travel vaccinations for 1 year old

Does your child need vaccines before international travel? Here's what you need to know.

Traveling with kids exposes us to new family travel adventures , but it can also expose our immune systems to unfamiliar diseases, ones not covered by routine vaccinations in our home countries. For this reason, travel vaccines are a vital part of preparation for international travel to certain countries or regions of the world.

According to the U.S. Centers for Disease Control, close to 2.4 million children from the United States travel internationally every year. And when it comes to illness, kids face similar risks as adults – but depending on their age, kids may not have completed their routine vaccine schedule. When you consider vaccines for international travel, different recommendations sometimes apply to children. 

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What to know about travel vaccinations

Pre-travel immunizations at a travel clinic can protect you and your children while you’re abroad, keeping everyone safe and happy as you explore the world. Here’s everything you should know about required vaccinations for travel, including travel vaccinations for babies, older kids, and everyone else in your family.

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Which travel vaccines should my child get before traveling internationally?

Recommended or required vaccines for travel depend on the destination. In some cases, recommended vaccines are based on the specific health risks. 

Start by checking the CDC’s travel vaccination website to get a sense of which vaccines are recommended or required for your destination , then follow up with a travel clinic visit or appointment with a travel medicine specialist. These specialists can provide tailored information based on the destination and the vaccination schedule of your child, and can help you decide if optional vaccines for travel are right for you.

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Recommendations and travel vaccination schedules vary depending on where you live (schedules vary among countries, states and provinces), your child’s health and the type of vaccine. A travel specialist can help you find out if any additional travel vaccines are recommended. 

Do some routine childhood vaccines require an adjusted schedule for travel?

Before you go on any trip, your children should be up to date on their routine immunizations. In some cases, routine childhood vaccination schedules may need to be adjusted to provide extra protection for travel. 

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For example, often MMR (measles, mumps and rubella) is given at the 1-year-old visit. But in case of travel, your travel specialist may recommend giving a dose of MMR vaccine before age 12 months (minimum 6 months old). Note that in this case, you’ll still need to re-vaccinate the full course (two doses for MMR vaccine) after age 1.

When should travel vaccinations be assessed?

Once you’ve booked your travel, it’s a good idea to start assessing which vaccines you and your children should receive. You should schedule an appointment at your doctor’s office or at a travel vaccine clinic at least four to six weeks before you leave. The ideal time to receive required vaccinations for travel is usually at least a month before departure. That allows your body time to build immunity before your trip.

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However, even if you’ve left it to the last minute, a pre-trip doctor’s appointment is still important. Immunizations can still be necessary, and pre-travel care extends beyond vaccinations. You and your child may still benefit from medicine to bring along in case of illness, and doctors are the best source of pre-travel medical advice beyond travel vaccines.

How effective are travel vaccines?

The effectiveness of vaccines varies. In general, most childhood vaccines provide more than 90% protection against diseases that are otherwise related to severe complications and death. 

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Factors contributing to the effectiveness of vaccines include the recipient’s age, the recipient’s health status, the recipient’s immune response to the vaccine, and how well the vaccine components match the disease-causing bacteria or virus circulating in the population. In some cases, people who have developed only partial immunity to the vaccine may contract the disease. In this case, the vaccine helps reduce disease severity and prevent complications.

Are travel vaccines safe for kids?

All routine childhood vaccines and vaccines for international travel in babies and children that are available have been fully tested and approved by the U.S. Food and Drug Administration. 

Vaccines stimulate the body to develop protective responses and make antibodies against a disease. As a result, you and your child can be protected against the disease when you’re exposed to the actual bacteria or virus in the future. 

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Rarely, vaccines may be contraindicated in some children, but the most common adverse effects of vaccines are minor and usually include fever and swelling or soreness at the injection site. Talk with a travel health care provider to know if a vaccine is right for your child, and about how to manage any adverse effect.

Does my child really need a vaccine against a disease that is now rare?

Widely adopted vaccination schedules are effective and may help explain the scarcity of diseases such as varicella or measles in your home country. But these diseases can still be prevalent in other parts of the world where such vaccination schedules are not in place. 

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Traveling to such a country without immunization may expose your child to these preventable diseases. In addition, travelers can unknowingly bring back the disease-causing bacteria or virus. If the community is not protected by vaccines, these diseases can quickly spread again.

Will multiple vaccines at the same time overload a baby’s immune system?

The safety of giving multiple vaccines at once has been established by numerous studies. In fact, children are exposed to lots of foreign particles from the environment and their diets every day without adverse outcomes. Similarly, the amount of bacterial or viral particles in vaccines is not adequate to cause harm. Giving multiple vaccines at once ensures the child will acquire protection as early as possible and prevents unnecessary delay in vital vaccinations. 

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Generally, there is no upper limit for the number of routine or travel vaccinations for babies that can be given at the same time. However, if live vaccines are to be given at separate times, each dose should be spaced out at least 28 days.

Tips for preparing your family for healthy travels

Schedule your family’s appointment with a travel clinic or travel medicine specialist four to six weeks before your departure date. Bring your and your children’s immunization records to every clinic visit so the health provider can sign and date each vaccination. And always bring your family’s immunization records with you when you travel.

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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 .

Do kids need to get the COVID-19 vaccine before traveling?

More than 50% of the U.S. population over the age of 18 has been fully vaccinated against COVID-19 . And many of the people who have been vaccinated -- or are scheduled to receive the vaccine soon -- are thinking about their travel plans for this summer and beyond.

There's a noticeable group of people who aren't vaccinated yet: kids under 12. And another group that just started to be vaccinated en masse: tweens and teens. The Food and Drug Administration (FDA) on May 10 authorized the Pfizer COVID-19 vaccine for kids ages 12 to 15 years old in the United States. (Moderna also said on May 25 that its vaccine was effective in children ages 12 to 17, although it has yet to gain approval for use). And now, roughly 2% of people under 18 have been fully vaccinated, according to data from the U.S. Centers for Disease Control and Prevention (CDC).

If you're traveling domestically with young kids, or even older ones, there are no COVID-19 testing requirements . But even if you haven't left home since the onset of the pandemic , you probably won't be shocked to hear that traveling abroad with kids is a bit different than it used to be. Adults traveling with kids may, in some instances, have different travel requirements as a result of the pandemic. So, what does that mean for your family's travel plans?

Here's what to know about traveling when part of your family is unvaccinated.

For more TPG news delivered each morning to your inbox, sign up for our daily newsletter .

Can children get a COVID-19 vaccine?

Approving children for vaccination is a crucial step in the fight against the pandemic and could mean many more families booking travel. Many parents have been waiting to hear about vaccinations for kids before booking family trips.

Currently, there's an age limit on all three vaccines available under the Emergency Use Authorization from the FDA. The Pfizer-BioNTech vaccine is the only vaccine available for kids 12 to 17, so far. The Moderna and Johnson & Johnson vaccines are only available for adults who are 18 and over.

According to The New York Times, younger children will probably be eligible this fall when Pfizer plans to seek emergency authorization for children between the ages of 2 and 11. Additionally, results from Moderna's clinical trial in children as young as 6 months are expected by the end of the year. For now, though, kids under 12 aren't eligible for any version of the COVID-19 vaccine.

"[The] CDC recommends COVID-19 vaccination for everyone 12 years of age and older to help protect against COVID-19," the CDC said on its website. "Children 12 years of age and older are able to get the Pfizer-BioNTech COVID-19 vaccine."

Related: What you need to know about all the COVID-19 vaccines in the U.S.

Can children travel abroad if they haven't been vaccinated?

Dozens of countries have now reopened to U.S. tourists , and some of those countries are only welcoming — or waiving testing and quarantine requirements for — fully vaccinated travelers.

At this time, travelers from the U.S., EU and Schengen area are now permitted to enter Greece, providing you're either vaccinated or can show proof of a negative COVID-19 test (this would apply to nonvaccinated children).

Italy is also open to travelers again with similar requirements, as is Croatia . As the summer progresses, and more European countries open their borders, you can expect to see other vaccination and negative COVID-19 test requirements. In brief: It will be quicker and easier to bring vaccinated teens and tweens across borders, but younger kids should still be able to travel with you as long they test negative for COVID-19.

In other cases, being able to show proof of vaccination may be your only way in. Iceland, for example, said it would accept fully vaccinated travelers . These travelers would not be required to quarantine upon arrival.

Related: Can you skip quarantine if you've been vaccinated?

We can also look at the cruise industry for an idea about how destinations and travel providers might accommodate families who are traveling with unvaccinated children.

Two sister cruise lines, Royal Caribbean and Celebrity , said adult passengers would need to be fully vaccinated to sail when they resume operations. However, both lines said children under 18 could sail with proof of a negative COVID-19 test instead of proof of vaccination. But changes are happening fast to these requirements and they aren't standard across embarkation ports. For example, on Royal Caribbean sailings to Alaska, anyone 16 years of age or older must be fully vaccinated against COVID-19, and those 12 or older as of Aug. 1.

But, Royal Caribbean has also relaxed its vaccination policy for sailings out of Florida and Texas. Even unvaccinated passengers may sail on those itineraries on Royal Caribbean ships. The cruise line said, "Guests are strongly recommended to set sail fully vaccinated, if they are eligible. Those who are unvaccinated or unable to verify vaccination will be required to undergo testing and follow other protocols, which will be announced at a later date."

At this time, there is no vaccine requirement to travel back to the United States. U.S. airlines oppose travel vaccine requirements but asked the Biden administration to exempt vaccinated travelers from international testing requirements.

At this time, however, travelers flying into the United States from abroad still need to provide a negative COVID-19 test result before boarding -- even if fully vaccinated. All passengers 2 years of age and older traveling into the U.S. must provide proof of a negative test taken no more than three days before flying back to the U.S.

Related: What you need to know about getting COVID-19 tested for US-bound international flights

Bottom line

It's not out of the realm of possibility that travelers, even children, may be required to be fully vaccinated against COVID-19 to visit certain countries or travel with certain providers.

We've seen this play out before with other vaccines required around the world. The yellow fever vaccination, for example, is recommended or required for entry into countries such as Liberia and Uganda, while the meningococcal vaccination is required for travelers entering Saudi Arabia for the Hajj and Umrah pilgrimages.

There's still a lot that's unclear about traveling with unvaccinated children, but the cruise industry's plan to require that children test negative for the virus in place of having a vaccine points to the most likely trend, as can be seen with the reopening of Greece and Italy.

The travel industry won't want to alienate a large swath of travelers -- and their parents -- by barring access to children who have yet to be vaccinated. That means it's likely that unvaccinated children will have to use other methods to prove they're healthy, such as testing negative for COVID-19.

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• Parenting, childcare and children's services
• Children's health and welfare
• Children's health
• Immunisations: babies up to 13 months of age
• UK Health Security Agency

A guide to immunisation for babies up to 13 months of age - from February 2022

Updated 17 April 2023

© Crown copyright 2023

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: [email protected] .

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/a-guide-to-immunisations-for-babies-up-to-13-months-of-age/a-guide-to-immunisation-for-babies-up-to-13-months-of-age-from-february-2022

Summary of immunisations

Your baby will have immunisations against:

• pertussis (whooping cough)
• Haemophilus influenzae type b ( Hib )
• hepatitis B
• meningococcal group B disease ( MenB )

These will be given as 2 injections and drops into the mouth.

At 12 weeks

• pneumococcal disease

At 16 weeks

These will be given as 2 injections.

At one year

Your baby will be immunised against:

• Hib /Meningococcal group C ( MenC )
• measles, mumps, rubella ( MMR )

Information about immunisation

Immunisation is a way of protecting against serious infectious diseases. Once we have been immunised, our bodies are better able to fight those diseases if we come into contact with them.

How vaccines work

Vaccines contain a small part of the bacterium or virus that causes a disease, or tiny amounts of the chemicals that the bacterium produces. Vaccines work by causing the body’s immune system to make antibodies (substances that fight off infection and disease). If your child comes into contact with the infection, the antibodies will recognise it and be ready to protect him or her. Because vaccines have been used so successfully in the UK, diseases such as diphtheria have almost disappeared from this country.

There are some diseases that can kill children or cause lasting damage to their health. Immunisations are given to prepare your child’s immune system to fight off those diseases if they come into contact with them.

When your baby should be immunised

It is important that your baby has their immunisations at the right age – the first ones are given at 8 weeks old. They will be given further doses of these immunisations when they are 12 weeks old and 16 weeks old. Other immunisations are given at one year of age and other immunisations are given later. Refer to the complete routine childhood schedule for a list of the immunisations, below.

Why babies are vaccinated so early

Many of these diseases can be particularly serious in young babies.

It is important to make sure babies are protected as early as possible to prevent them catching the diseases.

Why babies need more than one dose of vaccine

Most immunisations have to be given more than once to prepare your child’s immunity. For example, 3 doses of DTaP/IPV/Hib/HepB vaccine are needed to provide protection in babies. Booster doses are then given later in life to provide longer-term protection.

How will you know when your baby is due for their immunisations

Your doctor’s surgery or clinic will send you an appointment for you to bring your baby for their immunisations. Most surgeries and health centres run special immunisation or baby clinics. If you can’t get to the clinic, contact the surgery to make another appointment. All childhood immunisations are free. You can also find details in your child’s red book .

What happens at a vaccination appointment

The doctor or nurse will explain the immunisation process to you, and answer any questions you have. Most vaccines are injected into the muscle of the child’s thigh or the upper arm. Rotavirus vaccine is given as drops by mouth.

Missed vaccination appointments

If you miss the appointment or need to delay the immunisation, make a new appointment. You can pick up the immunisation schedule where it stopped without having to start again.

Rotavirus vaccine can only be started in babies up to 15 weeks of age and no dose of the vaccine can be given over 24 weeks of age.

Why we still immunise against diseases that have disappeared from this country

In the UK, these diseases, such as measles, are kept at bay by high immunisation rates. Around the world, millions of people a year die from infectious diseases with more than 5 million of these being children under the age of 5. Many of these deaths could be prevented by immunisation.

As more people travel abroad and more people come to visit this country, there is a risk that they will bring these diseases into the UK. The diseases may spread to people who haven’t been immunised so your baby is at greater risk if they have not been immunised.

Immunisation doesn’t just protect your child; it also helps to protect your family and the whole community, especially those children who, for medical reasons, can’t be immunised. Refer to reasons why your baby should not be immunised for details.

Vaccine safety

Before they are allowed to be used, all medicines (including vaccines) are thoroughly tested to assess how safe and effective they are. After they have been licensed, the safety of vaccines continues to be monitored.

Any rare side effects that are discovered can then be assessed further. All medicines can cause side effects, but vaccines are among the very safest. Research from around the world shows that immunisation is the safest way to protect your child’s health.

Worries about your baby being upset by having an injection

Your baby may cry and be upset for a few minutes, but they will usually settle down after a cuddle.

Side effects

Some babies will have side effects after an injection. They may:

• have redness, swelling or tenderness where they had the injection (this will slowly disappear on its own)
• be a bit irritable and feel unwell
• have a temperature (fever)
• babies having the rotavirus vaccine may get mild diarrhoea

A fever is a temperature over 37.5°C.

Fevers are quite common in young children, but are usually mild. If your child’s face feels hot to the touch and they look red or flushed, they may have a fever.

You should check their temperature with a thermometer.

Treating and preventing fever

Keep your child cool by:

• making sure they don’t have too many layers of clothes or blankets on
• giving them plenty of cool drinks

A dose of infant paracetamol liquid may help reduce your child’s fever. Read the instructions on the bottle very carefully. You may need to give another dose 4 to 6 hours later.

Fever is more common when babies have the  MenB  vaccine alongside their other vaccines. Refer to the section about MenB  vaccine below.

Never give medicines that contain aspirin to children under 16 years.

If you are worried about your child, trust your instincts. Speak to your doctor or call the free NHS helpline 111.

Call the doctor immediately if, at any time, your child:

• has a temperature of 39°C or above

If the surgery is closed and you can’t contact your doctor, trust your instincts, and go to the emergency department of your nearest hospital.

Asthma, eczema, hay fever, food intolerances and allergies do not prevent your child having any vaccine in the childhood immunisation programme. If you have any questions, speak to your doctor, practice nurse or health visitor.

Allergic reactions

Very rarely, children can have an allergic reaction soon after immunisation. This reaction may be a rash or itching affecting part or all of the body. The doctor or nurse giving the vaccine will know how to treat this. It does not mean that your child should stop having immunisations.

Anaphylactic reaction

Even more rarely, children can have a severe reaction, within a few minutes of the immunisation, which causes breathing difficulties and can cause the child to collapse. This is called an anaphylactic reaction. A recent study has shown that there is only 1 anaphylactic reaction in about a million immunisations.

An anaphylactic reaction is a severe and immediate allergic reaction that needs urgent medical attention. The people who give immunisations are trained to deal with anaphylactic reactions and children recover completely with treatment.

Reasons why your baby may not be able to be immunised

There are very few reasons why babies cannot be immunised. Vaccines should not be given to babies who have had a confirmed anaphylactic reaction to either a previous dose of the vaccine, or to neomycin, streptomycin or polymyxin B (antibiotics that may be added to vaccines in very tiny amounts).

Immunosuppressed children

In general, children who are ‘immunosuppressed’ should not receive live vaccines.

Children who are immunosuppressed include those whose immune system does not work properly because they are undergoing treatment for a serious condition such as a transplant or cancer, or who have any condition which affects the immune system, such as severe primary immunodeficiency. Primary immunodeficiencies are very rare diseases that mean you are more likely to catch infections. They are usually caused by a faulty gene and are diagnosed soon after birth

If this applies to your child, you must tell your doctor, practice nurse or health visitor before the immunisation.

They will need to get specialist advice on using live vaccines such as MMR , rotavirus vaccine and Bacillus Calmette-Guérin vaccine ( BCG ).

There are no other reasons why vaccines should definitely not be given.

Illness on the day of your baby’s vaccination appointment

If your baby has a minor illness without a fever, such as a cold, they should have their immunisations as normal. If your baby is ill with a fever, put off the immunisation until they have recovered.

This is to avoid the fever being associated with the vaccine, or the vaccine increasing the fever your child already has. If your baby:

• has a bleeding disorder (for example, haemophilia, in which the patient’s blood does not clot properly),
• has had a fit not associated with fever

Speak to your doctor, practice nurse or health visitor before your child has any immunisation.

Fits and febrile seizures or convulsions

Fits are also called seizures or convulsions. Some are associated with fever and some are not. Seizures associated with fever (which may be called a febrile seizure or febrile convulsion) are rare in the first 6 months of life and are most common in the second year of life.

After this age, they become less frequent and are rare after the age of 5 years. Most children who have febrile seizures recover fully. When a child has a seizure within a short time after immunisation, it might not have been caused by the vaccine or the fever. It could be due to an underlying medical condition.

If your baby has a fit after an immunisation, contact your doctor.

They may refer you to a specialist for advice about further investigations and future immunisations. If the surgery is closed or if you can’t contact your doctor, go straight to the emergency department of your nearest hospital.

Premature babies

Premature babies may be at greater risk of infection. They should be immunised in line with the recommended schedule from 8 weeks after birth, no matter how premature they were.

Deciding to immunise your baby

In the UK, parents can decide whether or not to have their children immunised.

Vaccination is recommended because it gives your baby protection against serious diseases, most of which can kill. Around the world, many children are now routinely protected with vaccines. Because of this, some of the world’s most serious diseases may soon disappear.

Immunisations and swimming

You can take your baby swimming at any time before and after their immunisations.

Multiple vaccinations

From birth, babies’ immune systems protect them from the germs that surround them. Without this protection, babies would not be able to cope with the tens of thousands of bacteria and viruses that cover their skin, nose, throat and intestines. This protection carries on throughout life.

Studies have shown that it is safe to have several vaccinations at the same time and your baby will be protected from some very serious infections.

Other immunisation methods

There is no other proven, effective way to immunise your child against infectious disease.

Changes to the immunisation programme

Immunisation programmes are regularly reviewed to make sure that all children are offered the best protection against preventable diseases. As new vaccines become available, or research shows that giving existing vaccines at different times improves protection, the programme will be changed.

Recent changes to the UK programme have been:

• giving hepatitis B vaccine at 8 weeks, 12 weeks and 16 weeks of age
• giving rotavirus vaccine at 8 weeks and 12 weeks of age
• giving  MenB  vaccine to babies at 8 weeks,16 weeks and 1 year of age
• giving flu vaccine to all eligible primary school aged children
• giving meningococcal A, C, W and Y ( MenACWY ) vaccine to young people around 14 years old
• giving human papillomavirus ( HPV ) vaccine to boys as well as girls from September 2019
• giving a single priming dose of pneumococcal vaccine at 12 weeks of age instead of 2 doses at 8 and 16 weeks

Remember, it’s never too late to have your child immunised. Even if your child has missed an immunisation and is older than the recommended ages, talk to your doctor, practice nurse or health visitor to arrange for your child to be immunised.

Immunisations at 8, 12 and 16 weeks of age

Immunisations are given to babies at 8, 12 and 16 weeks of age. Further immunisations are given at one year of age, as seen in the complete routine childhood schedule .

Remember to bring your child’s red book of immunisation with you to each appointment.

You will be offered DTaP/IPV/Hib/HepB , MenB , PCV and rotavirus for your baby during the first 4 months of their life.

The vaccines are described below, together with the diseases they protect against.

DTaP/IPV/Hib/HepB vaccine

Your baby should be immunised with DTaP/IPV/Hib/HepB vaccine when they are 8, 12 and 16 weeks old.

The DTaP/IPV/Hib/HepB vaccine protects against 6 different diseases:

Your child should have a Hib booster (in combination with MenC ) at one year of age; boosters against diphtheria, tetanus, pertussis and polio before they start school; and a further tetanus, diphtheria and polio booster around 14 years.

Effectiveness of the DTaP/IPV/Hib/HepB vaccine

Studies have shown that DTaP/IPV/Hib/HepB vaccine is very effective in protecting your baby against these 6 serious diseases. Further doses are needed to extend this protection as your child grows up.

There are 2 DTaP/IPV/Hib/HepB vaccines, your baby may receive either. You can read more about the vaccines, called Vaxelis and Infanrix hexa , in the patient information leaflets.

Diphtheria is a serious disease that usually begins with a sore throat and can quickly cause breathing problems. It can damage the heart and nervous system and, in severe cases, it can kill. Before the diphtheria vaccine was introduced in the UK, there were up to 70,000 cases of diphtheria a year, causing up to 5,000 deaths.

Tetanus is a disease affecting the nervous system which can lead to muscle spasms, cause breathing problems and can kill. It is caused when germs that are found in soil and manure get into the body through open cuts or burns. Tetanus cannot be passed from person to person.

Pertussis (whooping cough)

Whooping cough is a disease that can cause long bouts of coughing and choking, making it hard to breathe. Whooping cough can last for up to 10 weeks. Babies under one year of age are most at risk from whooping cough. For these babies, the disease is very serious and it can kill. It is not usually so serious in older children.

Before the pertussis vaccine was introduced, the average number of cases of whooping cough reported each year in the UK was 120,000 and 92 children died in the year before the vaccine was introduced.

Polio is a virus that attacks the nervous system and can cause permanent paralysis of muscles. If it affects the chest muscles or the brain, polio can kill.

Before the polio vaccine was introduced, there were as many as 8,000 cases of polio in the UK in epidemic years. Because of the continued success of the polio vaccination, there have been no cases of natural polio infection in the UK for over 30 years (the last case was in 1984).

Hib is an infection caused by Haemophilus influenzae type b bacteria. It can lead to a number of major illnesses such as blood poisoning (septicaemia), pneumonia and meningitis. The Hib vaccine only protects your baby against the type of meningitis caused by the Haemophilus influenzae type b bacteria – it does not protect against any other causes of meningitis.

The illnesses caused by Hib can kill if they are not treated quickly. Before the Hib vaccine was introduced, there were about 800 cases of Hib in young children every year. Since it’s been introduced, the number of children under 5 years of age with Hib has fallen by 99%.

Hepatitis B

Hepatitis B is an infection of the liver caused by the hepatitis B virus. In children, the infection can persist for many years and can sometimes lead to complications such as scarring of the liver (cirrhosis), which prevents it from working properly or liver cancer.

Although the number of children infected with the hepatitis B virus is low in the UK, hepatitis B immunisation has been provided to infants at a high risk of developing the infection from infected mothers since the 1980s. In 2017, hepatitis B vaccine was added to the routine immunisation programme so that all children can benefit from protection against this virus.

The hepatitis B vaccine only protects against the B type of the virus and 3 doses will provide long lasting protection for those children without additional risk factors.

After immunisation with DTaP/IPV/Hib/HepB

Your baby might get some side effects, which are usually mild:

• redness, swelling or tenderness where they had the injection
• your baby may be miserable for up to 48 hours after having the injection
• your baby could develop a mild fever
• you might notice a small lump where your baby had the injection; this may last for a few weeks but will slowly disappear

If you think your baby has had any other reaction to the DTaP/IPV/Hib/HepB vaccine and you are concerned about it, talk to your doctor, practice nurse or health visitor.

MenB vaccine

Your baby should be immunised with MenB vaccine when they are 8 weeks, 16 weeks and 12 months old.

This vaccine protects against meningitis and septicaemia (blood poisoning) caused by meningococcal group B bacteria. The MenB vaccine does not protect against meningitis and septicaemia caused by other bacteria or by viruses. Refer to the meningitis and septicaemia section below for further information.

Meningococcal B bacteria

There are several types of meningococcal bacteria (A, B, C, W, Y and Z) and most cases of meningitis and septicaemia in the UK are caused by the B strains, especially in young children. A vaccine that helps to protect against MenB disease was introduced into the UK programme in September 2015.

How common MenB disease is

In England and Wales, in 2013, there were over 500 confirmed MenB cases, with more than half of the cases in children under 5 years of age. Without vaccination, around 1 in 3,500 infants under one year and 1 in 8,000 toddlers aged one to 4 years will develop meningococcal disease every year.

After immunisation with MenB vaccine

Some babies may:

• have redness, swelling or tenderness where they had the injection (this will slowly disappear on its own within a few days)
• be a bit irritable and feed poorly

Giving paracetamol following the 8 and 16 week vaccinations

Fever can be expected after any vaccination, but is very common when the MenB vaccine is given with the other routine vaccines at 8 and 16 weeks. The fever shows the baby’s body is responding to the vaccine, although the level of fever depends on the individual child and does not indicate how well the vaccine has worked. Giving infant paracetamol will reduce the risk of fever, irritability and general discomfort (including pain at the site of the injection) after vaccination.

When to give doses of paracetamol for your baby

You will need to give your baby a total of 3 doses of paracetamol (2.5ml of infant paracetamol 120mg/5ml suspension) to prevent and treat any potential fever after both the 8 and 16 week vaccination visits.

You should give the first dose of paracetamol as soon as possible after your baby’s 8 week vaccination visit. You should then give the second dose 4 to 6 hours later and the third dose 4 to 6 hours after that.

You will need to follow the same steps after their 16 week vaccinations. No paracetamol is required at the 12 month dose (see MenB booster vaccine ). If you do not have any infant paracetamol liquid at home you should get some in time for your first vaccination visit. It is widely available from pharmacies and supermarkets.

More information about the meningitis B vaccine called Bexsero is available in the patient information leaflet.

Pneumococcal vaccine ( PCV )

Your baby should be immunised with PCV when they are 12 weeks and 12 months old.

PCV provides some protection against one of the most common causes of meningitis, and also against other conditions such as severe ear infections (otitis media), and pneumonia caused by pneumococcal bacteria. This vaccine only protects against 13 types of pneumococcal bacteria and does not protect against meningitis caused by other bacteria or viruses. Refer to the meningitis and septicaemia section below for further information.

Pneumococcal bacteria

There are more than 90 different pneumococcal types (serotypes) that can cause disease in humans, but the 13 types in the vaccine were the most common. The infection causes serious (invasive) disease such as meningitis and septicaemia (blood poisoning) and less serious infections such as ear infections (otitis media), sinusitis, pneumonia and bronchitis.

How common invasive pneumococcal infection is

More than 5,000 cases are diagnosed each year in England. The number of cases peaks in December and January.

It particularly affects:

• the very young
• the elderly
• people with certain medical conditions

Invasive infections due to the strains covered by the vaccine have declined dramatically since the vaccine was introduced.

After immunisation with PCV

Some babies may get swelling, redness or tenderness at the injection site or a mild fever (see the section on fever ).

Further information is available in the patient information leaflet on the pneumococcal vaccine for infants called Prevenar 13 .

Rotavirus vaccine

The vaccine will be given with your baby’s other routine vaccinations at 8 and 12 weeks of age.

Rotavirus is an infection that causes vomiting and diarrhoea. In England, before the vaccine was introduced, almost all babies got rotavirus at sometime in their first 5 years of life and about 1 in every 5 required medical attention. About 1 in 10 of these (roughly 13,000) were admitted to hospital because of rotavirus.

How rotavirus spreads

The virus can be spread through hand to mouth contact and be picked up from surfaces such as toys, hands or dirty nappies. It can also be spread through the air by sneezing and coughing.

When your baby will have the vaccination

The vaccine will be given with the other routine vaccinations at 8 and 12 weeks of age. Your baby needs 2 rotavirus vaccinations at least 4 weeks apart to get the best protection. If your baby misses one of the vaccinations, the first dose can be given up to 15 weeks of age. No dose of the vaccine will be given to babies over 24 weeks of age.

How the vaccine is given

Rotavirus vaccine is given as a liquid from a dropper to make it easy for your baby to swallow.

Many millions of doses of the vaccine have been used and it has a good safety record. Babies who have had the vaccine can sometimes become restless and irritable, and some may even develop mild diarrhoea.

In very rare cases (about 2 in 100,000 babies vaccinated), the vaccine can affect the baby’s lower gut and they may develop abdominal pain, vomiting, and sometimes they may pass what looks like redcurrant jelly in their nappies. If this happens, you should contact your doctor immediately.

Further information is available in the patient information leaflet on the rotavirus vaccine called Rotarix .

Immunisations at one year of age

Your child will need the combined Hib / MenC vaccine, PCV , and the MenB vaccine at one year of age to boost their protection against Haemophilus influenzae type b, meningococcal B and pneumococcal infections. These vaccines will help to protect your child through early childhood.

Your child will also have their first dose of MMR and MenC vaccine (in the combined Hib / MenC vaccine) at this time to protect against measles, mumps and rubella and meningococcal C. Your child will need a second dose of MMR vaccine before starting school.

The routine primary immunisations for babies at one year of age

Each vaccination is given as a single injection into the muscle of the child’s thigh or upper arm.

Hib / MenC vaccine

Your child should be immunised with their dose of Hib / MenC vaccine when they are one year of age at the same time as their MMR and booster PCV and MenB vaccinations.

This vaccine protects against Hib (see the Hib section above for information on Hib ) and meningitis and septicaemia (blood poisoning) caused by meningococcal group C bacteria. This vaccine does not protect against meningitis or septicaemia caused by other bacteria or by viruses. Refer to the meningitis and septicaemia section below for further information.

How common MenC disease is

Prior to the introduction of the vaccine there were around 800 to 900 MenC cases a year, mainly affecting babies and teenagers. Since the vaccine was introduced, the number of babies under the age of 1 with group C disease has fallen by about 99%.

A booster dose of MenC is contained in the MenACWY vaccine given to young teenagers, and is needed to provide longer-term protection against 4 of the causes of meningitis and septicaemia.

After immunisation with Hib / MenC vaccine

Your child may have redness, swelling or tenderness where they had the injection. About half of all babies who have the vaccine may become irritable, and about 1 in 20 could get a mild fever (see the section on fever ).

Further information is available in the patient information leaflet on the Hib / MenC vaccine called Mentorix .

MenB booster vaccine

Your child should be immunised with their booster dose of MenB vaccine when they are one year of age at the same time as their Hib / MenC and PCV vaccinations and their first MMR vaccination.

This booster dose provides longer-term protection against meningitis and septicaemia caused by meningococcal group B bacteria.

• be a bit irritable and go off their food

The risk of fever, which is common after the vaccinations at 8 and 16 weeks of age (see MenB vaccine ), is much less common after this vaccination because babies at this age can tolerate the vaccine better. There is no need, therefore, for paracetamol to be given as a precautionary measure, although it should be given if a fever does occur.

Pneumococcal booster vaccine ( PCV )

Your child should be immunised with their booster dose of PCV at one year of age at the same time as their Hib / MenC , MenB booster and MMR vaccinations.

This booster vaccination provides longer-term protection against pneumococcal infection.

After immunisation with the PCV booster

Out of 10 babies immunised, 1 or 2 may get swelling, redness or tenderness where they had the injection, or they may have a mild fever .

MMR vaccine

Your child should be immunised with their first dose of MMR vaccine at one year of age at the same time as their booster Hib / MenC , MenB and PCV vaccinations.

MMR protects your child against measles, mumps and rubella (German measles).

Types of MMR vaccine

The MMR vaccine contains weakened versions of live measles, mumps and rubella viruses. Because the viruses are weakened, people who have had the vaccine cannot infect other people.

In the UK, we have 2 MMR vaccines. Both of the vaccines work very well, 1 contains porcine gelatine (gelatine derived from pigs) and the other doesn’t.

If you want your child to have the porcine gelatine free vaccine, talk to your practice nurse or GP.

Further information is available in the patient information leaflets for both of the MMR vaccines, MMRVAXPRO and Priorix .

More information on vaccines and porcine gelatine is available on GOV.UK.

How and when the vaccine given

The vaccine is injected into the muscle of the child’s thigh or upper arm. It is given to a child at one year of age after the immunity they got from their mother wears off. It should be given again when children are 3 years and 4 months of age or soon after.

Effectiveness of the MMR vaccine

Since it was introduced in the UK in 1988, the MMR vaccine has dramatically reduced the 3 diseases (measles, mumps, rubella) in young children.

Measles is caused by a very infectious virus. Nearly everyone who catches it will have a high fever, a rash and generally be unwell. Children often have to spend about 5 days in bed and could be off school for 10 days. Adults are likely to be ill for longer. It is not possible to tell who will be seriously affected by measles. Around 1 in every 5 people with measles will go to hospital. The complications include chest infections, fits, encephalitis (infection of the brain) and brain damage. In very serious cases, measles can kill.

Before measles vaccine around 500,000 cases and a 100 deaths occurred in epidemic years. In 1987 (the year before the MMR vaccine was introduced in the UK), 86,000 children caught measles and 16 died.

Measles is one of the most infectious diseases known. A cough or a sneeze can spread the measles virus over a wide area. Because it’s so infectious, the chances are your child will get measles if they are not protected and comes near to someone who has measles.

Mumps is caused by a virus which can lead to fever, headache and painful, swollen glands in the face, neck and jaw. It can result in permanent deafness, viral meningitis (infection of the lining of the brain) and encephalitis. Rarely, it causes painful swelling of the testicles in males and the ovaries in females. Mumps lasts about 7 to 10 days. Before the MMR vaccine was introduced, about 1,200 people a year in the UK went into hospital because of mumps.

Mumps is spread in the same way as measles. It is about as infectious as flu.

Rubella (German measles) is also caused by a virus. In children it is usually mild and can go unnoticed. It causes a short-lived rash, swollen glands and a sore throat.

Rubella is very serious for unborn babies. It can seriously damage their sight, hearing, heart and brain. This condition is called congenital rubella syndrome ( CRS ). Rubella infection in the first 3 months of pregnancy causes damage to the unborn baby in 9 out of 10 cases. In many of the cases, pregnant women caught rubella from their own, or their friends’ children. In the 5 years before the MMR vaccine was introduced, about 43 babies a year were born in the UK with congenital rubella syndrome.

Rubella is spread in the same way as measles and mumps. It is about as infectious as flu.

After vaccination with MMR

The 3 viruses in the vaccine act at different times and may produce the side effects after the first dose.

Six to 10 days after the immunisation, as the measles part of the vaccine starts to work, about 1 in 10 children may develop a fever and some develop a measles-like rash and go off their food (see section above on treating and preventing fever ).

About one in every 1,000 immunised children may have a fit caused by a fever. This is called a febrile convulsion . However, if a child who has not been immunised gets measles, they are 5 times more likely to have a fit.

Rarely, children may get mumps-like symptoms (fever and swollen glands) about 3 weeks after their immunisation as the mumps part of the vaccine starts to work.

Very rarely, children may get a rash of small bruise-like spots in the 6 weeks after the vaccination. This is usually caused by the measles or rubella parts of the vaccine. If you see spots like these, take your child to the doctor to be checked. The doctor will tell you how to deal with the rash.

Fewer than one child in a million develops encephalitis (swelling of the brain) after the MMR vaccine. However, if a child who has not been vaccinated catches measles, the chance of developing encephalitis is between 1 in 200 and 1 in 5,000.

Side effects after the second dose are even less common and usually milder.

Egg allergies

The MMR vaccine can safely be given to children who have had a severe allergy (anaphylactic reaction) to egg. This is because MMR vaccine is grown on chick cells, not the egg white or yolk. If you have any concerns, talk to your health visitor, practice nurse or doctor.

MMR and autism

In the past, there have been stories in the media linking MMR with autism. It’s now acknowledged that there is no such link.

Concerns about overloading your baby’s immune system

Giving your baby the MMR vaccine, with boosters of MenB , PCV and Hib / MenC at the same time will not overload their immune system.

In theory, a baby could respond effectively to around 10,000 vaccines at any one time. The baby’s immune system can and does easily cope with the MMR , MenB , pneumococcal and Hib / MenC vaccines at the same time.

Parents and carers can also report suspected side effects of vaccines and medicines through the Yellow Card Scheme or by calling the Yellow Card hotline on Freephone 0808 100 3352 (available Monday to Friday from 10am to 5pm).

Other immunisations

Bcg vaccine.

BCG protects babies against tuberculosis ( TB ). In the UK, like many other countries, BCG is only offered to babies who are more likely than the general population to come into contact with someone with TB . This is because they either live in an area with high rates of TB or their parents or grandparents came from a country with high rates of TB .

The vaccination is usually offered around the first month after birth, once a test for SCID test has been completed.

TB is an infection that usually affects the lungs. It can also affect other parts of the body, such as the lymph glands, bones, joints and kidneys. Most cases can be cured with treatment. TB can also cause a very serious form of meningitis.

Although TB is no longer as common in the UK, worldwide it kills around 2 million people a year.

Babies that cannot have BCG vaccination

As with most other immunisations, the injection may not be given or should be delayed if:

• your baby has a high fever
• your baby is suffering from a generalised infected skin condition

If eczema is present, an injection site will be chosen that is free from skin lesions.

Rarely, in children who have weakened immune systems, the bacteria in the vaccine can cause serious infection.

It is very important that you tell the nurse or doctor if your child has, or is suspected of having, a weakened immune system. For example:

• the child is on treatment for cancer or other serious conditions *the child’s mother had immunosuppressive biological therapy in pregnancy
• there is a family history of problems with the immune system (for example HIV, Severe Combined Immunodeficiency ( SCID ))
• babies who have or might have SCID

Your baby may be tested for SCID if this is suspected. Once your baby has had a SCID negative result, the BCG vaccination can go ahead.

After immunisation

A blister or sore may appear where the injection is given. If it does appear, it will heal gradually, and it is best if you do not cover it up. The sore may leave a small scar. If you are worried or think the sore has become infected, see your doctor.

The BCG vaccine is called BCG Vaccine AJV and you can read more about it in the patient information leaflet.

You can also read the TB , BCG and your baby leaflet for more information.

Hepatitis B vaccine

Although the hepatitis B vaccine is part of the routine childhood immunisation programme, it is also given to babies whose mothers have hepatitis B to prevent the babies getting the infection from their mothers at birth. If the immunisations are given on time they will reduce the risk of the baby developing hepatitis B by over 90%.

Babies at high risk of developing hepatitis B infection are given 6 doses of hepatitis B containing vaccine:

• the first dose of hepatitis B containing vaccine is given immediately after birth
• a second dose of hepatitis B containing vaccine is given when the baby is 4 weeks old
• the baby will then transfer to the routine immunisation schedule and will get their first dose of DTaP/IPV/Hib/HepB at 8 weeks of age
• a second dose of DTaP/IPV/Hib/HepB is given at 12 weeks of age
• a third dose of DTaP/IPV/Hib/HepB is given when the baby is 16 weeks of age
• at 12 months of age the baby will be given their final dose of hepatitis B containing vaccine which is necessary to provide longer-term protection

A blood test is taken at 12 months to check that the baby has not developed hepatitis B.

Further information is available in the patient information leaflets for both of the hepatitis B vaccines used, Engerix and HBVAXPRO .

Hepatitis is an infection of the liver caused by hepatitis viruses. Hepatitis B vaccine protects against the B type of the virus, but it does not protect against hepatitis caused by other types of the virus.

The hepatitis B virus is passed through infected blood from mothers to their babies at birth. If you are pregnant and have hepatitis B, or if you get the disease during your pregnancy, you could pass it on to your baby. Your baby may not be ill immediately after birth but they have a high chance of developing serious liver disease later in life. Some people carry the virus in their blood without knowing it.

Pregnant women in the UK are offered a hepatitis B test during their antenatal care. If you have hepatitis B, you should have your baby vaccinated after birth to prevent them from becoming infected. It is safe to breastfeed your baby as long as they receive their vaccines on time.

The side effects of the hepatitis B vaccine are usually quite mild. There could be some redness, soreness or tenderness where the injection is given. This lasts for a few days.

Further information on hepatitis B vaccine is available on NHS.UK.

Meningitis and septicaemia

Both meningitis and septicaemia are very serious. It is important that you recognise the signs and symptoms and know what to do if you see them. Early symptoms of meningitis and septicaemia may be similar to a cold or flu (fever, vomiting, irritability and restlessness).

However, people with meningitis or septicaemia can become seriously ill within hours, so it is important to act fast.

Meningitis is an infection of the lining of the brain. Meningitis can be caused by several types of bacteria including pneumococcus, meningococcus and Haemophilus influenzae or by viruses.

Septicaemia

Septicaemia is a very serious condition when the bloodstream is infected. Septicaemia can be caused by several types of bacteria including pneumococcus, meningococcus and Haemophilus influenzae. The signs are cold hands and feet, pale skin, vomiting and being very sleepy or finding it difficult to wake up, and these signs can come on quickly. If you suspect you or someone else has septicaemia, get help urgently.

The bacteria that cause meningitis and septicaemia (blood poisoning), can also cause pericarditis (inflammation of the lining of the sac that contains the heart) and arthritis (swelling of the joints) and other serious infections.

Meningitis symptoms in babies

In babies, the main symptoms of meningitis may include:

• a high-pitched, moaning cry
• being irritable when picked up
• a bulging fontanelle
• feeling drowsy and not responding to you, or being difficult to wake
• being floppy and having no energy
• stiff with jerky movements (convulsions or fits)
• refusing feeds and vomiting
• having skin that is pale, blotchy or turning blue

Septicaemia symptoms in babies

In babies the main symptoms of septicaemia may include:

• fever and shivering
• severe pains and aches in limbs and joints
• very cold hands and feet
• pale or mottled skin
• rapid breathing
• diarrhoea and stomach cramps
• red or purple ‘bruised’ or blotchy rash on skin that will not not fade under pressure – do the glass test . On dark skin, check inside the eyelids or roof of the mouth where the spots may be more visible
• difficulty walking or standing
• severe sleepiness or losing consciousness

Meningitis symptoms in older children, adolescents and adults

In older children, adolescents and adults, the main symptoms of meningitis may include:

• a stiff neck (check that they can kiss their knees or touch their forehead with their knees)
• a very bad headache (although this on its own is not a reason to get medical help)
• wanting to avoid bright lights
• tiredness, being less responsive and confused

Septicaemia symptoms in older children, adolescents and adults

In older children, adolescents and adults, the main symptoms of septicaemia may include:

• sleepiness, being less responsive, uninterested or confused (a late sign in septicaemia)
• severe pains and aches in the arms, legs and joints
• red or purple spots that do not fade under pressure – do the glass test ; on dark skin, check inside the eyelids or roof of the mouth where the spots may be more visible

Not everyone will develop all these symptoms and some may not appear. They can appear in any order and be mixed between the 2 illnesses. Some of the symptoms are very similar to those of flu, so, if you’re in any doubt about the health of your baby, trust your instincts and get advice urgently by contacting your doctor or call the NHS on 111. It is important to seek early medical advice if you, your child or a friend have symptoms of concern or a condition that is getting rapidly worse.

The ‘glass test’

Press the side of a clear drinking glass firmly against the rash so you can see if the rash fades and loses colour under pressure. If it doesn’t change colour, contact your doctor immediately.

Further information

Meningitis information from NHS.UK

The following charities provide information, advice and support:

Meningitis Research Foundation Free helpline 080 8800 3344 (9am to 10pm weekdays, 10am to 8pm weekends and holidays)

Visit the Meningitis Research Foundation website

Meningitis Now 24 hour helpline 0808 80 10 388

Visit the Meningitis Now website

You can also ask your doctor, practice nurse or health visitor for advice, or for non-urgent enquiries call the free NHS helpline 111 or visit NHS.UK for more about child vaccination .

Vaccine Damage Payment Scheme

Current immunisations are extremely safe but, very rarely, an individual may suffer from a problem after vaccination. The Vaccine Damage Payment Scheme is designed to ease the present and future burdens of the person who, on that very rare occasion, may be affected by the vaccination. There are several conditions that need to be met before a payment can be made.

If you need more information, please contact:

Vaccine Damage Payments Unit Department for Work and Pensions Palatine House, Lancaster Road Preston PR1 1HB Phone: 01772 899944 Email: [email protected]

If you want advice on immunisation, speak to your doctor, practice nurse, health visitor or pharmacist, or call the NHS helpline 111.

Further information on vaccinations is available on NHS.UK .

Complete routine childhood immunisation programme from February 2022

Most vaccines are given as an injection in the thigh or upper arm. Rotavirus vaccine is given as drops to be swallowed and influenza vaccine as a nasal spray.

Additional vaccines for individuals with underlying medical conditions

Selective immunisation programmes, travel advice for children.

If your child is going abroad, make sure their routine immunisations are up to date. Your child may also need extra immunisations and you may also need to take other precautions.

Contact your doctor’s surgery or a travel clinic well in advance for up-to-date information on the immunisations your child may need.

For more information

You can get more information on the NHS website and Travel Health .

You can order free paper copies of this information from HealthPublications

Rotavirus vaccine should only be given after checking severe combined immunodeficiency ( SCID ) screening result  ↩   ↩ 2

One of the 2 MMR vaccines available contains porcine gelatine. If you want your child to have the porcine gelatine free vaccine discuss it with your practice nurse or GP.  ↩

See Green book chapter 19 or refer to Children’s flu vaccine on NHS.UK.  ↩   ↩ 2

The live attenuated influenza vaccine ( LAIV ) and 1 of the 2 brands of MMR vaccine contains porcine gelatine.  ↩   ↩ 2

If LAIV (live attenuated influenza vaccine) is contraindicated and child is in a clinical risk group, use inactivated flu vaccine.  ↩

Consider annual influenza vaccination for household members and those who care for people with these conditions.  ↩

To any age in severe immunosuppression.  ↩

Take blood for HBsAg at 12 months to exclude infection.  ↩

In addition hexavalent vaccine (Infanrix hexa) is given at 8, 12 and 16 weeks.  ↩

Where the annual incidence of TB is ≥ 40/100,000 – Tuberculosis by country: rates per 100,000 people .  ↩

Can be given from 16 weeks but usually offered after the anomaly scan.  ↩

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Information on how to stay safe and healthy abroad. About us.

• General Travel Health Advice

Advice for Child Travellers

Vaccinations, food and water hygiene, accident prevention, medical services.

Travelling with children requires practical consideration and careful planning. It is advisable to consult a travel health practitioner at least 6-8 weeks in advance of departure. The risks to health vary and many factors need to be taken into account such as destination, length of stay, planned activities, age and the general health of your child.

Vaccinations may be advisable for some destinations. The age of your child often determines which vaccines they may be able to receive and should have already received as per the UK Vaccination Schedule . Parents should be aware that some children may be too young to receive the vaccinations recommended for their chosen destination. Your health care practitioner can discuss additional preventative measures to reduce the chance of disease transmission in these circumstances, however you may be advised to change your travel plans.

The timing of vaccinations is important, some vaccines may offer disease protection within two weeks, whereas others may require over a month. Some vaccine schedules require two or more doses given over weeks or months before adequate protection is obtained.

Some vaccines are available free on the NHS, however, there may be a charge for some recommended vaccines. This should be taken into consideration when planning and budgeting for travel.

Children are at particular risk of severe and fatal malaria; parents are therefore advised to avoid taking infants and children to malarious areas. If travel is unavoidable it is imperative that infants and children are well protected against mosquito bites and receive appropriate chemoprophylaxis (antimalarials) .

A) Awareness of Risk

Malaria is now predominantly a disease affecting Africa, South America, Southeast Asia, the Indian sub-continent and less so in Central America and the Middle East:

• individual country pages should be checked to determine the risk at the destination
• for further information see the   malaria advice pages.

B) Mosquito Bite Prevention

• Parents and children must be aware of the risk and take precautions to avoid mosquito bites , including the use of repellents, nets and suitable clothing.

C) Chemoprophylaxis (antimalarials)

It is important to discuss antimalarial suitability with a qualified doctor, nurse or pharmacist:

• the choice of antimalarial is determined by the destination, age and weight of the child
• parents must supervise their child's antimalarial consumption and be careful not to exceed the recommended dose, overdosing antimalarials can be particularly toxic for children
• it is preferable to avoid crushing or breaking tablets, however, it may be necessary to crush some tablets in order to administer the correct dose. Qualified pharmacists should be able to offer further advice; tablet cutters can be purchased to help facilitate correct dosage
• infants and young children may resist taking medications, mixing tablets with jam, honey, chocolate spread or similar foods may make administration easier
• no antimalarial is 100% effective and should always be used in combination with mosquito bite avoidance

D) Diagnosis and Treatment

• Prompt diagnosis and treatment of malaria is essential and the importance of this should be stressed to all parents visiting malarious regions. Fever, occurring at least 7 days after exposure, is the most common symptom of malaria, but infection can develop even up to one year later.
• Symptoms in young children may be difficult to determine.  Parents must be aware that any child returning from a malarious zone who seems ‘off colour’ or just ‘not their normal self’ should be screened for malaria promptly.

Rabies is spread through the saliva of an infected animal (particularly dogs, cats, monkeys and bats) via a bite, scratch or lick of mucous membranes or broken skin. There is no specific treatment available for rabies once symptoms develop and those that develop symptoms will die.

Children can be more likely than adults to be exposed to rabies. Natural curiosity and exploration may entice them to approach animals; fear of being chastised may make them conceal an exposure.

• It is important that children are aware of the need to avoid animal contact during travel and equally the importance of reporting any exposure that does occur.

Pre-travel rabies vaccination should be considered for children travelling to countries that are considered high risk for rabies. Please see the Rabies advice page for further information.

Children, especially young children may be more likely to be exposed to food and water borne illness during travel due to their natural exploratory nature and hand to mouth habits.

Risk can be reduced by frequent hand washing (or use of alcohol based hand cleansing gel when hand washing is not an option).  Children should eat freshly cooked, hot food when possible and avoid raw food that cannot be peeled or cooked and unpasteurised dairy products.

Water for drinking, making up formula milk, diluting drinks and cleaning teeth should be bottled or boiled; see the Breastfeeding and Bottle-feeding advice page for further information.

Children and infants should be discouraged from drinking shower, bath or swimming pool water. Parents of toddlers may decide to take pre-packaged food with them.

Children suffering diarrhoeal illnesses can become dehydrated quickly, rehydration is a priority:

• clear fluids such as diluted fruit juices or oral rehydration solutions  should be drunk liberally
• all rehydrating drinks must be prepared with safe water
• children with severe or blood/mucous stained diarrhoea, high fever or severe abdominal pain should receive medical attention immediately

Babies and children are particularly vulnerable to sunburn and over exposure to the sun can increase their risk of skin cancer later in life. Sunburn may also cause considerable pain and discomfort in the short term.

The safest way to protect children from sunburn is to use a combination of shade, clothing and sunscreen.

• use a sunscreen of at least SPF 15 which also has high UVA protection
• ensure sunscreens are applied generously to ALL sun exposed areas. Sunscreen should be applied 20 - 30 minutes before sun exposure
• remember that showering, swimming and sweating may remove sunscreen; ensure frequent application and consider water resistant sunscreens
• cover children up using clothing such as wide brimmed hat and long sleeved tops, closed weaved fabrics may offer better sun protection
• protect eyes from sun exposure, use sunglasses with a CE mark, UV400 label or that offer 100% UV protection
• seek shelter; avoid sun exposure between 11am and 3pm when sun is typically stronger

See the Sun Exposure advice page for further information.

Local health and safety regulations vary between countries and may not be at the same standard as parents are used to in the UK.  Parents must be aware of this and make a judgement about the safety of their child using facilities abroad.

Equipment for young children such as high chairs, microwaves for heating food and changing stations  may not be available at many destinations. Parents should be advised to thoroughly research the facilities available prior to travel.

Road rules vary country to country and age appropriate child seats may not be available at the destination.  Parents should check this prior to travel and consider taking their own child car seats if necessary.

• See the Accident Prevention advice page for further information.

Many countries do not provide the same access to medical facilities and treatments as the UK. Some countries may have reciprocal health care agreements with UK, see individual country pages for details.

All child travellers should be included in travel insurance policies, medical emergencies including repatriation should be included in the policy.

• See the  travel insurance advice page for further details.

Medical Assistance

Parents should be aware of what to do if their child becomes ill whilst abroad including how to access emergency medical treatment. Parents should try and identify health care facilities prior to departure. 

The Foreign, Commonwealth and Development Office (FCDO) provides details of the nearest British Embassy or Consulate that may be able to help locate health care facilities at the destination. Neither the FCDO or Embassy will pay for medical care even in an emergency.

• The International Society of Travel Medicine has a Global Travel Clinic Locator available on their website.
• Addresses for local medical services might also be available from larger hotels and from tour company representatives.

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• Disease Prevention Advice

Australian Government Department of Health and Aged Care

Immunisation for travel

It’s important to protect your health when travelling overseas. You can avoid diseases and other health conditions by planning ahead for any vaccinations you may need.

If you are looking for information COVID-19 vaccines, please visit the  COVID-19 digital certificate page.

Vaccines needed for travel

If you travel outside Australia, you may get sick from a number of diseases that vaccination can prevent. Travellers can bring these diseases into Australia when they return and cause disease outbreaks.

You should always ask your doctor or travel health clinic about vaccinations before you travel.

Your immunity to some diseases may have changed or reduced with time – you may need a booster.

Different countries have different vaccination requirements. The recommended vaccines for travelling depend on a number of factors, including:

• pregnancy or planning pregnancy
• underlying medical conditions
• vaccination history
• season of travel.

When to get vaccinated

You should consult your doctor or visit a travel health clinic 6 to 12 weeks before you leave Australia.

It is important to see your doctor early. If you do need vaccinations:

• your body needs time to develop full immunity
• you may need several doses of a vaccine to achieve full immunity. 

How to check your vaccination record

You may have already received recommended vaccines from previous travel or routine vaccinations. These may be recorded in the Australian Immunisation Register.

The Australian Immunisation Register (AIR) is a national register that records vaccines given to all people in Australia.

The AIR includes vaccines given:

• Under the National Immunisation Program
• through school programs
• privately, such as for flu or travel.

You can check your immunisation record :

•  online on MyGov through Medicare
•  via the Express Plus Medicare mobile app
•  by calling 1800 653 809 (Monday to Friday 8 am to 5 pm).

Cost of vaccines

The vaccines you need for travel may not be covered by the National Immunisation Program. In this case, you will need to buy them. This may involve:

• getting a prescription for the vaccine
• buying it from a pharmacy
• returning to your doctor to give you the vaccination.

The cost of vaccines varies depending on the type, the formula and where you buy them.

Some doctors might have these vaccines available in their clinics. Some pharmacies also offer vaccination services.

Check with your provider when you book your appointment.

How to stay safe overseas

The vaccine information you find on various websites is only a guide. You should not rely on such information. Talk to your doctor or travel health clinic for advice on travel vaccines and how to stay safe while you are overseas.

Find more information:

• Travel Health Information  for things to consider before you leave, while you are away and when you return.
• Smartraveller (Department of Foreign Affairs and Trade)
• Travellers’ health  (US Center for Disease Control & Prevention)

Keep routine vaccinations up to date

Travel is an important time to check whether you and your children are up to date with your vaccinations. This includes routine childhood vaccinations and boosters. Some of these include:

• measles-mumps-rubella (MMR)
• diphtheria-tetanus-whooping cough (pertussis)
• chickenpox (varicella)

Influenza is the most common vaccine-preventable disease caught by travellers.

The chance of getting these diseases may be greater while travelling overseas. Travellers can bring these diseases into Australia. This can lead to disease outbreaks.

Get more about information about routine vaccinations:

• National Immunisation Program Schedule
• When to get vaccinated

Diseases to be aware of

Some countries require proof of immunisation for certain infectious diseases before you can legally enter that country. Ask your doctor or travel health clinic if you need proof of immunisation before you travel.

Read about some of the common vaccine-preventable diseases found in other areas of the world.

Cholera is found in places with poor water and waste facilities. It spreads through contaminated food and water and causes severe diarrhoea and dehydration.

Humanitarian disaster workers should get vaccinated for cholera because they are more likely to get infected. Most travellers do not need a cholera vaccination because the risk of getting cholera is very low. 

Your doctor may recommend the cholera vaccine if you have a condition that puts you at greater risk of travellers’ diarrhoea.

Hepatitis A

Hepatitis A is one of the most common vaccine-preventable diseases caught by travellers. It is a liver disease spread by contaminated food and water. It is common in parts of India, Africa, Asia, South and Central America and the Middle East where there is poor sanitation and limited access to clean water.

You and your children over 1 year of age should get a Hepatitis A vaccination if you are travelling to an area where Hepatitis A is common.

Japanese encephalitis

Japanese encephalitis is a serious disease spread by mosquitoes in Asia and the Torres Strait region of Australia. We recommend vaccination against this disease if you are travelling to these parts and will be:

• travelling in rural areas
• undertaking certain activities with increased risk of exposure
• spending a month or more in the region.

You should avoid mosquito bites when you are in these areas.

Meningococcal

Meningococcal disease is a serious disease spread by close contact with an infected person. It is commonly found in sub-Saharan Africa.

Rabies is common to Central and South America, Eastern Europe, Africa and Asia. It is spread from infected animals to humans through bites, scratches and licks to open wounds. It is fatal when left untreated. The animal does not have to appear ill to have rabies. Infected animals can include dogs, monkeys, cats, rats, bats, foxes and chipmunks.

Ask your doctor if you need the rabies vaccine before you travel.

Tuberculosis

Tuberculosis (TB) is a serious disease spread by close contact with an infected person. It is common in developing countries.

We recommend the TB vaccine called BCG for children aged 5 years or under who are:

• travelling a lot
• spending a long time in countries where TB is common .

Typhoid is a disease spread through contaminated food and water. It causes diarrhoea and other symptoms. It is common in parts of India, Africa, Asia, South and Central America and the Middle East where there is poor sanitation and limited access to clean water.

Yellow fever

Yellow fever can be a serious disease. It causes fever, yellowing of the skin (jaundice) and damages the liver and kidneys. Mosquitoes spread yellow fever. It is found in Africa, the Caribbean and Central and South America.

You must be immunised for yellow fever before you can legally enter some countries. Only authorised yellow fever vaccination centres can give yellow fever vaccinations and certification. Ask your doctor about this.

Find more information: Yellow fever fact sheet

• Immunisation
• Travel health

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Volume 43, Issue 6, June 2014

Are we there yet? Travel vaccinations for Australian children

Routine vaccination.

A travel consultation is an ideal opportunity to ensure that travellers are up to date with the routine immunisation schedule. It is not our intention in this short article to list all the specific requirements for routine vaccination, which are listed in detail elsewhere. 1,2 Some general principles are: a) minor febrile illnesses are not a reason to postpone routine vaccinations; 3 b) it is generally safe to administer more than one vaccine at a time; 4 and c) live viral vaccines, such as measles/mumps/rubella (MMR), varicella and yellow fever vaccines, should be given at the same time or at least 30 days apart. 5

Influenza is the most common vaccine-preventable disease acquired by travellers. 6 Particular risks include travel in large tourist groups, on cruise ships or travel to areas of increased seasonal risk (eg. the northern hemisphere winter). Influenza vaccination is strongly recommended for children with heart disease, chronic respiratory conditions, renal disorders, immunocompromising conditions and haematological disorders, 7 but could be considered for all children. 8

In some instances there may be a case for accelerating the routine vaccination schedule (Case 1). This should be considered if a young child is travelling over a prolonged period and may therefore miss their scheduled vaccinations, or if a child is travelling to an area where diseases such as polio, hepatitis B or measles are more prevalent. Vaccines that can be accelerated include diphtheria/tetanus/pertussis (DTP), haemophilus influenza type B (Hib), hepatitis B, inactivated polio vaccine (IPV) and pneumococcal and rotavirus vaccines. 9 If MMR and varicella vaccines are given before the recommended age, repeat doses will be required. It should be noted that there are recommendations about the minimum interval to next dose for each vaccine 2 and these should be checked for individual vaccines.

Vaccines for children visiting high risk areas

The commonly administered travel vaccines for children travelling to high-risk areas are summarised in Table 1. Most of the vaccines have a lower age limit at which they may be commenced. There are also a number of options in terms of oral or injectable vaccines and different brands available that have differing product information, so it is important to check the information before administering. It is worth noting that sometimes the product information is not up to date so it is prudent to also check the Australian Immunisation Handbook , 2 particularly the ‘Variations from Product Information’ sections in Part 4.

Case 1. Prianka visits family in India

An Australian family, originally from India, comes to see you at your practice with their 3-week-old baby girl Prianka, as they are planning to go to India in 11 weeks to attend a family wedding. The family is wondering if you could start the vaccination schedule early as they have heard this is a possibility. The vaccines that are usually given at 2, 4 and 6 months (DTP, Hib, hepatitis B, IPV, pneumococcal vaccine and rotavirus vaccine) can all be accelerated and given at 6, 10 and 14 weeks. In this case BCG is also indicated.

Case 2.  A family of 5 travel to Bali

The Anderson family comes to see you before flying off for a 2-week holiday in Bali. They have three children, Jessica, Samson and Freddy, aged 8, 4 and 2 years, respectively. The children have never been outside Australia and are all up to date with their scheduled immunisations, although Samson has not had his 4-year-old vaccines. Today he should receive DTPa-IPV and MMR (he did not have the MMRV vaccine at 18 months as this vaccine was not yet available) and all 5 family members should have hepatitis A and typhoid vaccines. These can be given as the combined vaccine (Vivaxim), which, although licensed for use in people aged ≥16 years, is frequently prescribed off-label for children as young as 2 years of age. Rabies vaccine should be discussed, as rabies has continued to be reported in Bali.

Vaccines for patients visiting friends and relatives

Given the culturally diverse population in Australia, an overseas visit to friends and relatives is a common scenario and in fact visiting friends and relatives (VFR) travellers are often at a higher risk of contracting certain diseases. 14 The risk increases because VFR travellers usually eat local food, may not take the same precautions as other tourists do, have closer contact with local people and often stay longer. For Australian VFR travellers, travel destinations often include tropical parts of the world where the risk of some diseases is higher. 15 Malaria is known to be 8–10 times more likely in VFR travellers. 15 VFR travellers are more likely to contract food-borne illness, including hepatitis A and typhoid, which are both preventable through vaccination. 15 VFR travellers are also at a higher risk of exposure and, therefore, morbidity due to Dengue fever, parasitic infection, tuberculosis and sexually transmitted diseases. 15 These travellers have the highest risk of infection but are significantly less likely than other travellers to get vaccinations or seek travel advice before they leave. 16 This is because the destination is familiar to them and they often rely on buying medications more cheaply in the country they are visiting.

Case 3. Byrne family visiting friends in Sri Lanka

The members of the Byrne family are all major cricket fans and regularly visit Sri Lanka where they have been involved in cricket matches and social events for the past 15 years. Since the tsunami hit when they were visiting in 2004, they have been visiting every few years to assist with rebuilding a Sri Lankan community health centre in Galle. They come to the GP enquiring about which vaccines should be given to their 6-year-old son, who is going with the family for the first time. Apart from checking that the child is up to date with routine vaccinations, the child should be given hepatitis A and typhoid vaccines. Rabies vaccination should be offered and mosquito-borne diseases, including Dengue and Japanese encephalitis, should be discussed. It would be reasonable to offer influenza vaccine as well.

With travel rates increasing and general practitioners (GPs) being relied on to provide up-to-date and sound advice to families who travel overseas with their children, it is timely to review this topic. The GP is often called on to put in place a complex vaccination plan for the family, which can be challenging in the midst of busy general practice consulting. Planning a safe and effective vaccination schedule is all about the context: when the family is travelling, how old the children are, whether they have had their previous routine vaccinations and whether they are travelling to visit overseas family and friends. In some circumstances, specialist advice may be needed (eg. when the child has a chronic medical illness or is immunocompromised). Some vaccines, such as BCG and yellow fever, are only available from specialist clinics. There are some excellent resources available online (see Resources). Travel vaccinations provide a perfect opportunity for the GP to practice preventive health and ensure that patients travel safely and remain well covered for common diseases during their overseas trip.

Vaccination advice for childhood travel vaccination

• www.who.int/ith/en/
• www.health.gov.au/ internet/immunise/publishing. nsf/Content/handbook10-3-2
• wwwnc.cdc.gov/ travel/page/yellowbook-home-2014
• wwwnc.cdc.gov/ travel/destinations/list
• www.nathnac.org/travel/

Competing interests: None. Provenance and peer review: Commissioned; externally peer reviewed.

• Yung A, Leder K, Torresi J, et al. Manual of Travel Medicine. 3rd edn. Melbourne: IP Communications, 2011. Search PubMed
• National Health and Medical Research Council. The Australian Immunisation Handbook. 10 edn. Canberra: NHMRC, 2013. Available at www.health.gov.au/ internet/immunise/publishing.nsf/Content/ Handbook10-home [Accessed 1 May 2014]. Search PubMed
• Conte JE. Manual of Antibiotics and Infectious Diseases Treatment and Prevention. 9th edn. Philadelphia: Lippincott Williams & Wilkins, 2002. Search PubMed
• Borner N, Muhlberger N, Jelinek T. Tolerability of multiple vaccinations in travel medicine. J Travel Med 2003;10:112–16. Search PubMed
• Kroger A, Atkinson W. General Recommendations for Vaccination & Immunoprophylaxis. New York: Oxford University Press, 2012. Available at wwwnc.cdc.gov/ travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/general-recommendations-for-vaccination-and-immunoprophylaxis [Accessed 1 May 2014]. Search PubMed
• Steffen R. Influenza in travelers: epidemiology, risk, prevention, and control issues. Curr Infect Dis Rep 2010;12:181–85. Search PubMed
• Recommendations for Prevention and Control of Influenza in Children, 2012–2013. Pediatrics: Official Journal of the American Academy of Pediatrics. 2012;130:787. Search PubMed
• Questions and Answers for Influenza (flu) Vaccination 2013. Canberra, 2013. Available at www.immunise.health.gov.au/ internet/immunise/publishing.nsf/Content/immunise-influenza-qanda [Accessed 1 May 2014]. Search PubMed
• Mackell SM. Vaccine Recommendations for Infants & Children. New York: Oxford University Press, 2012. Available at wwwnc.cdc.gov/ travel/yellowbook/2012/chapter-7-international-travel-infants-children/vaccine-recommendations-for-infants-and-children [Accessed 1 May 2014]. Search PubMed
• Keystone JS, Freedman DO, Kozarsky PE, Connor BA, Nothdurft HD. Travel Medicine. 3rd edn. Philadelphia: Saunders, 2013. Search PubMed
• Starr M. Paediatric travel medicine: vaccines and medications. Br J Clin Pharmacol 2013;75:1422–32. Search PubMed
• Centers for Disease Control and Prevention. Update: Prevention of hepatitis A after exposure to hepatitis A virus and in international travelers. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2007;56:1080–84. Search PubMed
• Dubischar-Kastner K, Kanesa-Thasan N. Vaccinating against Japanese encephalitis virus: what have we learned from recent clinical trials? Expert Rev Vaccines 2012;11:1159–61. Search PubMed
• Leder K, Tong S, Weld L, et al. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis 2006;43:1185–93. Search PubMed
• CDC Features: Visiting Friends or Relatives Overseas. Atlanta: CDC, 2012. Available at www.cdc.gov/ features/vfrs/ [Accessed 1 May 2014]. Search PubMed
• Keystone JS. Immigrants Returning Home to Visit Friends & Relatives. New York: Oxford University Press, 2012. Available at wwwnc.cdc.gov/ travel/yellowbook/2012/chapter-8-advising-travelers-with-specific-needs/immigrants-returning-home-to-visit-friends-and-relatives-vfrs [Accessed 1 May 2014]. Search PubMed

Also in this issue: Addictions

Printed from Australian Family Physician - https://www.racgp.org.au/afp/2014/june/travel-vaccinations-for-children © The Australian College of General Practitioners www.racgp.org.au

Travel vaccination advice

If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fever , typhoid and hepatitis A .

In the UK, the  NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

When should I start thinking about the vaccines I need?

If possible, see the GP or a private travel clinic at least 6 to 8 weeks before you're due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you're:

• travelling in rural areas
• backpacking
• staying in hostels or camping
• on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

Which travel vaccines do I need?

You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these websites:

• Travel Health Pro
• NHS Fit for Travel

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it's still a good idea to take a record of the vaccinations you have had with you.

Find out more about the vaccines available for travellers abroad

Where do I get my travel vaccines?

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

• written information on what vaccines are needed
• the cost of each dose or course
• any other charges you may have to pay, such as for some certificates of vaccination

You can also get travel vaccines from:

• private travel vaccination clinics
• pharmacies offering travel healthcare services

Which travel vaccines are free?

The following travel vaccines are available free on the NHS from your GP surgery:

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

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?

You'll have to pay for travel vaccinations against:

• hepatitis B
• Japanese encephalitis
• tick-borne encephalitis
• tuberculosis (TB)
• yellow fever

Yellow fever vaccines are only available from designated centres .

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.

Other things to consider

There are other things to consider when planning your travel vaccinations, including:

• your age and health – you may be more vulnerable to infection than others; some vaccines cannot be given to people with certain medical conditions
• working as an aid worker – you may come into contact with more diseases in a refugee camp or helping after a natural disaster
• working in a medical setting – a doctor, nurse or another healthcare worker may require additional vaccinations
• contact with animals – you may be more at risk of getting diseases spread by animals, such as rabies

If you're only travelling to countries in northern and central Europe, North America or Australia, you're unlikely to need any vaccinations.

But it's important to check that you're up-to-date with routine vaccinations available on the NHS.

Pregnancy and breastfeeding

Speak to a GP before having any vaccinations if:

• you're pregnant
• you think you might be pregnant
• you're breastfeeding

In many cases, it's unlikely a vaccine given while you're pregnant or breastfeeding will cause problems for the baby.

But the GP will be able to give you further advice about this.

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised.

This may be the case if:

• you have a condition that affects your body's immune system, such as HIV or AIDS
• you're receiving treatment that affects your immune system, such as chemotherapy
• you have recently had a bone marrow or organ transplant

A GP can give you further advice about this.

Non-travel vaccines

As well as getting any travel vaccinations you need, it's also a good opportunity to make sure your other vaccinations are up-to-date and have booster vaccines if necessary.

Although many routine NHS vaccinations are given during childhood, you can have some of them (such as the MMR vaccine ) as an adult if you missed getting vaccinated as a child.

There are also some extra NHS vaccinations for people at higher risk of certain illnesses, such as the flu vaccine , the hepatitis B vaccine and the BCG vaccine for tuberculosis (TB) .

Your GP can advise you about any NHS vaccinations you might need.

Find out about NHS vaccinations and when to have them

Page last reviewed: 16 March 2023 Next review due: 16 March 2026

Vaccines at 12 to 23 Months

Vaccinations are safe and effective for children to receive at the recommended ages.

CDC recommends COVID-19 vaccination for everyone aged 6 months and older. If your child has not gotten vaccinated yet, talk to his or her doctor about getting it as soon as possible.

Vaccines your baby should get

As your child enters their toddler stage, they will start becoming aware of themselves and their surroundings. As a parent, make sure you are aware of their next vaccines.

Between 12 and 23 months of age, your baby should receive vaccines to protect them from the following diseases:

1 st dose of 2

Chickenpox is a very contagious disease known for its itchy, blister-like rash and a fever. Chickenpox is a mild disease for many, but can be serious, even life-threatening, especially in babies, teenagers, pregnant women, and people with weakened immune systems.

See Related: Chickenpox vaccination

4 th dose of 5

A DTaP vaccine is the best protection from three serious diseases: diphtheria, tetanus, and whooping cough (pertussis). All three of these diseases can be deadly for people of any age, and whooping cough is especially dangerous for babies.

See Related:   DTaP vaccination

3 rd dose of 3 or 4 th dose of 4

Hib disease is a serious illness caused by the bacteria Haemophilus influenzae type b (Hib). Babies and children younger than 5 years old are most at risk for Hib disease. It can cause lifelong disability and be deadly. Doctors recommend that your child get three or four doses of the Hib vaccine (depending on the brand).

See Related: Hib vaccination

1 st Dose of 2

Hepatitis A can be a serious, even fatal liver disease caused by the hepatitis A virus. Children with the virus often don’t have symptoms, but they often pass the disease to others, including their unvaccinated parents or caregivers.

See Related: HepA vaccination

3 rd dose of 3 between 6 months and 18 months

Hepatitis B is an infectious and potentially serious disease that can cause liver damage and liver cancer. If babies are infected at birth, hepatitis B can be a lifelong, chronic infection.  There is no cure for hepatitis B, but the hepatitis B vaccine is the best way to prevent it.

See Related:  Hepatitis B vaccination

Flu is a respiratory illness caused by influenza viruses. Flu spreads easily and can cause serious illness, especially in children younger than 5 years and children of any age with certain chronic conditions including asthma. Everyone 6 months of age and older should get a flu vaccine every year ideally by the end of October.

See Related:  Flu vaccination

The MMR vaccine helps prevent three diseases: measles, mumps, and rubella (German measles). These diseases are contagious and can be serious.

See Related: MMR vaccination

4 th dose of 4

Pneumococcal disease can cause potentially serious and even deadly infections. The pneumococcal conjugate vaccine  protects against the bacteria that cause pneumococcal disease.

See Related:  Pneumococcal vaccination

3 rd dose of 4 between 6 months and 18 months

Polio is a disabling and life-threatening disease caused by poliovirus, which can infect the spinal cord and cause paralysis. It most often sickens children younger than 5 years old. Polio was eliminated in the United States with vaccination, and continued use of polio vaccine has kept this country polio-free.

See Related: Polio vaccination

Additional protection your baby may need during RSV season

Children 12 to 19 months old who are at increased risk of severe RSV may be recommended to get an RSV immunization to protect them against severe RSV disease as they enter their second RSV season.

Respiratory Syncytial Virus (RSV)

RSV is a common cause of severe respiratory illness in infants and young children. Those infected with RSV can have difficulty breathing and eating and sometimes may need respiratory support or hydration in the hospital. An RSV immunization uses monoclonal antibodies  to protect infants and young children from severe RSV disease. This immunization gives your baby’s body extra help to fight an RSV infection.

Children 8 through 19 months old who are at increased risk of severe RSV disease and entering their second RSV season (typically fall through spring) should get a one-dose of an RSV immunization to protect them against RSV. This dose should be given shortly before or during the RSV season.

Children 8 through 19 months who are at greatest risk for severe RSV illness include:

• Children who were born prematurely and have chronic lung disease
• Children with severe immunocompromise
• Children with cystic fibrosis who have severe disease
• American Indian and Alaska Native children

Care for your child after vaccinations

Call 911 if you think your child might be having a severe allergic reaction after leaving the vaccination site.

Give your child extra care and attention

Pay extra attention to your child for a few days. If you see something that concerns you, call your child’s doctor.

• Read the Vaccine Information Sheet(s) your child’s doctor gave you to learn about side effects your child may experience.
• Offer breastmilk or formula more often. It is normal for some babies to eat less during the 24 hours after getting vaccines.

Treat mild reactions

Sometimes children have mild reactions from vaccines, such as pain at the injection site or a rash. These reactions, also called side effects, are normal and will soon go away.

• Use a cool, damp cloth to help reduce redness, soreness, and/or swelling at the injection site.
• Reduce fever with a cool sponge bath.
• Ask your child’s doctor if you can give your child a non-aspirin pain reliever.

See which vaccines your child needs to stay on-track with routine vaccinations.

Birth to 6 years

7 to 18 years

Take a short quiz to get a list of vaccines your child may need based on their age, health conditions, and other factors.

Child vaccine quiz

• Pregnancy and Vaccination
• Make Shots Less Stressful
• Travel and Vaccines
• Keeping Track of Vaccine Records
• The Vaccines for Children (VFC) Program
• How Vaccines Prevent Diseases
• Vaccines & Immunizations

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100-Year-Old Woman Mistakenly Identified as Unaccompanied Minor on Flights Due to Glitch with Birth Year, 1923

"I’m going through my second childhood," jokes the centenarian in an Instagram video

Gayle Kirschenbaum

At 100 years old, Mildred Kirschenbaum still enjoys traveling — but since reaching her milestone birthday last August, she’s had an unusual experience flying.

The centenarian, who once owned a travel agency in New York and is still a registered agent,  says she now shows up as an “unescorted minor” due to a glitch in the airlines’ computer systems.

“The code is two digits for the month, two digits for the day, and two digits for the year. I was born in 1923. So I put in 23,” Mildred explains in a video posted on the Instagram account of her daughter, Gayle.

“Soon as I check in, I’m an unescorted minor,” she continues. “The supervisor has to come. And they have to see me right through security. No one seems to know how to correct it.”

Mildred, who’s previously gone viral on social media for sharing advice on life and longevity, adds with her trademark humor, “I’m going through my second childhood.”

While the birth year error requires extra time to sort out at the airport before boarding, she tries not to stress too much over it.

“I allow myself a half hour at the counter,” she tells PEOPLE. “I'm not going to get myself worked up with it.”

The Florida resident shared the video ahead of a May trip to New York, where Gayle lives. But she’s taken multiple flights since turning 100, including traveling to London in September for a transatlantic cruise. And a quick jaunt to New York for an appearance on Sherri, hosted by Sherri Shepherd , just last week.

While the mother-daughter duo often fly Delta, they say the problem isn’t limited to one airline — nor was it caused by a booking mistake on Mildred's part.

“I was busy blaming her, saying, ‘Let me see what you did. You probably put it in incorrectly,’” Gayle tells PEOPLE. 

However, Gayle then called a travel agency her mom is connected to and was told, “That's how it is. It's two digits in the system." 

She adds that it now happens “every time" Mildred flies, no matter how they book the flight.

Delta confirmed to PEOPLE that because of how several legacy, industry-wide back-end booking and ticketing systems are built, the fields for customers' birth years only have the capacity for two digits instead of four.

"While it’s clear this customer is young at heart, she’ll simply have to check in with a friendly Delta agent at the airport to get her boarding pass," a representative for the airline told PEOPLE in a statement. "We appreciate her understanding and we’d love to hear her points on longevity and why she likes to travel as Delta marks our own 100th birthday next year.”

Gayle says she thinks the video she posted of her mom "has woken up the industry,” noting, “I'm hearing from people in the aviation IT area saying, ‘We're working on this.’”

Gayle has also heard from other relatives of centenarians who’ve had similar experiences.

“This happened to my mom too,” one commenter, who said her own mother was born in 1913, wrote on Gayle’s Instagram post.

Gayle says her social media followers also appreciated her mom’s playful take on the frustrating situation.

“They all love her attitude,” she says. “She makes light of everything.”

Never miss a story — sign up for  PEOPLE's free daily newsletter  to stay up-to-date on the best of what PEOPLE has to offer, from juicy celebrity news to compelling human interest stories. 

Gayle describes Mildred — with whom she recently collaborated on a book, Mildred's Mindset: Wisdom from a Woman Centenarian — as “incredibly resilient and fearless” and “absolutely not her age.”

“Travel is in our blood, I have to tell you,” says Gayle, a photographer, writer and filmmaker, who made the 2015 documentary Look at Us Now, Mother! “We have had great adventures all over the world.”

“When you don't have this fear, you get to enjoy a lot of things in life and have a lot of adventures,” she adds.

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Traveling with Children

Children may face the same health risks as their parents during travel, but the health consequences can be more serious. For example, some illnesses can be difficult to recognize in children especially if they can’t talk yet to express what they are feeling, or children may be more likely to encounter health risks such as animals because of their size and curiosity. If you are planning to travel with children familiarize yourself with the information on this page to help everyone stay safe and healthy.

Make an appointment  with your child’s primary health care professional or a travel medicine specialist at least one month before you leave. They can help you get destination-specific vaccines, medicines, and information. Discussing your itinerary and planned activities with your provider allows them to give more specific advice and recommendations. 

Make sure your child is up to date on all  routine vaccines . Routine vaccinations protect your child from infectious diseases such as measles that can spread quickly in groups of unvaccinated people. Many diseases prevented by routine vaccination are not common in the United States but are still common in other countries. 

Some routine vaccines for young children have different recommendations if you plan to travel internationally. For example, although the first dose of measles-mumps-rubella (MMR) vaccine is not usually given until after 12 months of age, infants 6 to 11 months old should get 1 dose of before international travel. Some travel vaccines can be given on an accelerated schedule, meaning doses are given in a shorter period of time. Not all travel vaccines can be given to very young children, so it's important to check with a travel medicine doctor or your child's pediatrician, as early as possible before traveling.

Plan for the unexpected. It is important to plan for unexpected events as much as possible. Doing so can help you get quality health care or avoid being stranded at a destination. A few steps you can take to plan for unexpected events are to  get travel insurance ,    learn where to get health care during travel ,  pack a travel health kit ,  and  enroll in the Department of State’s STEP .

Diarrhea is among the most common illness experienced by children who travel abroad. Diarrhea can lead to dehydration. The best treatment for children with diarrhea is plenty of fluids; there is usually no need to give medicine. If your child appears to be dehydrated, has a fever, or bloody stools, get medical attention immediately. Keep in mind:

• Oral rehydration salts (available online or in stores in most developing countries) may be used to prevent dehydration.
• Over-the-counter drugs that contain bismuth (Pepto-Bismol or Kaopectate) should NOT be used in children.
• Antibiotics are usually reserved for serious cases.
• Other common treatments for diarrhea, such as loperamide, are not recommended for children younger than 6 years old.

For infants, breastfeeding is the best way to prevent diarrhea and keep infants who have diarrhea hydrated. If you use formula, you may need to bring your own. Follow the manufacturer's instructions on how to prepare it. If there is poor water quality where you are traveling, you should use sterile water to prepare formula and to sterilize bottles, nipples, caps, and rings before using them. You can sterilize items in a dishwasher, boil in water for five minutes, use a microwave steam sterilizer bag or use bleach if none of the other options are available.

Everyone should choose safer food and drinks  to prevent diarrhea. This includes eating foods that are served hot or are dry or packaged. Drink bottled, canned, or hot drinks and only drink milk that has been pasteurized. For short trips, you may want to bring a supply of snacks from home for times that available food may not be safe.

Wash hands  with soap and water. If soap and water are not available, you can use an alcohol-based  hand sanitizer  that contains at least 60% alcohol. Use soap and clean water and to wash bottles, pacifiers, and toys that fall on the floor.

Diseases Spread by Bugs

Mosquitoes can spread diseases, such as Zika , chikungunya , malaria , dengue , and yellow fever . Ticks can spread diseases such as Lyme disease and Tick-borne encephalitis.

Children can be protected against most of these diseases by using  Environmental Protection Agency (EPA)-registered insect repellents  with one of the following active ingredients:

• Picaridin (known as KBR 3023 and icaridin outside the US)
• Oil of lemon eucalyptus (OLE)
• Para-menthane-diol (PMD)
• 2-undecanone

When using insect repellent on your child, always follow label instructions. Spray insect repellent onto your hands and then apply to a child’s face. Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children under 3 years old. Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin. If also using sunscreen, apply sunscreen first.

More steps to protect your child include dressing them in clothing that covers the arms and legs. Cover strollers and baby carriers with mosquito netting.

Malaria is a serious infection that children can get while traveling internationally. Children visiting friends and relatives in areas with malaria may be at higher risk because they usually stay for longer periods of time.

Children traveling to an area with malaria should take malaria prevention medicine. Your health care professional can help you know which medicine your child should take. Many malaria prevention medicines have a bitter taste, but a pharmacist can crush the capsules and put the powder in a flavorless gelatin capsule. Because of the risk of overdose, malaria drugs should be stored in childproof containers and kept out of the reach of children.

Even if you are taking malaria medicine you should still use bug spray and take other steps to avoid bug bites .

Rabies  is spread primarily through contact (bites, scratches, or licks) with animals that can have rabies (mammal) . Rabies is almost always fatal if not treated promptly. Children are at greater risk for rabies because they are smaller than adults, may play with animals and may not report bites.

Supervise children closely around animals, especially around dogs and puppies, cats and kittens, and wildlife. Any animal bite should be washed thoroughly with soap and water and you should seek medical attention immediately.

Road Safety

Children should always wear a seat belt or sit in appropriate car and booster seats. Research car seat guidelines for the country you are going to; a car seat from the United States may not be approved in another country for use. In general, children are safest traveling in the back seat. No one should ever travel in the back of a pickup truck. See Traffic and Road Safety for more tips to avoid getting in an accident.

Water Activities

When doing water activities, supervise children closely and have them wear a life jacket.

You might also want to see the following topics to prepare for traveling with children:

• Travel to High Elevations
• Motion Sickness
• Protect Your Skin from the Sun
• Swimming and Diving Safety
• Travel and Breastfeeding

After Travel

If your child recently traveled and feels sick,  particularly if they have a fever, talk to their healthcare provider, and tell them about the travel. 

More Information

CDC Yellow Book: Traveling Safely with Infants and Children

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• Best overall
• Best for expensive trips
• Best for exotic trips
• Best for annual plans

How we reviewed travel insurance for seniors

Best travel insurance for seniors of may 2024.

Affiliate links for the products on this page are from partners that compensate us (see our advertiser disclosure with our list of partners for more details). However, our opinions are our own. See how we rate insurance products to write unbiased product reviews.

Reaching your golden years doesn't mean your adventures have to end. In fact, in this stage of life, you'll hopefully have more time and resources to travel. But as a senior citizen, you'll want to ensure you have travel insurance that covers any health-related issues arise while you travel.

Our top picks for the best senior travel insurance

• Best overall: Allianz Travel Insurance
• Best for expensive trips: John Hancock Travel Insurance
• Best for exotic trips: World Nomads Travel Insurance

Best for annual plans: Travel Guard

How we rate the best senior travel insurance companies »

Compare travel insurance for seniors

Your health gets more unpredictable as you age, which makes travel insurance more important for seniors. Unfortunately, it's also more expensive. The best travel insurance for seniors won't have too steep of a price hike compared to rates for younger travelers. It will have high coverage limits for emergency medical coverage, trip cancellations, and and emergency medical evacuation. It's also important that your travel insurance offers pre-existing condition waivers , ideally at no extra cost to the traveler. 

Here are our picks for the best travel insurance coverage for seniors in 2024.

Best overall: Allianz

• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Good option for frequent travelers thanks to its annual multi-trip policies
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Doesn't increase premium for trips longer than 30 days, meaning it could be one of the more affordable options for a long trip
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Some plans include free coverage for children 17 and under
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Concierge included with some plans
• con icon Two crossed lines that form an 'X'. Coverage for medical emergency is lower than some competitors' policies
• con icon Two crossed lines that form an 'X'. Plans don't include coverage contact sports and high-altitude activities
• Single and multi-trip plans available
• Trip cancellation and interruption coverage starting at up to $10,000 (higher limits with more expensive plans)
• Preexisting medical condition coverage available with some plans

Allianz Travel Insurance is one of the most widely recognized names in travel insurance, and it stands out as one of the top travel insurance providers for seniors. It offers a wide range of policies covering medical treatments overseas and emergency medical transport.

Allianz also provides options for varying trip lengths. Its annual multi-trip policies , for example, cover any trip you make during your policy period, even if they aren't yet planned, making it an excellent option for seniors who vacation multiple times per year.

Read our Allianz Travel Insurance review here.

Best for expensive trips: John Hancock

• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Offers 3 travel insurance plans
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Cancel for any reason rider available
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Affordable travel insurance premiums
• con icon Two crossed lines that form an 'X'. Reviews of claims process are mixed
• con icon Two crossed lines that form an 'X'. Buyers may not get specialty coverage for sports equipment and other high value items
• Trip cancellation for 100% of the trip cost
• Trip interruption insurance for up to 150% of the trip cost
• Emergency medical coverage of up to $250,000 per person
• Medical evacuation coverage of up to $1,000,000

John Hancock Travel Insurance plans for seniors offer some of the best coverage available. It provides generous maximum benefit amounts while still offering affordable prices.

Each plan includes coverages like trip cancellation, emergency accident, and emergency medical, with the option to add benefits like CFAR (cancel for any reason) . Plus, getting a free online quote is a quick and straightforward process.

Read our John Hancock Travel Insurance review here.

Best for exotic trips: World Nomads

• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Coverage for 200+ activities like skiing, surfing, and rock climbing
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Only two plans to choose from, making it simple to find the right option
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. You can purchase coverage even after your trip has started
• con icon Two crossed lines that form an 'X'. If your trip costs more than $10,000, you may want to choose other insurance because trip protection is capped at up to $10,000 (for the Explorer plan)
• con icon Two crossed lines that form an 'X'. Doesn't offer coverage for travelers older than 70
• con icon Two crossed lines that form an 'X'. No Cancel for Any Reason (CFAR) option
• Coverage for 150+ activities and sports
• 2 plans: Standard and Explorer
• Trip protection for up to $10,000
• Emergency medical insurance of up to $100,000
• Emergency evacuation coverage for up to $500,000
• Coverage to protect your items (up to $3,000)

World Nomads Travel Insurance is a great choice for active senior citizens under 70 who want comprehensive travel insurance. The key difference between World Nomads and many other providers is that it covers 200+ adventurous activities like scuba diving, mountain biking, surfing, skiing, and even bungee jumping. In addition, World Nomads' trip cancellation and emergency medical coverage includes COVID-19-related issues. Many other insurers are excluding that type of coverage now.

For adventurous senior citizens over the age of 70 years, World Nomads suggests working with its partner, TripAssure .

Read our World Nomads Travel Insurance review here.

Trip cancellation coverage for up to 100% of the trip cost and trip interruption coverage for up to 150% of the trip cost

• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Trip cancellation coverage of up to 100% of the cost, for all three plan levels
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. CFAR covers up to 75% of total trip costs (maximum of $112,500 on some plans) 
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Medical coverage of up to $500,000 and evacuation of up to $1,000,000 per person
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Includes COVID coverage 
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. Above average baggage loss and delay benefits
• Check mark icon A check mark. It indicates a confirmation of your intended interaction. High medical evacuation coverage
• con icon Two crossed lines that form an 'X'. Premiums may run slightly higher than competitors

Travel Guard is a well-established and highly rated name in the travel insurance industry. It offers three main coverage options to choose from, and in general its policies have above-average coverage for baggage loss and baggage delays, plus high medical evaluation coverage limits.

• Trip cancellation coverage for up to 100% of the trip cost
• Trip interruption coverage for up to 150% of the trip cost
• Preexisting medical conditions exclusions waiver must be purchased within 15 days of initial trip payment
• Annual travel insurance plan and Pack N' Go plan (for last-minute trips) available

Travel Guard  offers comprehensive insurance plans for shorter and longer trips. One of its more unique offerings is its Travel Guard Annual Plan.

This annual travel insurance comes with standard coverage benefits (trip delay, baggage loss, etc.) and substantial coverage amounts, which is important for seniors who travel multiple times per year. Travel Guard also offers a preexisting medical condition waiver, meaning those with certain medical issues can still gain coverage.

Read our AIG Travel Guard Insurance review here.

Understanding travel insurance for seniors

Before diving into the specifics, it's essential to understand what travel insurance is and why it's particularly important for senior travelers. The best travel insurance offers financial protection against unexpected events affecting your trip, such as trip cancellations, medical emergencies, or lost luggage.

Types of coverage

• Medical Coverage: Ensures your medical expenses are covered in case of illness or injury.
• Trip Cancellation/Interruption Coverage: Provides reimbursement if your trip is canceled or cut short due to unforeseen events.
• Baggage Coverage: Covers loss, damage, or theft of personal items during your trip.

Benefits of travel insurance for seniors

• Peace of Mind: Knowing you're covered in case of emergencies can make your travel stress-free.
• Financial Protection: Shields you from potentially overwhelming medical costs and trip cancellations fees.
• Assistance Services: Many plans offer 24/7 assistance services, providing help whenever and wherever you need it.

Making the most of your plan

After choosing a plan, it's crucial to understand your policy fully and know what services are available to you in case of an emergency.

Understanding your policy

• Read the fine print and understand the claims process to avoid surprises.

Emergency assistance services

• Familiarize yourself with the emergency assistance services offered by your plan and keep all necessary contact information handy.

How to pick senior travel insurance

It's wise to compare several different travel insurance policies for the best coverage and pricing, as premiums vary widely between insurers and depend on factors like your age and travel destination.

That said, some of the more essential coverages to look for if you're a senior citizen include:

• Travel medical coverage - This coverage will pay for your medical bills outside the US.
• Medical evacuation coverage - If you're injured or become sick while traveling, this coverage will transport you to the nearest hospital or even back home if your condition necessitates it.
• Preexisting conditions - Coverage for known health conditions. You'll need to purchase travel insurance within a certain time period from when you book your trip to qualify for a preexisting condition waiver .
• Cancel for any reason (CFAR) - The name says it all! It'll cost extra and you'll need to purchase insurance early, but it's the most comprehensive trip cancellation coverage you can get. Note that CFAR insurance usually only covers up to 75% of your trip fees.
• Trip cancellation insurance - This coverage provides reimbursement for your prepaid and nonrefundable costs if you cannot make your trip due to an unforeseen event.
• Baggage delay insurance - This coverage will reimburse you for essentials like toiletries and clothes if your bags are delayed.
• Lost luggage insurance - This coverage will reimburse you up to a specified amount if your bags get lost en route.

Of these, the most critical to note are whether or not your policy covers preexisting conditions and the limits for travel medical insurance and emergency medical evacuation.

Some insurance companies offer a waiver that will cover preexisting conditions. You'll have to follow the requirements for adding a waiver to your policy, like insuring the entire cost of your trip. Or purchase the policy within a specific time after making your first trip deposit payments.

You'll also want to find a policy with high maximum limits for travel medical and emergency medical evacuation coverage. These types of expenses can be substantial, so you want to have appropriate coverage.

When comparing senior travel insurance options, we looked at the following factors to evaluate each travel insurance provider:

• Coverage limits: We looked at each travel insurance company's coverage amounts for benefits like medical emergencies and trip cancellation.
• Flexibility: We looked at how customizable a policy is, so you can choose what your travel insurance policy covers .
• Coverage for preexisting conditions: Preexisting conditions are one of the more critical factors for travel insurance for senior citizens, so we looked at travel insurance companies that offer the best coverage for preexisting conditions.
• Price: We compared travel insurance providers offering reasonable basic and comprehensive coverage rates.
• Benefits geared towards seniors: We compared travel insurance companies that offer solid coverage for senior citizens, like medical evacuation, COVID-19 coverage, and trip cancellation.

You can read more about our insurance rating methodology here.

Seniors should look for travel insurance policies that offer comprehensive medical coverage, including for preexisting conditions and emergency medical evacuation. They should also consider policies with higher coverage limits to ensure adequate protection. Additionally, seniors should seek travel insurance plans that provide 24/7 assistance services, as well as coverage for trip cancellations, interruptions, and baggage protection.

The cost of senior travel insurance coverage can vary depending on your age, overall health, state of residence, travel destination, and length of your trip. However, assuming all other factors are the same, you'll pay more for travel insurance at 70 than at 30.

All travel insurance companies, except World Nomads, included in this guide offer coverage for pre-existing medical conditions as long as you buy your policy within the qualifying period from when you placed your trip deposit.

Allianz is the best travel insurance for seniors due to its wide array of medical coverages and emergency medical transport. Allianz also offers multi-trip insurance policies , which could make sense for seniors who travel frequently.

In some instances, travel insurance companies will have age eligibility restrictions, often only insuring people 80 years old and younger.

Editorial Note: Any opinions, analyses, reviews, or recommendations expressed in this article are the author’s alone, and have not been reviewed, approved, or otherwise endorsed by any card issuer. Read our editorial standards .

Please note: While the offers mentioned above are accurate at the time of publication, they're subject to change at any time and may have changed, or may no longer be available.

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