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With summer in full swing, you're probably preparing or jetting off on your summer holidays. While you’re busy sorting out the taxi to the airport, your foreign currency, what to pack, etc, have you thought about travel vaccinations? It’s vital that you and your family are protected from a whole host of vaccine preventable diseases, both here in the UK, and abroad, particularly if you’re travelling to tropical regions of the world.
What kind of vaccinations for children should you be considering?
The most common problem is travellers’ diarrhoea or an ‘upset stomach’. Many are not vaccine preventable, but some are. Cholera and typhoid are both food and water borne infections common in popular holiday destinations such as Kenya, Tanzania, Zimbabwe and Zambia and there are vaccine available for these diseases. The very young may be even more vulnerable to these tropical infections, so it’s really important that you consider these travel vaccinations for children and infants.
In this article, we’ll discuss:
Understanding Travel Vaccinations for Children and Babies
It's important to differentiate travel vaccinations from your childhood immunisations. Travellers often assume that they've had all the vaccinations they need for their trip as part of their childhood jabs, but this isn't the case.
During your childhood you’ll have been vaccinated for diseases like diphtheria, tetanus, polio and measles but travel vaccinations protect you from common diseases that you might encounter abroad like typhoid, or specific diseases that you might be exposed to, depending on your activities (for example, rabies is transmitted through the bites and scratches of animals)
But as you can imagine there are unique challenges in vaccinating babies and children. For example, not all travel vaccines can be given to children and even if they can, it might need to be a smaller dose, whereas for other vaccines, it’s exactly the same dose as for adults.
This is why it’s so important that you seek specialist travel health advice from trusted and knowledgeable experts.
Common Travel Vaccinations for Children
Sometimes it's difficult to know where to start. A myriad of questions may run through your mind…
What travel vaccinations are appropriate for my destination?
What about travel vaccines for babies?
To help you with this, we've listed a few examples of travel vaccinations for children in the table below. This will give you a flavour of the kind of vaccines you might need for international travel with kids.
Vaccine | Destination | Suitable age group |
Throughout the tropics | 1 year and above | |
Throughout the tropics | 2 years and above* | |
Throughout the tropics and Mainland Europe | Any age | |
Parts of South America and Africa | 1 year and above* | |
Asia and Far-East | 2 months and above |
*May be given in younger age groups under expert advice
Safety and Effectiveness of Vaccinations for Young Children
You’ll want to make sure that any vaccination, your child is effective is not only effective but safe.
Is it a question of effectiveness or a concern of vaccine safety in children?
Well although it's both, it's mainly a lack of data on effectiveness for most vaccines. The big vaccine manufacturers don't always conduct vaccine trials below certain age groups. This simply means they don't have any evidence of either safety or effectiveness for some vaccines in infants. It's for this reason that some vaccines are only licenced above a certain age group.
Let’s take a look at a couple of vaccines to illustrate our case.
The cholera vaccine is only licenced for children two years and above. This is mainly because there’s a lack of research and experience in children less than 2 years.
Vaccine safety in infants is much better documented with the yellow fever vaccine. We know that this vaccine is contraindicated (reasons why you should not give the vaccine) in infants 6 months or younger because of a well-recognised yellow fever vaccine associated neurotropic disease (YEL-AND). This serious side effect can occur about two to three weeks after the vaccine has been given. In affected infants, there’s inflammation of the brain (encephalitis) or the lining around the brain (meningitis)
Timing and Scheduling
International travel with kids as you know presents its own challenges. So it's good to plan travel vaccinations for children well in advance. The first thing you should do is contact your family GP as early as possible as some vaccines for children are free through the NHS. But your family doctor will need time, at least four to six weeks before you travel.
The specialist vaccines are usually only available through independent travel health clinics (and some GPs) like Health Klinix, and we would recommend you contact us at least six weeks before you travel. We realise this isn’t always possible as holidays are often booked at the last minute, so if this is the case, we can still try and adapt vaccination schedules so that you have as many as possible before you travel.
In summary, the good news is that most vaccines for babies and children are essentially the same course and schedule but there are sometimes differences with the doses.
Let's address these special circumstances in more detail.
Special Considerations for travel vaccines in babies and children
Children’s vaccinations are surprisingly similar to adults both in terms of schedule, and sometimes even the doses. Typhoid, rabies and the yellow fever vaccination are exactly the same dosage and schedule for children and adults.
There are, however, some important differences you should be aware of for example, although the yellow fever vaccine is exactly the same dose, we've already discussed that it should not be given to babies under six months an only under expert guidance for infants between 6 to 9 months. If your baby is not able to have the vaccine, then it's really important to make sure that mosquito bites are avoided as much as possible as this is how yellow fever is transmitted. Your baby's skin should be covered as much as possible to create a physical barrier and apply insect repellent to exposed skin. Your child will also and need to sleep under mosquito nets that's been soaked in a special insect repellent called permethrin to further reduce the risk of mosquito bites.
The very young and very old are particularly vulnerable to infections that are spread through food and water; typhoid and hepatitis A are classic examples in the tropics. You need to be aware though that the typhoid vaccine is not licenced for children less than two years of age and hepatitis A is restricted to children aged one year and over.
If your baby is unable to receive such vaccines, you can still significantly reduce the risk of these diseases with simple food and hygiene precautions.
Preparing for the Appointment
Travel vaccines for children can be a daunting and anxious time for both the parent and the child but planning well ahead for the vaccination and for the appointment itself can help the process and relieve anxiety.
At Health Klinix, we have lots of children who attend our travel health clinic and so we're very familiar with making them feel at ease. Here are some handy tips we’ve picked over the years:
Before the vaccination
1. Spend some time talking to your child and informing them how vaccines work and why they’re important in protecting them so that they can have a safe and enjoyable holiday.
2. Be honest with them. Let them know that they will feel the injection, but it will be over very quickly.
3. It's a good idea to bring your child's favourite toy, something that they can cuddle and feel safe during the vaccination process.
4. It's also worth downloading your child's favourite songs or games on your phone that can be used as a distraction during the appointment.
During the vaccination - what we can do:
1. We have toys and books in our waiting area to keep your child occupied.
2. If you like we can play your child's favourite music while they're waiting for their vaccinations.
3. Our doctors and nurses use several distraction techniques to make sure your child's vaccination is given with minimal distress and is over as quickly as possible.
After the vaccination
1. We’ll reward your child with bravery sticker and a special little gift!
2. You as a parent, should let them know how brave they’ve been and adorn them with praise and love. Remember, it's an incredibly scary time for them and they need to know that they've overcome their fear, and you're proud of that fact.
Finding reliable information and travel clinics you can trust
It’s vital that you know who you can trust with your children’s vaccinations. Here are a few questions you can ask travel health clinics to make sure you and your child are in safe hands.
1. Choose a travel clinic with proven expertise in Infectious Diseases and Tropical Medicine
Don't be afraid to ask for their experience. Travel clinics should be up to date with the latest disease outbreaks around the world and therefore should have the ability to give you a very tailored advisory service.
For example, at the time of writing this article, Health Klinix can tell you that there’s an ongoing cholera outbreak in Zimbabwe, Zambia, Ethiopia, Syria and Iraq. We can also tell you that there's a massive outbreak of dengue fever throughout Latin America in the first six months of this year. Or did you know about Nipah virus, the emerging viral infection that’s found in parts of India and South-east Asia?
2. Ask for their qualifications in infectious diseases, Tropical Medicine or travel health
You need to be clear that the clinicians that are going to be vaccinating your children appropriately qualified. Again, you can ask for their formal qualifications. Here at
Health Klinix, the medical director overseeing the services has formal specialist qualifications in infectious diseases, tropical medicine, general practice and paediatrics (that's me, the author!) You can see the full list of qualifications at the end of this article.
3. Are they regulated by the Care Quality Commission (CQC)?
The Care Quality Commission are much more stringent than other regulatory bodies and ensure that every clinic as a very high standard of service they provide. Following a CQC inspection, every travel clinic is given a CQC rating; find out our CQC rating.
4. Are they a registered yellow fever vaccination centre?
Yellow fever vaccination is a specialist field and yellow fever vaccination centres are regulated by NATHNAC, a national authority on travel health in the UK. There are strict requirements on staff training and competence, and yellow fever vaccination licences are only issued after the completion of a formal assessment.
5. Do they have experience in dealing with complex cases?
This will give you an indication of the level of skill and expertise of the travel clinic. If the clinicians are willing to see complex cases, such as individuals with multiple medical problems or weakened immune systems, then this should also give you confidence in their knowledge of vaccine safety for infants and children.
6. Do they have experience in vaccinations for children and babies?
Does your travel clinic have experience in offering and managing travel vaccinations for children? As previously mentioned, our team have specialised UK qualifications in travel medicine, child health and obstetrics.
Concluding thoughts...
Finally, do remember travel vaccinations are important part of international travel with kids and you should plan well ahead; at least four six weeks in advance of your journey.
Vaccine safety for infants and children matter so choose a travel clinic with proven expertise and qualifications in infectious diseases, tropical medicine as well as experience in vaccinating babies and young children.
Health Klinix is overseen by specialists with all these qualifications and so vaccine safety for infants and children is our top priority. We’ll help you navigate through this complex process so that you and your family can travel safely.
References:
Reviewed and approved by:
Dr Ravi Gowda, Consultant in Infectious Diseases and Travel Medicine
MBBS, MRCP(UK), DTM&H, MRCGP, DCH, DRCOG, DFFP
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