07 Jul 2020

Interrupted travel vaccination courses: guidance for travellers

Information on interrupted vaccination schedules Interrupted travel vaccination courses: guidance for travellers
  • This updates the news item of 11 June 2020

The COVID-19 pandemic resulted in international travel plans being put on hold. As travel restrictions are gradually eased, many travel health providers will start offering travel vaccination service again.

Some travel vaccinations require more than one dose to complete a course. Travellers may have started courses and been unable to complete them.

Advice for travellers

The COVID-19 outbreak continues to evolve. The Foreign and Commonwealth Office (FCO) has updated its global advisory against ‘all but essential’ travel and from 4 July 2020 some destinations have been assessed as no longer presenting an unacceptably high risk to British nationals travelling abroad [1].

Details on the exempted countries and territories can be found on the GOV.UK website [1]. This advice is being kept under constant review [1]. Travellers should continue to monitor the GOV.UK travel advice and check the UK FCO website for country specific information regularly, as information may change.

If you are travelling, consider the risks of COVID-19 during your journey and at the destination, and plan how to apply the current UK recommendations to reduce your risk of infection. This is particularly important if you are considered vulnerable or extremely vulnerable COVID-19 and you may wish to seek further advice, including whether to postpone travel, from a health professional, when planning such trips.

Check that travel and accommodation arrangements are still possible for your planned destination and review the FCO foreign country advice pages for information on possible travel restrictions or extra control measures in place, such as quarantine for arriving international passengers. See our general advice for travellers’ news item.

If you are planning to visit a destination you originally planned to visit before the COVID-19 pandemic occurred, it is likely that the travel vaccination recommendations are the same. However, you should still check our Country Information pages for up to date information. See the ‘vaccination recommendations’ tab for a full list of the vaccines to consider. You can also click on links at the bottom of each vaccine listed to see further information on the recommended vaccination schedule.

If you have changed your travel destination, it is possible the vaccination recommendations are different – again check the Country Information pages (link above) for details. You should discuss your plans with a travel health professional, when possible, particularly if you are in a vulnerable group.

Completing interrupted travel vaccination courses

Ideally travel vaccinations should be provided according to their recommended schedule (timeframe between first and subsequent doses) as this will have been carefully studied and licensed by the manufacturer.

However, if the interval left between vaccine doses is longer than the recommended schedule interval, it is not necessary to repeat doses or restart the course (but see ‘exceptions’ below). Health professionals may start where the course was left off as the immune memory made in response to a previous dose(s) is boosted by subsequent doses. A general principle is that lengthening the intervals between vaccine doses does not impair the response to the vaccine [2] and where a course has been interrupted, it should be resumed not repeated.

Exceptions

In some circumstances, such as where the effect of interrupted doses in a schedule may not be clear (for example with the oral typhoid vaccine or oral cholera vaccine - Dukoral), re-starting a course may be recommended.

If you have no, or inadequate documentation of your previous vaccination doses, and are unable to obtain these records, re-starting a course of vaccine may be recommended.

If you have an impaired (weakened) immune system, the best approach to providing protection against the disease will be decided on a case by case basis with your health care professional, taking in to account your health status, the length of time between doses and specific information on the vaccine used. Immunological response may be reduced in immunosuppressed individuals. Vaccination is recommended even if the antibody response may be limited. Additional doses of the vaccination may be recommended.

UK vaccination programme during the COVID-19 pandemic

If you or your family are due for vaccinations as part of the routine UK vaccination schedule, you should call your GP practice to make an appointment. They will provide advice on the arrangements in place. It is important to keep up to date with these vaccinations to protect your family, and prevent outbreaks occurring in the UK [3].

Resources

  1. Foreign and commonwealth office, Travel Advice: coronavirus (COVID-19) Last updated 4 July 2020 [Accessed 7 July 2020]
  2. Kroger AT, Atkinson WL, Pickering LK General Immunization Practices. In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM (eds). Plotkin’s Vaccines.7th Edn. Philadelphia 2018. p96-120
  3. Public Health England: Vaccine Update 303. 2020; Keep calm and carry on vaccinating [Accessed 7 July 2020]

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