Wanderlust meets prevention: travel vaccinations

“We’re off to Thailand in three weeks – do I need vaccinations?” Questions like this pile up before every holiday season. The community pharmacy is often the first port of call: low-threshold, no appointment, with a look at the vaccination record and travel plan. Good travel counselling begins early – an appointment should ideally take place four to six weeks before departure, so that multi-dose vaccination schedules still take effect.[12]

Travel medicine is, however, a moving field: entry requirements, outbreak situations and vaccination recommendations change constantly. The binding basis in Switzerland is formed by the recommendations of the Federal Office of Public Health and the Swiss Expert Committee for Travel Medicine (ECTM), accessible via the HealthyTravel platform (formerly safetravel.ch).[1] [2]

Travel counselling in the pharmacy: role and limits

The pharmacy’s strength lies in triage and in dealing with what is close at hand: checking the vaccination record, boosting basic vaccinations and measles protection, administering common travel vaccinations (where cantonally permitted) and advising on the travel first-aid kit and on mosquito and diarrhoea protection. Clear limits exist for yellow fever vaccination – it may only be given at authorised centres – as well as for prescription-only malaria prophylaxis and complex constellations (pregnancy, immunosuppression, infants, chronic illnesses). Here the referral goes to the family doctor or a travel medicine centre.[3] [12]

Four questions that structure any travel consultation

Which vaccinations are sensible or mandatory does not emerge from the destination country alone, but from the interplay of several factors.

The basics first: routine vaccinations and measles

Before exotic vaccinations come up, the vaccination record deserves a look. For all travellers, current protection against diphtheria, tetanus, poliomyelitis and measles as well as against hepatitis A is recommended; in special situations hepatitis B, typhoid fever and rabies are added.[3]

Measles protection deserves particular attention: travel raises the risk of exposure and outbreaks, and outbreaks occur repeatedly in Europe in particular. All people born after 1963 without documented protection should be able to show two MMR doses.[3] Checking measles and basic vaccination protection is a genuine, quickly delivered pharmacy service – and often the most valuable.

The most important travel vaccinations at a glance

One change concerns rabies: the pre-exposure schedule in travel medicine has been updated and now manages with two doses (day 0 and 7). What remains important is the message that vaccination before travel simplifies but does not replace post-exposure prophylaxis: after a bite or scratch, immediate further medical treatment is necessary even in vaccinated people.[10]

Vaccinations are mandatory rather than merely recommended above all in two constellations: yellow fever (see below) and the meningococcal vaccination (ACWY) as a prerequisite for the pilgrimage to Saudi Arabia (Hajj/Umrah), where a polio booster is additionally required.[11]

Yellow fever: the special case of travel medicine

Yellow fever occurs in sub-Saharan Africa and in South America; no vaccination is needed for Europe and Asia. The vaccination is in part an entry requirement, in part urgently recommended – and it is subject to special rules: it may only be administered at WHO-authorised yellow fever vaccination centres, should be given at least ten days before entry and is recorded in the international certificate of vaccination (ICVP, the “yellow booklet”).[5] [3]

On validity: since 2016 the WHO certificate has in principle been valid for life after one dose.[5] The ECTM nonetheless recommends for immunocompetent people a single booster ten years after the first vaccination (a maximum of two doses in a lifetime) before lifelong immunity is assumed.[4] For the pharmacy this means: always refer yellow fever to a travel medicine centre – particularly for pregnant or breastfeeding women or the immunocompromised.

New vaccines: dengue and chikungunya

Both diseases are transmitted by day-active mosquitoes and are increasing worldwide – questions about them come up correspondingly often. Here differentiated counselling is required.

For dengue, the vaccine Qdenga has been approved in Switzerland since 2024. The ECTM, however, recommends it only to travellers with indications of a previous dengue infection who are staying in regions with high transmission – because in those not previously infected a more severe course cannot be ruled out. A consultation with a specialist in tropical and travel medicine is recommended.[1] [6]

Against chikungunya, two vaccines are approved in Europe (Ixchiq, 2024; Vimkunya, 2025), but neither in Switzerland; use is only possible off-label through specialised centres, and some ECTM centres keep the vaccine in stock. The ECTM considers vaccination for instance for people over 12 travelling to current outbreak areas.[7] In both cases, consistent mosquito protection remains the most important measure.

Malaria: no vaccination for travellers – but three pillars

Important up front: a malaria vaccination is not available for travellers. The vaccines recommended by the WHO (RTS,S, R21) are intended for children in endemic areas and are not routinely used in travellers.[9] Protection instead rests on three pillars.

Which strategy applies depends on region, season and travel style and is determined individually.[8] Since all malaria medicines are prescription-only, the pharmacy acts here in an advisory capacity and refers to the family doctor or a travel medicine centre for prescription and selection.[9]

Three travel profiles from practice

How differently the same basic rules play out is shown by three frequent destinations. What remains decisive is always the up-to-date country information – the following profiles serve as orientation.