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Could you please advise me on the travel vaccinations I would need to go to China.

Tags: vaccine

Could you please advise me on the travel vaccinations I would need to go to China (Shaghai, Beijing, Xian and Hong Kong).

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The answer

Ultimately necessary travel vaccinations will depend on a couple of factors such as: the nature of visit i.e. work/leisure/backpacking, length of stay, access to safe food, water and good sanitation and any pre-existing medical conditions, particularly those that require medication.

First off, it is important to check your status is up to date for all primary courses and boosters on the vaccination schedule recommended for the UK. This should be available to check at your registered GP surgery. You may also be able to check any previous vaccinations you have had for travel as it may not be necessary to have the same again.

The following vaccinations are recommended for most travellers to China:

Hepatitis A – routes of transmission include contaminated food and water and direct contact with an infected person. It is recommended for all previously unvaccinated travellers2. It is a two-dose schedule and protection can last up to 20 years1. It is eligible on the NHS as a single vaccine but there are combinations with other eligible vaccines should they be required.

Tetanus – all individuals should have completed a primary course of tetanus as per the UK schedule. However, a booster dose within the last ten years is normally necessary and is covered by the NHS.

The following vaccinations should be considered by travellers to China:

Hepatitis B – routes of transmission include exposure to contaminated blood or bodily fluids2. Vaccination could be considered for all travellers and is recommended for those whose activities or medical history put them at increased risk – so those who may have unprotected sex, those who may be exposed to contaminated needles through injecting drug use, those who may be exposed to blood or body fluids through their work (e.g. health workers), those who may be exposed to contaminated needles as a result of having medical or dental care e.g. those with pre-existing medical conditions and those travelling for medical care abroad, long-stay travellers, those who are participating in contact sports and families adopting children from this country2. The above list may not be applicable to your travel but it is best practice to notify you.

The schedule is a three-dose schedule but the cost is not usually covered by the NHS. In some instances it can be combined with other eligible vaccines.

Japanese Encephalitis – route of transmission is from animals to humans via mosquitos. Those at increased risk include travellers who are staying for a month or longer during the transmission season, especially if travel will include rural areas with rice fields and marshland. Travellers on shorter trips (typically less than a month), or trips that take place outside the peak transmission season and those who restrict their visits to urban areas are usually considered to be at very low risk2.

The vaccine is a two-dose schedule at 0 and 28 days and its cost is not covered by the NHS. Whether it is applicable is usually after discussion with the vaccine provider about your visit. If previously vaccinated, depending on when the vaccine was completed, a booster dose may be necessary.

Rabies – route of transmission is via the saliva of an infected animal. Pre-exposure vaccinations are recommended for travellers whose activities put them at increased risk including: those at risk due to their work (e.g. laboratory staff working with the virus, those working with animals or health workers who may be caring for infected patients).those travelling to areas where access to post-exposure treatment and medical care is limited, those planning higher risk activities such as running or cycling and long-stay travellers (more than one month)2. The list above may not be applicable but it is best practice to notify you.

The vaccine is a three-dose schedule usually at days 0, 7 and 28 and its cost is not covered by the NHS. If the vaccine has been given before, depending on the vaccine type, a booster may or may not be necessary.

Tick-Borne Encephalitis – route of transmission is by the bite of infected ticks. Less commonly, cases occur following ingestion of unpasteurised milk products2. Vaccination is recommended for those visiting affected areas whose activities put them at increased risk including: those who are going to live in TBE risk areas, those working in forestry, woodcutting, farming and the military, travellers to forested areas typically during spring to late autumn e.g. campers, hikers, hunters and individuals who undertake fieldwork and laboratory workers who may be exposed to TBE2. Again the list above may not be applicable but it is best practice to notify you.

The vaccine is a three-dose schedule and its cost is not covered by the NHS. There are booster requirements if this vaccine has been completed on a previous occasion.

Tuberculosis – route of transmission is via the inhalation of droplets from an infected person. The BCG programme has now stopped in schools and a booster is not required if the vaccine has been given in the programme. It should be discussed with the vaccine provider whether this vaccine is necessary as there are specific criteria and certain contraindications.

Typhoid – route of transmission is via contaminated food and water. Travellers who have access to safe food and water are likely to be at low risk. Those at increased risk include travellers visiting friends and relatives, frequent or long-stay travellers to areas where sanitation and food hygiene are likely to be poor2.

Vaccination can either be given in an injectable form or a capsule form (usually issued on a private prescription). Furthermore, it can be combined with the Hepatitis A vaccine. If previously vaccinated, a booster is required after three years.

Finally, there is low to no risk of malaria in China and thus antimalarial chemoprophylaxis is not usually advised.

It is now prudent to contact your travel nurse at your GP surgery or a private travel clinic provider to discuss the vaccines further.

Please find the below links useful as reputable sources of further information particularly on Yellow Fever requirements:

NHS - Fit for travel – general information regarding vaccinations and staying healthy while travelling. Also please see specific information regarding Yellow Fever requirements.

Masta travel health – an example of a nationwide travel clinic provider.