommended from the Australian government—especially for medical care.

The standard of medical facilities in South Africa can vary by region, but medical facilities are generally of a much lower standard than Australia. In fact, many regional hospitals only provide basic facilities, meaning you may have to be relocated in order to receive the right medical attention.

There is no shared healthcare agreement between Australia and South Africa, which makes travel insurance even more essential. If you need to be transferred by air evacuation to a major city in order to receive treatment, and you don’t have travel insurance, you’ll likely face a hefty bill out of your own pocket.

As Smartraveller advises all Australians, if you can’t afford travel insurance, you can’t afford to travel.

Vaccinations to Consider for Your Trip to South Africa

There is a high risk of certain diseases in South Africa, so it is worth making sure your vaccinations are up to date before you travel and taking any preventative measures with you, such as medications.

This can help reduce your chances of needing to seek medical attention.

There is a risk of Hepatitis A and B throughout South Africa, so vaccinations for Australian travellers are recommended. There is also a moderate risk for most travellers of typhoid, so a vaccination is also recommended if you are travelling to smaller cities, villages and rural areas.

Malaria is present throughout the country, so it could be a good idea to equip yourself with malaria tablets before you travel.

It is essential that you consult a medical practitioner regarding your need for vaccinations before you travel to South Africa, especially as some medical conditions can predispose travellers to certain infections.

When purchasing a travel insurance policy for South Africa, you will have the option to choose a basic policy or a comprehensive policy. A basic policy is cheaper , but may turn out to be more expensive in the long run if you aren’t covered for the things you need.

While a basic policy will usually cover medical needs, it may not provide cover for things such as lost luggage and cancellations (or, if it does, will provide it at a much lower claim level).

That’s why a comprehensive policy is highly recommended for travel to South Africa, as you will receive cover for stolen items, lost luggage, delays and more, in addition to medical and emergency dental care.

Smartraveller asks Australians to exercise a high degree of caution due to the threat of violent crime in South Africa, which includes robbery and carjacking.

The government website warns that opportunistic criminals will target travellers at the approaches to tourist-hotspot Kruger National Park, at well-known resorts, and on public transport.

Additionally, as ATM and credit card fraud are common crimes in South Africa, a comprehensive policy can be the more financially sound choice to give you peace of mind.

Going on a Safari?

South Africa is a popular tourist region for many reasons, including wildlife safaris. If you wish to partake in a safari or a game walk—walking with wild animals and a professional guide—you will need to ensure that these activities are covered in your policy’s list of included sports and activities.

If they are not, you will not receive cover for anything that occurs during the safari.

However, your policy may offer the option for you to choose an ‘adventure pack’ at an additional cost, which can include many activities that aren’t covered in the standard offering.

This can also include hiking or trekking to certain altitudes.

It’s important to consider which activities you may be participating in during your trip to South Africa in order to ensure you have the appropriate coverage, and purchase an additional add-on if necessary.

What Travel Insurance Won’t Cover

Your travel insurance policy won’t cover anything that is set out in its exclusions, as per the product disclosure statement (PDS). This could include certain sports and activities (such as a safari), or travel to certain regions in South Africa due to safety.

While each travel insurance policy differs on the fine-print, it is standard for most policies not to cover:

• Cancellations due to ‘disinclination to travel’, being if you change your mind about your holiday;
• Accidents or injuries that occur when not following the appropriate safety guidance or official guidelines;
• Intoxicated behaviour, including recreational drugs;
• Any illegal activity.

Be sure to carefully read the PDS of your policy so you know exactly what you can and cannot claim on your trip to South Africa.

Is it safe to travel to South Africa?

Smartraveller recommends that Australians exercise a high degree of caution when travelling to South Africa, due to the threat of violent crime. This includes armed robbery, mugging, carjacking, credit card theft, and more.

There is a higher risk of violent crime in major cities after dark, or during “rolling blackout” periods.

For these reasons (and more), Smartraveller urges Australians to take out a travel insurance policy before travelling to South Africa.

Do Australians need a visa for South Africa?

No, Australians do not need a visa for South Africa if they are visiting for tourism for stays of up to 90 days.

Where can I buy travel insurance for South Africa?

Most Australian travel insurance providers will cover Aussies wanting to head abroad to South Africa. When shopping around for a policy, you will be able to choose your destination when you request a quote. If there is no option to choose South Africa, this would be a clear indicator that the insurance provider does not provide policies to this region.

At the time of writing, a few of our top picks for comprehensive travel insurance cover South Africa, including Allianz and Cover-More .

Travel insurance providers can revoke the issuing of new policies to certain destinations at any time, especially if Smartraveller changes the alert warning for a country to ‘Do Not Travel’.

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• Section 5 - Rubella
• Section 5 - Smallpox & Other Orthopoxvirus-Associated Infections

Rubeola / Measles

Cdc yellow book 2024.

Author(s): Paul Gastañaduy, James Goodson

Infectious Agent

Transmission, epidemiology, clinical presentation.

INFECTIOUS AGENT: Measles virus

TRAVELER CATEGORIES AT GREATEST RISK FOR EXPOSURE & INFECTION

PREVENTION METHODS

Rubeola is a vaccine-preventable disease

DIAGNOSTIC SUPPORT

Measles virus is a member of the genus Morbillivirus of the family Paramyxoviridae .

Measles is transmitted from person to person via respiratory droplets and by the airborne route as aerosolized droplet nuclei. Infected people are usually contagious from 4 days before until 4 days after rash onset. Measles is among the most contagious viral diseases known; secondary attack rates are ≥90% among susceptible household and institutional contacts. Humans are the only natural host for sustaining measles virus transmission, which makes global eradication of measles feasible.

Measles was declared eliminated (defined as the absence of endemic measles virus transmission in a defined geographic area for ≥12 months in the presence of a well-performing surveillance system) from the United States in 2000. Measles virus continues to be imported into the country from other parts of the world, however, and recent prolonged outbreaks in the United States resulting from measles virus importations highlight the challenges faced in maintaining measles elimination.

Given the large global measles burden and high communicability of the disease, travelers could be exposed to the virus in any country they visit where measles remains endemic or where large outbreaks are occurring. Most measles cases imported into the United States occur in unvaccinated US residents who become infected while traveling abroad, often to the World Health Organization (WHO)–defined Western Pacific and European regions. These travelers become symptomatic after returning to the United States and sometimes infect others in their communities, causing outbreaks.

Nearly 90% of imported measles cases are considered preventable by vaccination (i.e., the travelers lacked recommended age- and travel-appropriate vaccination). Furthermore, observational studies in travel clinics in the United States have shown that 59% of pediatric and 53% of adult travelers eligible for measles-mumps-rubella (MMR) vaccine at the time of pretravel consultation were not vaccinated at the visit, highlighting a missed opportunity to reduce the likelihood of measles introductions and subsequent spread. Encourage all eligible travelers to receive appropriate MMR vaccination. Outbreak investigations are costly and resource intensive, and infected people—in addition to productivity losses—can incur direct costs for the management of their illness, including treatment, quarantine, and caregiving.

The incubation period averages 11–12 days from exposure to onset of prodrome; rash usually appears ≈14 days after exposure. Symptoms include fever, with temperature ≤105°F (≤40.6°C); conjunctivitis; coryza (runny nose); cough; and small spots with white or bluish-white centers on an erythematous base appearing on the buccal mucosa (Koplik spots). A characteristic red, blotchy (maculopapular) rash appears 3–7 days after onset of prodromal symptoms. The rash begins on the face, becomes generalized, and lasts 4–7 days.

Common measles complications include diarrhea (8%), middle ear infection (7%–9%), and pneumonia (1%–6%). Encephalitis, which can result in permanent brain damage, occurs in ≈1 per 1,000–2,000 cases of measles. The risk for serious complications or death is highest for children aged ≤5 years, adults aged ≥20 years, and in populations with poor nutritional status or that lack access to health care.

Subacute sclerosing panencephalitis (SSPE) is a progressive neurologic disorder caused by measles virus that usually presents 5–10 years after recovery from the initial primary measles virus infection. SSPE manifests as mental and motor deterioration, which can progress to coma and death. SSPE occurs in ≈1 of every 5,000 reported measles cases; rates are higher among children <5 years of age.

Measles is a nationally notifiable disease. Laboratory criteria for diagnosis include a positive serologic test for measles-specific IgM, IgG seroconversion, or a significant rise in measles IgG level by any standard serologic assay; isolation of measles virus; or detection of measles virus RNA by reverse transcription PCR (RT-PCR) testing. The Centers for Disease Control and Prevention’s Measles Virus Laboratory is the national reference laboratory; it provides serologic and molecular testing for measles and technical assistance to state public health laboratories for the collection and shipment of clinical samples for molecular diagnostics and genetic analysis. See detailed information on diagnostic support .

A clinical case of measles illness is characterized by generalized maculopapular rash lasting ≥3 days; temperature ≥101°F (38.3°C); and cough, coryza, or conjunctivitis. A confirmed case is one with an acute febrile rash illness with laboratory confirmation or direct epidemiologic linkage to a laboratory-confirmed case. In a laboratory-confirmed or epidemiologically linked case, the patient’s temperature does not need to reach ≥101°F (38.3°C) and the rash does not need to last ≥3 days.

Treatment is supportive. The WHO recommends vitamin A for all children with acute measles, regardless of their country of residence, to reduce the risk for complications. Administer vitamin A as follows: for infants <6 months old, give 50,000 IU, once a day for 2 days; for infants 6 months old and older, but younger than 12 months, give 100,000 IU once a day for 2 days; for children ≥12 months old give 200,000 IU once a day for 2 days. For children with clinical signs and symptoms of vitamin A deficiency, administer an additional (i.e., a third) age-specific dose of vitamin A 2–4 weeks following the first round of dosing.

Measles has been preventable through vaccination since a vaccine was licensed in 1963. People who do not have evidence of measles immunity should be considered at risk for measles, particularly during international travel. Acceptable presumptive evidence of immunity to measles includes birth before 1957; laboratory confirmation of disease; laboratory evidence of immunity; or written documentation of age-appropriate vaccination with a licensed, live attenuated measles-containing vaccine 1 , namely, MMR or measles-mumps-rubella-varicella (MMRV). For infants 6 months old and older, but younger than 12 months, this includes documented administration of 1 dose of MMR; for people aged ≥12 months, documentation should include 2 doses of MMR or MMRV (the first dose administered at age ≥12 months and the second dose administered no earlier than 28 days after the first dose). Verbal or self-reported history of vaccination is not considered valid presumptive evidence of immunity.

1 From 1963–1967, a formalin-inactivated measles vaccine was available in the United States and was administered to ≈600,000–900,000 people. It was discontinued when it became apparent that the immunity it produced was short-lived. Consider people who received this vaccine unvaccinated.

Vaccination

Measles vaccine contains live, attenuated measles virus, which in the United States is available only in combination formulations (e.g., MMR and MMRV vaccines). MMRV vaccine is licensed for children aged 12 months–12 years and can be used in place of MMR vaccine if vaccination for measles, mumps, rubella, and varicella is needed.

International travelers, including people traveling to high-income countries, who do not have presumptive evidence of measles immunity and who have no contraindications to MMR or MMRV, should receive MMR or MMRV before travel per the following schedule.

Infants (6 months old and older, but younger than 12 months): 1 MMR dose. Infants vaccinated before age 12 months must be revaccinated on or after the first birthday with 2 doses of MMR or MMRV separated by ≥28 days. MMRV is not licensed for children aged <12 months.

Children (aged ≥12 months): 2 doses of MMR or MMRV separated by ≥28 days.

Adults born in or after 1957: 2 doses of MMR separated by ≥28 days.

One dose of MMR is ≈85% effective when administered at age 9 months; MMR and MMRV are 93% effective when administered at age ≥1 year. Vaccine effectiveness of 2 doses is 97%.

Adverse Reactions

In rare circumstances, MMR vaccination has been associated with anaphylaxis (≈2–14 occurrences per million doses administered); febrile seizures (≈1 occurrence per 3,000–4,000 doses administered, but overall, the rate of febrile seizures after measles-containing vaccine is much lower than the rate with measles disease); thrombocytopenia (≈1 occurrence per 40,000 doses during the 6 weeks after immunization); or joint symptoms (arthralgia develops among ≈25% of nonimmune postpubertal females from the rubella component of the MMR vaccination, and ≈10% have acute arthritis-like signs and symptoms that generally persist for 1–21 days and rarely recur; chronic joint symptoms are rare, if they occur at all). No evidence supports a causal link between MMR vaccination and autism, type 1 diabetes mellitus, or inflammatory bowel disease.

Contraindications

People who experienced a severe allergic reaction (difficulty breathing, hives, hypotension, shock, swelling of the mouth or throat) following a prior dose of MMR or MMRV vaccine, or who had an anaphylactic reaction to topically or systemically administered neomycin, should not be vaccinated or revaccinated. People who are allergic to eggs can receive MMR or MMRV vaccine without prior routine skin testing or the use of special protocols.

Immunosuppression

Enhanced replication of live vaccine viruses can occur in people who have immune deficiency disorders. Death related to vaccine-associated measles virus infection has been reported among severely immunocompromised people; thus, severely immunosuppressed people should not be vaccinated with MMR or MMRV vaccine. For a thorough discussion of recommendations for immunocompromised travelers, see Sec. 3, Ch. 1, Immunocompromised Travelers .

MMR vaccination is recommended for all people with HIV infection aged ≥12 months who do not have evidence of measles, mumps, and rubella immunity, and who do not have evidence of severe immunosuppression. The assessment of severe immunosuppression can be based on CD4 values (count or percentage); absence of severe immunosuppression is defined as CD4 ≥15% for ≥6 months for children aged ≤5 years, or CD4 ≥15% and CD4 count ≥200 cells/mL for ≥6 months for people aged >5 years.

People with leukemia in remission and off chemotherapy, who were not immune to measles when diagnosed with leukemia, may receive MMR vaccine. At least 3 months should elapse after termination of chemotherapy before administering the first dose of vaccine.

Steroids & Other Immunosuppressive Therapies

Avoid vaccinating people who have received high-dose corticosteroid therapy (in general, considered to be ≥20 mg or 2 mg/kg body weight of prednisone, or its equivalent, daily for ≥14 days) with MMR or MMRV for ≥1 month after cessation of steroid therapy. Corticosteroid therapy usually is not a contraindication when administration is short-term (<14 days) or a low to moderate dose (<20 mg of prednisone or equivalent per day).

In general, withhold MMR or MMRV vaccine for ≥3 months after cessation of other immunosuppressive therapies and remission of the underlying disease. See Sec. 3, Ch. 1, Immunocompromised Travelers , for more details.

MMR vaccines should not be administered to pregnant people or people attempting to become pregnant. Because of the theoretical risk to the fetus, people should be counseled to avoid becoming pregnant for 28 days after receiving a live-virus (e.g., MMR) vaccine.

Precautions

Personal or family history of seizures of any etiology.

Compared with administration of separate MMR and varicella vaccines at the same visit, use of MMRV vaccine is associated with a higher risk for fever and febrile seizures 5–12 days after the first dose among children aged 12–23 months. Approximately 1 additional febrile seizure occurs for every 2,300–2,600 MMRV vaccine doses administered. Use of separate MMR and varicella vaccines avoids this increased risk for fever and febrile seizures.

Thrombocytopenia

The benefits of primary immunization are usually greater than the potential risks for vaccine- associated thrombocytopenia. Avoid giving subsequent doses of MMR or MMRV vaccine, however, if an episode of thrombocytopenia occurred ≤6 weeks after a previous dose of vaccine.

Postexposure Prophylaxis

Measles-containing vaccine or immune globulin (IG) can be effective as postexposure prophylaxis. MMR or MMRV administered ≤72 hours after initial exposure to measles virus might provide some protection. If the exposure does not result in infection, the vaccine should induce protection against subsequent measles virus infection.

When administered ≤6 days of exposure, IG can be used to confer temporary immunity in a susceptible person. If the exposure does not result in modified or typical measles, vaccination with MMR or MMRV is still necessary to provide long-lasting protection. Six months after receiving intramuscularly administered IG, or 8 months after receiving intravenously administered IG, administer MMR or MMRV vaccine, provided the patient is aged ≥12 months and the vaccine is not otherwise contraindicated.

CDC website: Measles

The following authors contributed to the previous version of this chapter: Paul A. Gastañaduy, James L. Goodson

Bibliography

Centers for Disease Control and Prevention. Prevention of measles, rubella, congenital rubella syndrome, and mumps, 2013: summary recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2013;62(RR-04):1–34.

 Gastañaduy P, Redd S, Clemmons N, Lee AD, Hickman CJ, Rota PA, et al. Measles. In: Roush SW, Baldy LM, Kirkconnell Hall MA, editors. Manual for the surveillance of vaccine-preventable diseases. Atlanta: Centers for Disease Control and Prevention; 2019. Available from: www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html .

Hyle EP, Fields NF, Fiebelkorn AP, Taylor Walker A, Gastañaduy P, Rao SR, et al. The clinical impact and cost-effectiveness of measles-mumps-rubella vaccination to prevent measles importations among US international travelers. Clin Infect Dis. 2019;69(2):306–15.

Hyle EP, Rao SR, Bangs AC, Gastañaduy P, Parker Fiebelkorn A, Hagmann SHF, et al. Clinical practices for measles-mumps-rubella vaccination among US pediatric international travelers. JAMA Pediatr. 2020;174(2):e194515.

Hyle EP, Rao SR, Jentes ES, Parker Fiebelkorn A, Hagmann SHF, Taylor Walker A, et al. Missed opportunities for measles, mumps, rubella vaccination among departing U.S. adult travelers receiving pretravel health consultations. Ann Intern Med. 2017;167(2):77–84.

Lee AD, Clemmons NS, Patel M, Gastañaduy PA. International importations of measles virus into the United States during the post-elimination era, 2001–2016. J Infect Dis. 2019;219(10):1616–23.

National Notifiable Diseases Surveillance System. Measles (rubeola): 2013 case definition. Atlanta: CDC; 2013. Available from: https://ndc.services.cdc.gov/conditions/measles/ .

Patel MK, Goodson JL, Alexander JP Jr., Kretsinger K, Sodha SV, Steulet C, et al. Progress toward regional measles elimination—Worldwide, 2000–2019. MMWR Morb Mortal Wkly Rep. 2020;69(45):1700–5.

Pike J, Leidner AJ, Gastañaduy PA. A review of measles outbreak cost estimates from the US in the post-elimination era (2004–2017): Estimates by perspective and cost type. Clin Infect Dis. 2020;1(6):1568–76.

World Health Organization. Measles vaccines: WHO position paper—April 2017. Wkly Epidemiol Rec. 2017;92(17):205–27.

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