Q. Which travel vaccines can be supplied on an NHS prescription?

A. Confusion may arise over which vaccines can be funded by the NHS when administered for foreign travel purposes. Irrespective of whether a vaccine is clinically recommended for travellers abroad, the question is; who pays for it?

Importantly for us, under the terms of the pharmacy contract, pharmacists will be reimbursed for supplying any vaccine on prescription, provided it is not on the blacklist (Part XVIIIA of Drug Tariff).

However, under the terms of the General Medical Services contract, there are three different categories of travel vaccine for payment purposes:

1. Travel vaccines that must be given on the NHS (free of charge)

• Hepatitis A
• Typhoid
• Cholera
• Polio (tetanus, diphtheria, pertussis)

It should be noted that combinations of these vaccines (e.g. Hepatitis A/Typhoid or hepatitis A+B) are permitted.

Also note that polio is only available as a combined vaccine with tetanus and diphtheria with or without pertussis (DTap/IPV). By inference then, immunisation against these diseases is also permitted on the NHS.

2. Travel vaccines that must not be given on the NHS (private service only)

• Yellow Fever
• Japanese B Encephalitis
• Tick-borne Encephalitis
• Rabies (for pre-exposure prophylaxis)

Note that post-exposure prophylaxis of rabies following travel to an endemic country must be provided free of charge on the NHS.

3. Travel vaccines supplied either on the NHS or privately

There are some vaccines where it lies with the prescriber’s professional discretion as to whether they are provided free of charge on the NHS or as a paid private service.

• Hepatitis B
• Meningococcal ACWY

In most cases there will be local guidelines to follow as to whether the NHS will fund immunisation or not. Hepatitis B for travel does not tend to be funded unless combined with Hepatitis A vaccination (see above).

For a full discussion of this issue and its relevance to GPs see the BMA guidance document “Focus on travel immunisation”.

Tariff Tip written by Sue Swift, UK Drug Tariff and Information Technician