Travel Vaccines: What PLAB 2 Candidates Must Know for Safe Practice in the UK

Ann Augustin
Jul 14
2 min read

Updated: Aug 11

Summary:

This scenario focuses on travel vaccination assessment and counselling for patients planning international travel, a common PLAB 2 station topic. It includes NHS coverage, indications, assessment approach, and communication tips for safe and confident practice.

Key Points:

1. Importance of Travel Vaccination Counselling

Protects individual travellers from region-specific infections.
Prevents potential public health risks upon return to the UK.
Demonstrates comprehensive history-taking and anticipatory guidance skills.

2. Routine Vaccines to Check

Ensure standard UK vaccinations are up to date, including:
- MMR (Measles, Mumps, Rubella)
  - No routine boosters are needed beyond the 2-dose course.
  - Anyone without 2 documented doses can be vaccinated at any age.
  - Minimum interval: 4 weeks between the two doses.
- Tetanus, Diphtheria, Polio (Td/IPV) booster every 10 years if needed.

3. Common Travel Vaccines

Vaccine	Indication	NHS Coverage
Hepatitis A	Food & water-borne infection in many countries	✅ NHS covered
Typhoid	Food & water-borne, especially South Asia	✅ NHS covered
Cholera	Limited indication (e.g. aid workers in outbreaks)	✅ NHS covered
Hepatitis B	High risk activities (healthcare, tattoos, sex)	❌ Private
Rabies	Animal exposure risk (trekking, caving, working with animals)	❌ Private
Japanese Encephalitis	Long stays or rural travel in Asia	❌ Private
Yellow Fever	Mandatory for some countries (Africa, South America)	❌ Private

4. NHS Coverage Summary

✅ Covered by NHS (if done via GP practice):

Hepatitis A, Typhoid, Cholera (specific criteria), Tetanus/Diphtheria/Polio booster.

❌ Not covered by NHS:

Hepatitis B (if for travel only), Rabies (pre-exposure), Japanese Encephalitis, Yellow Fever.

🔑 Exam tip: Even if a vaccine is NHS-covered, if administered in a private clinic, the patient pays privately.

Important Considerations:

Assess destination, duration, accommodation type, activities, and underlying medical conditions.
Explain side effects, dosing schedules, and timings (e.g. Japanese Encephalitis requires 2 doses 28 days apart).
Emphasise bite avoidance measures for mosquito-borne infections (e.g. JE, malaria, dengue).
Provide written records of vaccines administered for travel documentation.

Diagnostic Approach (Counselling Station):

Establish travel details: country, rural vs urban, duration, season.
Review medical history: immunisations, allergies, chronic conditions.
Identify risk activities: working with animals, trekking, caving, healthcare work.
Advise vaccines needed + malaria prophylaxis if relevant.

Management:

Provide NHS vaccines via GP practice if eligible.(e.g., Hepatitis A, Typhoid, Tetanus/IPV/Diphtheria, Cholera)
Refer to private travel clinic for non-NHS vaccines(e.g., Rabies, Japanese Encephalitis, Yellow Fever).
Issue private prescriptions for malaria prophylaxis if needed.(e.g., Atovaquone/Proguanil, Doxycycline, Mefloquine)
Refer to NaTHNaC (National Travel Health Network and Centre) for up-to-date guidance on country-specific vaccination requirements and malaria prophylaxis recommendations.
Use NaTHNaC’s TravelHealthPro website to access country-specific vaccination requirements, outbreak alerts, and malaria risk zones.
Document clearly in patient records(Include travel itinerary, vaccines given, advice provided, and any prescriptions issued.)

Communication Skills:

Use patient-centred language to explain infection risks.
Clarify cost implications honestly for private vaccines.
Encourage bite prevention and food/water hygiene alongside vaccines.
Offer reassurance while emphasising importance of vaccination for protection.

Ethical Considerations:

Respect patient autonomy in vaccine decisions while ensuring informed choice.
Avoid coercive language; instead use risk-based explanation.
Uphold public health duty by advising on potential risks to UK population post-travel.