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Vaccinations for Nepal

Unless you are entering Katmandu from tropical Africa there are no legally required vaccinations for Nepal for entry or exit. We used to receive reports of buses being stopped coming overland from India and for all on board to have evidence of Cholera vaccination. However, this does not appear to be a current problem.

Nevertheless, for your own personal health it is strongly recommended that travellers are covered against the following diseases; Poliomyelitis (childhood booster), Tetanus (childhood booster), Typhoid (food and water borne disease) and Hepatitis A (food and water borne disease). For those undertaking a longer more rural trip to Nepal other vaccinations may need to be considered including Hepatitis B, Rabies, Japanese B and Meningitis.

Short-term travellers to Nepal should book their initial consultation for vaccinations at least 4 – 6 weeks in advance of their trip. However, those camping or trekking may wish to consider attending earlier.

The main risk of Malaria in Nepal will be for those visiting the Terai region. Even here, the significant risk occurs during the monsoon season and for a period afterwards. However, Malaria transmission is reported from other regions of the country and this will need to be talked through in depth before you leave home and the Doctor may recommend Malaria Prophylaxis.

Apart from Malaria there are two other significant mosquito borne diseases that occur in regions of Nepal. Dengue Fever and Japanese B Encephalitis are both frequently implicated in outbreaks and both diseases can cause severe illness even death. Avoiding mosquito and sand-fly bites at all times is essential.

Please always remember each traveller will require an itinerary specific consultation and this information only contains general guidelines.

All Travellers

Poliomyelitis
Poliomyelitis is a viral disease transmitted through oral/faecal contamination and the respiratory route. The vaccine is combined with cover against Tetanus and Diphtheria. Most travellers who have completed their primary course of childhood vaccines will only require a single booster dose to provide cover. Once completed it is expected that cover should last for 10 years.
Tetanus
Tetanus is contracted through contaminated cuts, bites and breaks in the skin. The vaccination provides cover for approximately 10 years in the majority of patients. It is frequently combined with cover against other diseases such as Poliomyelitis, Diphtheria and/or Pertussis.
Hepatitis A
Hepatitis A is a common disease in many of the hotter regions of the world and usually contracted through contaminated food and water. Cover against Hepatitis A can be given alone or combined with protection against Typhoid or Hepatitis B. Once completed, the Hepatitis A vaccination (given on two occasions 6 to 12 months apart) provides cover for approximately 25 years in the majority of patients.
Typhoid
Typhoid is a bacterial disease contracted through contaminated food and water. This vaccine can be combined with cover against Hepatitis A. Once completed, the Typhoid vaccination given on one occasion provides cover for between 2 to 3 years in the majority of patients

Optional

Hepatitis B
Hepatitis B is a viral disease which is usually transmitted in a very similar fashion to HIV/AIDS through contact with infected body fluids (eg blood exposure and sexually). This vaccine can be combined with cover against Hepatitis A. The standard schedule for Hepatitis B is to administer the vaccine on days 0, 28 and 180. A more rapid schedule can be used in cases where cover is needed more urgently and this is administered on days 0, 7, 21 to 28 and also 365. Following either course (and not before completion) a blood test can be taken to confirm sufficient antibody protection. Where the correct level of antibodies are showing (>100iu) the vaccination is recognised to provide cover for life.
Rabies
Rabies is a viral disease which is usually transmitted through the bite, the lick or the scratch of any infected warm blooded animal. The vaccine is usually administered on days 0, 7 and between 21 to 28. A final 4th vaccine is administered about 1 year later. Once a course is completed, the vaccination provides life long 'immune memory' in the majority of patients BUT after any possible exposure the individual always needs further vaccination to boost antibody production
Meningococcal Meningitis
Meningococcal Meningitis is a bacterial disease which is usually transmitted through the respiratory route. The vaccine is given on one occasion and provides cover against four of the main forms of this disease. Once a course is completed the vaccination provides for over 5 years in the majority of patients.
Cholera
Cholera / E coli are both food / water borne diseases. This oral vaccine is given on two occasions between 1 to 6 weeks apart before travel. The second dose (frequently given one week after the initial one) should be administered 7 days before potential exposure. Once completed the cover against Cholera is expected to be for about 2 years. The cover against E coli is shorter and thought to be effective for between 3 to 4 months. In travellers who have completed an initial primary course within the past 2 years a single further dose is sufficient to maintain this cover.
Japanese Encephalitis
Japanese Encephalitis is a viral disease transmitted through the bite of an infected mosquito. The Ixiaro vaccine is given on two occasions one month apart with a third dose at 12 months. Once completed the vaccine is thought to provide cover for between 2 to 3 years but possibly longer.

Country Profile

Find out more about the health risks you should be aware of when travelling in Nepal by reading the DFA Nepal country information page
or the WHO Nepal country information page.