April 24-30 is World Immunization Week – a week that aims to promote the life-saving power of immunization to protect people of all ages from preventable diseases. This protection is offered to both those living in countries where preventable diseases are prevalent and those who travel to those areas, countries and regions. In this instance, protection is through the form of travel vaccinations.
As The World Health Organization (WHO) says, “Vaccines are one of humanity’s greatest achievements.”[1] They save 154 million lives. Since 1974, this equates to more than 3 million lives per year. It is also the equivalent of six people, per minute, over the course of five decades. To provide further context, it has reduced infant deaths by 40%. Thanks to the measles vaccine alone, 60% of lives have been saved.
The theme of this year’s World Immunization Week is that ‘immunization for all is humanly possible.’ It is a message aimed at saving still more lives, particularly those of children.
What is vaccination?
Vaccination is a simple and effective way to protect against the horrific diseases that exist in the world. It uses the body’s natural defences to create resistance to specific infections, making the immune system stronger. Vaccines offer the body a weakened form of the bacteria of the viruses against which they protect, so the body can create antibodies that can fight the disease, if future contact with it occurs.
Here in the UK, a variety of vaccines are provided during childhood. Should a child or adult have missed any of these, it is important to catch up. This is not just a form of travel protection but also general health protection. Gaps in vaccination strategy can be exploited by diseases, as we saw with a measles outbreak in the UK last year. Some of the diseases that the UK’s childhood vaccination programme should be preventing against are actually rife in other countries around the world.
Unfortunately, in every world region, we are witnessing a rise in the incidence of preventable diseases like polio and cholera, and malaria too.
Why do we need travel vaccinations?
When a traveller chooses to venture abroad, they expose their health to diseases they would not typically encounter in the UK, but which can be very prevalent overseas. However, travel vaccinations are not mandatory. Having a travel vaccine is often a choice.
The only occasions on which it is not down to the personal decision of the individual traveller as to whether to add a layer of protection through vaccination, or not, is when there is a specific certification requirement. This is where a traveller would be legally unable to enter a country, until they proved they had been given a necessary travel vaccination. This is the case, most typically, with Yellow Fever. However, it also exists with regard to meningococcal meningitis, with vaccination against this disease a requirement of those making pilgrimages for both Hajj and Umrah.[2] Other such requirements can be specific to a particular country.
But most of the time, travel vaccines are ‘recommended’, or there is a list of travel vaccinations to ‘consider.’ It is then down to the individual traveller to decide whether to take up the vaccines, by organising their own vaccination schedule with a medical facility or travel clinic.
Unsatisfactory travel vaccination take-up
In a large US study, it was found that the overall refusal rate for one or more recommended vaccine was 25% within a travel clinic[3]. The rate was higher for some vaccines, particularly for vaccines such as rabies and Japanese encephalitis (JE). The main reason for not taking up the vaccine was lack of concern about the disease.
The refusal rate also tended to be higher when travellers were visiting family and friends, with travellers often not appreciating the travel health risk still attached, even if staying with relatives and acquaintances.
In a UK study[4], the refusal rate was 37%. At an individual level, only 54% of travellers accepted all vaccines. 17.3% refused one vaccine, nearly 12% refused two and 17% refused three.
Nearly half of those who refused to take up a vaccine (46%) said they would be trying to source a vaccine elsewhere, through a primary care facility.
But over a third (36%) of those who said they would be getting a typhoid vaccine elsewhere actually did not.
There was shown to be a correlation between the price of the travel vaccine and the refusal rate – factors that influenced the higher refusal rate of the more expensive Japanese encephalitis and rabies travel vaccinations.
There is also confusion and lack of awareness as to which travel vaccinations are required. Here in the UK, this was evidenced in a 2011 YouGov Poll.
Add to this a new hesitancy, in younger generations, to take up the protection that vaccines require and the picture is disturbing.
Lack of conversation around travel vaccinations
The question has to be, ‘what price do you put on your health?’ We also need to question why the media rarely focuses on the topic of travel vaccines and why it does not address the issue of vaccine refusal. Why is there not more emphasis on the issues that can result from contracting the diseases in question? And why is there not more conversation around the fact that refusing a vaccine could invalidate travel insurance?
Travel vaccination budgeting should also be a key part of travel planning, but it is the failure to recognise this, at the trip planning stage, that undoubtedly leads to some travellers running the risk of not having the travel vaccines and antimalarial treatments that they and their family require. The trip has probably been booked long before the realisation that vaccinations are required hits home. By that stage, there may not be the money available to cover the cost.
But, here at Pinpoint Travel Health, we also have to question why, knowing that cost can influence over travel vaccine refusal, more members of the media are not highlighting to travellers that precise planning behind travel vaccines works both ways. It can absolutely tell you which vaccines you need but also state which ones you do not need, lessening the impact on your budget. By having this clarity, you can spend your travel health budget wisely.
We unfortunately currently have the majority of travellers relying on websites that only provide a country-wide assessment of required travel vaccines and no personalisation of information, tailored to the individual traveller. This presents information that is too vague for the vast majority of those planning on taking a trip to a country in which diseases are prevalent.
Accurate and tailored planning is exactly what Pinpoint Travel Health’s ‘Travel Health Brief’ service provides, offering the traveller a precise examination of their own individual itinerary, plans, existing health conditions and time and duration of travel, to pinpoint what is needed and what is not. This can be done right down to village or conference centre level. Data is continually updated and provided by leading world health authorities including WHO. Our own clinical team also review data and add another level of professionalism to the service.
For a very small outlay on a Travel Health Brief, a traveller can remove all doubts as to whether a vaccine is really required for their own individual trip and the things they will be doing whilst abroad. They can also discover whether current medications could present a vaccination issue.
Summary of travel vaccination situation in the UK
Having a continued ‘grey area’ lingering over travel vaccination planning is proving helpful to nobody. Our aim should be to encourage vaccine take-up both within overseas populations, through campaigns like World Immunization Week, but also within our travelling population of UK holidaymakers, gap year adventurers and business travellers. Until there is more conversation around the topic of travel vaccines, the latter may well not happen.
Lead photo credit: Photo by CDC on Unsplash
[1] https://www.who.int/campaigns/world-immunization-week/2025
[2] https://www.gov.uk/foreign-travel-advice/saudi-arabia/pilgrimage#:~:text=Health%20risks%20and%20vaccine%20requirements,prolonged%20exposure%20to%20direct%20sunlight.
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC5091771/
[4] https://www.journalofinfection.com/article/S0163-4453(24)00027-6/fulltext