Which travel vaccines do I need?
Vaccine recommendations depend on age and destination. For best effect, you should take vaccines in good time before departure.
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The recommendations for vaccination and malaria prevention depend on the destination, type and duration of the journey and the epidemiological situation at any time. The person's health, age and previous immunisation status should also be considered. For most vaccines, it take 1-2 weeks before they are effective and for some two or more doses are required. For optimal effect, vaccination should therefore begin well before departure.
1. Vaccines that everybody should have
In general, everyone should be vaccinated against diphtheria, tetanus, whooping cough (pertussis) and poliomyelitis. Adults who were vaccinated in childhood should receive a booster dose against these diseases every 10 years. Even though the trip may not increase the risk of contracting these diseases, it is convenient to update these vaccines together with travel vaccines.
People who have not been vaccinated against mumps, rubella and measles or have not had these diseases should have the MMR vaccine. This is the case even when not travelling, but is particularly important when travelling to countries where mumps, rubella and measles are more common than in Norway. These include countries in Western Europe. If adults contract these diseases, the risk of serious illness is greater than for children. Rubella in pregnancy can cause serious harm to the foetus.
Children who will stay for a long time in countries with a high incidence of infectious diseases in their first year of life may need to begin vaccination earlier than normal and be given doses with shorter intervals to achieve two or three doses of DTP-IPV-Hib vaccine and pneumococcal disease vaccine before departure. If necessary, the first dose can be given at 6 weeks of age and the interval between the first and second dose can be reduced to four weeks. This means that the child must be vaccinated using the four dose programme. The interval between the second and third dose can be as short as 4-8 weeks and the fourth dose is given a year after the third dose. The MMR-vaccine can be given from 9 months of age, but doses given before 12 months of age should be repeated at 15 months.
3. Risk groups for influenza and pneumococcal disease
People who are 65 years or older, and people in defined risk groups for influenza and pneumococcal disease should be vaccinated against these diseases.
4. Other travel vaccines
Yellow fever vaccine
Yellow fever is endemic in Africa, South America and Central America. The yellow fever vaccine is recommended for travel to countries where there is risk of infection. Some countries, with or without a yellow fever risk may require an international certificate of vaccination against yellow fever upon arrival. This applies to all travellers coming from, or via, countries with a risk for yellow fever infection (also low risk countries), and may also apply for intermediate landings in these countries. Some countries require yellow fever vaccination for all travellers from all countries. The vaccination certificate is valid from ten days after basic vaccination. The vaccine can be given from nine months of age but the certificate is not usually required for children under one-year-old.
In most cases, yellow fever vaccination leads to lifelong protection. By June 2016, all countries have implemented lifelong validity for the vaccination certificate. Land-specific requirements for yellow fever vaccination change from time to time and travellers should contact the relevant embassy or consulate in good time before departure to check the certification requirements.
Hepatitis A vaccine
This vaccine is recommended for travellers to most non-western destinations and can be given from one year of age.
Hepatitis B vaccine
This vaccine is recommended for health care workers and orphanage personnel working outside low endemic areas. It is also recommended for travellers who are likely to have unprotected sex, inject drugs, seek medical treatment (e.g. due to disease or who are at risk of accidents that require medical treatment in unhygienic conditions, as the risk of infection increases with length of stay). Children should maybe be vaccinated before a long-term stay, as they can be infected from local children during play. The vaccine is included in many countries’ immunisation programmes and can be given to babies from the first day of life.
Japanese encephalitis vaccine
This vaccine is recommended for people who will stay in rural areas for 3-4 weeks or more or will have shorter stays in areas where the disease is common. Vaccination should also be considered for shorter stays where the risk of infection is particularly high. The vaccine can be given from two months of age.
When travelling to areas with cholera, this vaccine is recommended for emergency relief workers, for the army, for people living under poor sanitary conditions without access to safe drinking water and for people who lack stomach acid or who use antacids. The vaccine can be given from 2 years of age.
The cholera vaccine provides some protection against infection with enterotoxin-producing E. coli (ETEC) but the total protection is low and the vaccine is therefore not approved for this indication.
Vaccination against meningococcal bacteria types A, C, W and Y is recommended before staying in the "meningitis belt" of tropical Africa, or other places where there are outbreaks. The meningococcal C vaccine or the ACWY vaccine is recommended for children and adolescents who will attend nursery, school or study in certain western countries, including the UK and USA.
The recommendations apply mainly to children and young people under 25 years on long stays but can also be considered for shorter stays and for adults, depending on the epidemiological situation. Documented meningococcal ACWY vaccination is necessary for a visum for pilgrimage to Saudi Arabia. The meningococcal C conjugate vaccine can be given from 2 months of age. The available meningococcal ACWY conjugate vaccines can be given from 1 and 2 years of age, respectively.
This vaccine is for people who are going to live or travel in areas with rabies where medical treatment is not readily available or for those who will work with animals that could be infected with rabies. Since children are likely to have contact with infected animals without their parents’ knowledge, it may be necessary to vaccinate children who will stay in areas with rabies. There is no minimum age for use of the rabies vaccine.
Tick-borne encephalitis (TBE) vaccine
This vaccine is recommended for people who will spend time in wooded areas and fields (e.g. in connection with orienteering, forestry, hiking or camping) in areas where the disease is prevalent. Outside of Norway, this applies to Central and Eastern Europe, the Baltic states, Åland, Bornholm and the Stockholm archipelago. The vaccine is not recommended for travel to towns in these areas. The vaccine can be given from one year of age.
Tuberculosis vaccine (BCG)
Vaccination is recommended for people who have not previously been BCG vaccinated and who will stay for more than three months in countries with a high prevalence of tuberculosis and will have close contact with the local population. In addition, the vaccine is recommended for unvaccinated workers with a significant risk of tuberculosis infection (health care personnel, prison workers etc., in countries with high prevalence of tuberculosis).
The vaccine has no proven efficacy in people over 35 years of age. The vaccine can be given from the first day of life.
This vaccine is recommended for people travelling to areas where typhoid fever is prevalent. The risk of infection is increased by close contact with the local population and with increasing length of stay. The vaccine can be injected from 2 years of age and given orally from 5 years of age.
Prophylactic measures against malaria include preventing mosquito bites and medication. The Norwegian Institute of Public Health has published a guide with information on the prevention of malaria for travellers, in Norwegian only. Malaria prevention is recommended for various destinations within the guide.
5. Vaccination abroad
With vaccination abroad it is important to obtain written documentation about the type of vaccine and date of vaccination so that it can be followed up on your return. This is particularly important if the vaccination is part of preventive treatment after possible infection with rabies or hepatitis B.