Polio vaccination certificateHow to complete an International Certificate of Vaccination or Prophylaxis (ICVP) for polio
Supply of the ICVPCopies of the ICVP can be ordered by the clinic via the NaTHNaC online shop or the World Health Organization.
Completing the ICVPThe ICVP for polio vaccination should be completed as follows:
Name, date of birth and gender
The recipient’s name should be written the same as it appears on their passport. For date of birth, the day and the year should be written in numbers and the month in text (see image). This format is to avoid confusion with other countries that write the date differently from the UK.
National identification (ID) documentCitizens of some countries are issued with a national identification (ID) document/card. The ICVP has been developed for universal use and documentation of national ID is more applicable to those who are nationals of such countries. There is no equivalent to a national ID document/card in the UK. It is acceptable to leave this blank.
Signature of vaccine recipientThe vaccine recipient is required to sign their ICVP following receipt of polio vaccine. Those unable to write should make a mark, which should be countersigned by another present, as proof of that person’s mark. The signature does not imply consent for vaccination; consent should be obtained separately.
There is no regulation at what age a child can sign their ICVP. A certificate issued to a child who is unable to write should be signed by a parent or guardian (see above for those not able to write).
‘Vaccine or prophylaxis’ box‘Poliomyelitis’ should be written in the ‘vaccine or prophylaxis’ box. The trade name of the vaccine should not be written anywhere on the certificate. Details of administration of tetanus/diphtheria/inactivated polio should be recorded elsewhere for future reference.
Date of administrationThe date of administration should be written in the same format as that written for the date of birth (see above).
Signature and professional status of supervising clinicianThe certificate must be signed by the clinician (doctor, nurse or pharmacist) who administered the vaccine. Their professional status should be included (e.g. MBBS; RN/RGN; GPC/RPharmS).
‘Manufacturer and batch no.’ boxThe name of the vaccine manufacturer and the batch number should be recorded. It is not necessary to write the expiry date of the vaccine on the certificate.
Valid from and expiry dateThe certificate becomes valid immediately following administration of the vaccine. The date format should be the same as that used for the date of birth (see above). The certificate is valid for one year from the date the vaccine was administered (see image). The format should be the same as the date of birth (see above).
Official stamp of the administering centreThe official stamp is the practice stamp or Yellow Fever Vaccination Centre stamp.
'Passport number or travel document number'On the front cover of the ICVP booklet, travellers can add their passport number if they wish. They do not need to bring their passport with them to the appointment unless they have changed their name and are requesting a duplicate certificate or a new certificate in their new name.
Record keeping at the practice/clinicIt is necessary for separate records to be kept of the administration of the polio vaccine for one year. Within one year a duplicate could be issued if the original was lost or a new certificate could be issued if the recipient changes their name.
Certificates issued retrospectivelyAssuming that all the details are recorded in the traveller’s notes in order to correctly complete the certificate (date of administration, manufacturer, batch number etc), a traveller who has received poliomyelitis within the previous twelve months can have a certificate issued retrospectively.
Yellow fever vaccine and poliomyelitis vaccine documented on the same ICVPNaTHNaC does not recommend this. It is necessary to complete the section '......has on the date indicated been vaccinated against .....' with the name of the disease. Writing more than one disease in this section could result in the certificate being challenged (NaTHNaC opinion). We therefore advise a separate certificate is written for each disease (i.e. poliomyelitis OR yellow fever) until further information becomes available.
Revised: October 2014