With many schools in Lothian planning exciting overseas trips — sometimes to destinations as far afield as Malawi — families are often asked to review a list of recommended vaccinations before travel. These lists are commonly provided by tour operators. While helpful, they do not always reflect the most up-to-date UK travel health guidance or the specific health needs of each pupil.
At the NHS Lothian Travel Clinics, our travel health specialists provide individual risk assessments based on the latest advice from national experts. This helps ensure pupils receive the vaccines and advice that are truly appropriate for their destination, activities and personal health.
Why vaccine lists can be confusing
Travel companies sometimes circulate standardised vaccine lists that are intended to cover a wide range of travel scenarios. However, UK travel vaccine guidance is based on recommendations from national advisory bodies such as the UK Health Security Agency’s National Travel Health Network and Centre (NaTHNaC) and the Joint Committee on Vaccination and Immunisation (JCVI).
These recommendations consider several factors, including:
- The specific country and region being visited
- Length of stay
- Type of accommodation
- Planned activities
- Access to safe food and drinking water
- Any underlying medical conditions
Because of this, two pupils travelling to the same country may not always require the same vaccinations.
Parents and schools can review country-specific advice on the NaTHNaC website: https://travelhealthpro.org.uk
BCG (Tuberculosis) vaccination
BCG vaccination is sometimes included on travel vaccine lists for countries where tuberculosis (TB) occurs more frequently. However, most pupils travelling on short school trips will not require BCG vaccination.
For travellers, BCG is generally recommended for:
- Unvaccinated children under 16 who will be living in a high TB incidence country for more than three months
- Certain individuals with occupational exposure, such as healthcare workers who have direct contact with TB patients
For many school trips lasting a few weeks, these criteria are not met.
In addition, NHS Lothian Travel Clinics do not currently provide BCG vaccination. Where BCG may be indicated, we can advise families on appropriate next steps.
Cholera vaccination
Cholera vaccination is another area where advice can sometimes appear unclear. In practice, cholera vaccination is rarely required for typical school travel, even in countries where cholera occurs.
The oral cholera vaccine is usually recommended only when travellers:
- Have limited access to safe drinking water
- Are working in humanitarian or emergency settings
- Are travelling to areas experiencing outbreaks without reliable sanitation or medical care
- Have certain medical conditions that increase their risk of complications
Even when pupils are volunteering or participating in school programmes abroad, accommodation is generally arranged with safe drinking water, food safety measures and hand-washing facilities. This is very different from travellers who must rely directly on local water sources.
For example, although Malawi may sometimes be listed as experiencing cholera outbreaks, the usual advice for most travellers remains:
- Follow careful food and water precautions
- Maintain good hand hygiene
If a trip is expected to involve circumstances where safe water and sanitation cannot be maintained, cholera vaccination may be considered following a detailed risk assessment.
NHS eligibility for cholera vaccine
Cholera vaccine can only be provided free on the NHS when specific criteria are met.
In practice, families may be asked to demonstrate:
- · That travellers will not have reliable access to safe drinking water, and
- · That the school or organiser has completed a risk assessment addressing this issue
This is an important safety consideration beyond vaccination alone and helps ensure parents fully understand the real risks involved.
Some travellers may still choose to receive cholera vaccination privately (for a fee) if it is not available through the NHS.
The importance of a medical risk assessment
Schools and tour operators organising overseas travel should have an up-to-date medical risk assessment and health plan for the trip.
This should include:
- Health risks specific to the destination
- Plans for managing illness or injury abroad
- Information accessible to those responsible for pupils during the trip
Incidents are far more difficult to manage when medical planning is outdated or unclear.
How NHS Lothian Travel Clinics can help
Our travel health specialists provide:
- Individual travel risk assessments
- Advice tailored to the destination, activities and health needs of each pupil
- Vaccination guidance based on current UK national recommendations
If your child is preparing for a school trip overseas and you are unsure which vaccines are required, our clinics can help ensure they receive the most appropriate and up-to-date advice.
For detailed country-specific travel health information, visit: https://travelhealthpro.org.uk
For appointments please book online or call our booking line.
Generalised Group Information
Our service is happy to discuss itinerary and activities with the trip’s organisational lead and produce an information letter detailing current vaccine recommendations, NHS vaccine provision and associated costs of any private medications specific to the planned trip.
Schools and groups can use this information as a guide before booking into one of our 6 NHS Lothian clinics for a full individualised assessment with one of our specialist travel nurses.
Please call our booking line to request information on group infomation provision.
