Vaccinations for travelling abroad: which ones might be required and what the recommendations depend on

Before an international trip, vaccinations against hepatitis A and B, typhoid fever, yellow fever, dengue, rabies, meningococcal disease or Japanese encephalitis, amongst others, may be considered. However, there is no one-size-fits-all guideline for all travellers. The decision depends on previous vaccinations, the destination, the itinerary, the length of stay, planned activities and each person’s medical circumstances.

When someone starts planning a trip abroad, one of the first health-related questions is usually very specific: what vaccinations do I need?

There is a practical answer to this question, but no universal list.

One person may simply need to check that their routine vaccinations are up to date. Another may benefit from one or more additional vaccinations. And for certain itineraries, it may also be necessary to meet specific health requirements relating to entry into or transit through a country.

Dr Abelardo Fernández Chávez, a specialist in Preventive Medicine and Public Health and head of the International Traveller’s Clinic at the Publio Cordón Memorial Hospital, explains that the approach should not start with the name of the destination, but with a more comprehensive assessment: “There is no set package of vaccinations that automatically applies to travelling to a country. First, we need to know what protection the person already has, and then examine their itinerary, how long they will be staying and what activities they have planned.”

This approach avoids two common mistakes: thinking that international travel necessarily requires many vaccinations or, conversely, assuming that if none are compulsory, there is nothing to check either.

Firstly, find out what cover the traveller already has

Before adding any travel-related vaccinations, it is advisable to review routine vaccinations. A consultation can be a good opportunity to check that the vaccination schedules appropriate to the traveller’s age and medical condition are up to date. Depending on each person’s medical history, it may be necessary to review vaccinations such as tetanus, diphtheria or polio, as well as other immunisations included in the routine schedule.

Vaccination records are particularly useful. They show which vaccines have been administered, whether a course has been completed, or whether protection remains valid and does not need to be repeated.

For Dr Fernández Chávez, this step is essential: ‘Before prescribing a new vaccine, we need to know the patient’s history. Reviewing this allows us to identify incomplete vaccination schedules, complete whatever is actually needed and avoid unnecessary interventions’.

The aim, therefore, is not to start from scratch before every trip, but to know precisely what level of protection each person already has.

Which vaccines might be considered?

Once the medical history has been reviewed, various vaccines may be considered depending on the itinerary and potential exposures during the stay.

Vaccines of interest in travel medicine include those against hepatitis A and B, typhoid fever, yellow fever, dengue, rabies, meningococcal disease, Japanese encephalitis, poliomyelitis, tick-borne encephalitis, cholera, tetanus and diphtheria, amongst others.

However, simply knowing which ones are available does not mean that they are all appropriate. The important thing is to understand when it may be appropriate to consider each one.

Hepatitis A, for example, is one of the vaccinations frequently considered for unimmunised travellers when the destination and travel conditions warrant such protection. Hepatitis B may also be considered, although vaccination history is particularly relevant here as many people may already be protected.

Typhoid fever may be considered for certain itineraries where there is a higher risk of exposure to contaminated water or food. The length of stay, the areas visited and the nature of the trip help to determine whether the vaccine is indicated.

In all these cases, the same principle applies: the need for vaccination is assessed on the basis of the trip and prior protection, not solely on the basis of the country’s name.

Yellow fever: protection and requirements are not the same thing

Yellow fever warrants a separate explanation because it involves two distinct issues. On the one hand, there may be a medical indication for vaccination when a traveller is going to stay in an area at risk of transmission. On the other hand, certain itineraries may be subject to the presentation of an International Certificate of Vaccination.

Dr Fernández Chávez considers it essential to distinguish between these two situations: ‘With yellow fever, we must differentiate between the medical recommendation and the documentary requirement. It is one thing to assess whether the vaccine is recommended to protect the traveller, and quite another to check whether there are any requirements relating to the destination, the traveller’s country of origin or the previous itinerary’.

This distinction is important because the requirements may depend not only on the final destination, but also on countries visited previously or on certain stopovers.

Rabies and Japanese encephalitis: when the nature of the trip is particularly important

There are vaccines for which the recommendation depends much more on the activities undertaken and the itinerary. Rabies vaccination before travelling may be considered when there is a significant risk of contact with certain mammals, particularly if the itinerary includes places where it might be difficult to access medical care quickly following a bite or scratch.

Key factors here include the type of activity, the length of stay and access to healthcare.

Japanese encephalitis provides another very clear example. Most travellers on standard holidays in Asia are at low risk. However, vaccination may become more important for certain extended trips or where there is significant exposure in areas where the virus circulates, particularly during extended outdoor activities.

For Dr Fernández Chávez, both vaccines illustrate why the itinerary can be more informative than the country itself: ‘There are vaccines where we need to know quite precisely which regions will be visited, how long the stay will last and what activities will be undertaken. That information can significantly alter the recommendation.’

Vaccination against meningococcal disease may also form part of the preparation for certain trips and, in some circumstances, be linked to specific health requirements. Other vaccines, such as those for hepatitis B, polio, Central European encephalitis or cholera, are assessed according to the expected exposure and individual characteristics.

The conclusion is not that there is a long list of vaccines that must be administered before leaving Spain. It is quite the opposite: each vaccine requires a specific indication.

The destination provides direction; the itinerary provides the details

It is natural to search for information by country: ‘vaccinations for Thailand’, ‘vaccinations for Kenya’, ‘vaccinations for Indonesia’. The destination is a good starting point, but it does not tell the whole story.

Even within the same country, there may be differences between regions. Other factors that play a part include the length of stay, the time of year, planned activities, the type of accommodation and the ease of access to healthcare during certain stages of the trip.

That is why, during consultations, Dr Fernández Chávez pays particular attention to the actual itinerary: “When someone tells us which country they are travelling to, we know where to start. But to make a precise recommendation, we need to know which regions they will be visiting, how long they will be staying in each, and what activities they have planned.”

This level of detail allows us to tailor our recommendations more effectively and avoids applying the same guidelines to all travellers heading to the same destination.

Recommended and compulsory vaccinations for travel: what is the difference?

Not all vaccinations that may be advised before a trip are compulsory, nor do all health requirements follow the same criteria. A vaccine may be recommended because it helps reduce a specific risk whilst travelling, even if proof of vaccination is not required to enter the country. Entry requirements, on the other hand, depend on current health regulations and may vary depending on the destination, the country of origin, territories visited previously or specific stopovers.

That is why it is important to distinguish between medical advice, which aims to protect travellers based on their itinerary and personal circumstances, and documentary requirements, which relate to entry or transit conditions. This distinction prevents the misconception that a non-compulsory vaccine is of no use and, at the same time, allows travellers to check precisely what documentation may be required before setting off on their journey.

How far in advance should you arrange your vaccinations before travelling?

Whenever possible, it is advisable to have this check-up several weeks in advance. As a general guide, a consultation between four and eight weeks before departure allows sufficient time to check your vaccination history, complete any outstanding vaccination schedules and administer any vaccines that require multiple doses or specific intervals between them.

This planning is not solely about ensuring you receive a vaccine in good time. It enables a more accurate assessment of the trip and allows you to organise the various preventive measures that may be necessary in a structured way. Even so, when departure is imminent, you should not assume it is already too late: there may still be useful recommendations that should be prioritised depending on the destination and the nature of the trip.

Health preparation for a trip goes beyond vaccinations

Vaccination is an important part of prevention, but not the only one. Depending on the destination and the nature of the trip, it may also be necessary to consider malaria prevention, measures to reduce insect bites, precautions regarding water and food consumption, or putting together a first-aid kit suited to the type of trip.

Regular medication may also require some planning, particularly for extended stays or when certain treatments require specific conditions for transport, storage or documentation. At the International Traveller’s Clinic at the Publio Cordón Memorial Hospital, all these aspects are taken into account alongside vaccination, the itinerary, medical history and the individual circumstances of each traveller.

Vaccinations tailored to each trip and each individual

The question “What vaccinations do I need to travel abroad?” can have specific answers. Vaccinations against hepatitis A, typhoid fever, yellow fever, dengue, rabies, Japanese encephalitis, meningococcal disease and others may be recommended for certain trips. However, no list can replace an individual assessment.

The decision begins with determining what protection the traveller already has and continues with an analysis of the destination, the itinerary, the length of stay, the planned activities and personal medical circumstances. Based on this information, it can be determined which vaccines actually provide a benefit and which health requirements must be checked before travelling.

As Dr Fernández Chávez summarises: ‘We are not aiming to administer as many vaccines as possible. We aim to ensure that each traveller receives only those that are genuinely recommended and that they can prepare for their trip with clear recommendations tailored to their specific situation.’

Medical and informational content

This content is for information and educational purposes only and is not a substitute for an individual medical assessment. Vaccination recommendations and health requirements relating to travel may vary depending on the itinerary, personal circumstances, the epidemiological situation and the regulations in force at any given time.

The information in this article is provided for general awareness and does not replace an individualised medical assessment.