1. Travel risk assessment consultation

The vaccination advice follows a risk assessment procedure. This is a usual first step in any travel consultation before the journey. This assessment will determine what advice to give in response to the destinations, type and length of travel. It is expected that the information you provide will be individualised to the traveller.

The consultation should be carried out by a member of staff trained in providing travel advice. The Numark vaccine advice service will help to determine what information is needed in order for the healthcare professional to provide appropriate advice. Use the list of questions listed here to give a good indication of risk as part of the consultation.

The information required falls into two categories:

Traveller information
Age Age restrictions apply with certain vaccines. The elderly are more likely to have pre-existing illness and concurrent medication.
Medical history Existing health condition(s), recent major surgery and immunosuppression will lead to varying responses to vaccination.
Medication Always consider drug interactions with immunisations. E.g vivotif and antibiotics Although not part of vaccination advice, as a pharmacist please ensure traveler has enough medication for the duration of visit and legal status when bringing in specific drugs.
Allergies Usually a major contraindication to vaccines when hypersensitive to excipients or residues from the manufacturing process eg neomycin, formaldehyde, polymyxins. Also consider ovalbumin content if grown in hens’ eggs.
Previous vaccinations This will help plan the vaccination schedule and ensure unnecessary vaccines are not given
Pregnancy actual or planned Please see contraindications in the SPC.


Travel details
Destination The destination will determine which diseases are prevalent. Certain diseases are contained within specific regional boundaries. For example, Japanese encephalitis is only found in South East Asia and yellow fever in Africa and South America. Travel to the tropics and developing countries is generally associated with greater risks to health than travel elsewhere, particularly risks associated with contaminated food and water.
Date of Journey Vaccination and antibody titre will take some time for immune response to develop. Protection will depend on the length of time between immunisation and travel.
Duration Short stay travelers have less risk.
Purpose of journey Reasons for travel and the degree of contact with local population will determine risk. 2 week holidays have less risk than travelers in contact with host community. Consider close contact transmission of infections like diphtheria, tuberculosis and meningitis. Travelers working abroad will have specific health needs.
Accommodation Five star hotel and cruising ship accommodation with safe access to water and “clean” food will have low risk. Sleeping in hostels and purchasing “street” food carries inherent risk.
Urban/Rural Risks will vary depending on access to clean water, medical facilities and living conditions. Consideration should be given to multisite holidays where trekking and safaris are involved. Certain disease are more prevalent in rural locations, for example Japanese Encephalitis is often transmitted in and around rice paddies.
Travel Budget Travelers on a limited budget may well have higher risk and they might not have access to better or consistent quality food and accommodation or may take bigger risks.



 Travel risk assessment


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