Whilst it is desirable that travellers access health advice well in advance of travel to enable sufficient time for vaccinations to be administered and immunity achieved, it is also important that advice regarding malaria chemoprophylaxis is not provided too far in advance. Providing advice nearer to the travel date ensures that the most up to date advice is provided as malaria chemoprophylaxis regimes can change. It is also important that the most up to date resources are used when providing travel advice.

It is recommended that some antimalarial drugs are used for a trial period before travel to ensure the traveller does not experience any adverse or side effects. This is only applicable to patients who have not used the drugs before. The recommended trial periods are:

• Lariam® - three weeks
• Doxycycline - one week
• Malarone® - one or two days

Additionally the risk of infection can vary at different times of the year. Infections transmitted by mosquitoes such as malaria, dengue fever, yellow fever and Japanese Encephalitis are more common in the rainy season whilst meningitis is more common in the dry season. It is important to consider this factor when advising patients.

When providing advice on vaccinations pharmacists should consider the time interval that may be necessary between vaccines. It is not always possible to administer multiple vaccinations on the same day. This is a particular problem with live vaccines that may impact on the patient's immune response to further vaccines. As a general rule, non-live vaccines can be administered at the same time as other vaccines whilst there are specific restrictions on the administration of multiple live vaccines. For example, it is not recommended to administer an MMR vaccine on the same day as either yellow fever or varicella vaccines; there should be a minimum four week interval between the administration of these vaccines.