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Immunizations - travel vaccinations - Management
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Definition
- Tick-borne encephalitis is caused by a flavivirus and is usually spread by tick bites, although unpasteurized milk is also thought to be a source of the disease. There are three forms of the disease related to the virus subtypes, namely European, Far Eastern, and Siberian.
When is tick-borne encephalitis vaccine indicated?
- Give tick-borne encephalitis vaccine to anyone who:
- Intends to live in tick-borne encephalitis-endemic areas.
- Is at occupational risk in endemic areas (e.g. farmers, forestry workers, soldiers).
- Intends to travel to rural endemic areas during late spring and summer (e.g. campers, hikers, Scout or Guide groups).
In depth
What types of tick-borne encephalitis vaccines are available?
- One inactivated vaccine for tick-borne encephalitis is available in the UK: Ticovac®.
In depth
What schedule is used for tick-borne encephalitis vaccine?
- Maximum immunity is achieved 1 week after the second dose.
Table 1. Schedule for immunization with tick-borne encephalitis vaccine.
Vaccine | Schedule | Length of protection | Age range |
|---|
TicoVac® | 3 doses: on day 0, 1–3 months later, and then 5–12 months after the second dose. | First booster no 3more than 3 years after third dose. After this, boosters may be given at 3–5 year intervals if at risk.* | Over 16 years. |
TicoVac Junior® | 3 doses: on day 0, 1–3 months later, and then 5–12 months after the second dose. | First booster no more than 3 years after third dose. After this, boosters may be given at 3–5 year intervals if at risk. | Over 1 year of age and below 16 years. |
* In those aged > 60 years, booster intervals should not exceed 3 years. |
In depth
Can I use a rapid schedule for tick-borne encephalitis vaccine?
- Two doses can be given 2 weeks apart. Of those who receive this schedule 90% achieve immunity 2 weeks after the second dose.
- The third dose should be given 5 to 12 months after the second dose, either on return or, during travel if still overseas.
In depth
What are the adverse effects of tick-borne encephalitis vaccine?
- Reported reactions to tick-borne encephalitis vaccine are rare. Local reactions such as swelling, pain and redness at the injection site may occur. Pyrexia, particularly after the first dose, can occur in children and adults, usually occurring within 12 hours of immunization and settling within 24–48 hours.
In depth
Prescriptions
Tick-borne encephalitis vaccine: primary course
Age from 1 year to 15 years 11 months
Primary course: tick-borne encephalitis vaccine (0.25ml syringes)
Tick-borne encephalitis (inactivated) vaccine suspension for injection 0.25ml pre-filled syringes
Give by intramuscular injection. For primary immunization, give 0.25ml for the first dose. Give a second dose of 0.25ml after 4-12 weeks.
Supply 1 0.25 ml prefilled syringe.
Primary course: tick-borne encephalitis vaccine (0.5ml syringes)
Tick-borne encephalitis (inactivated) vaccine suspension for injection 0.5ml pre-filled syringes
Give by intramuscular injection. For primary immunization, give 0.5ml for the first dose. Give a second dose of 0.5ml after 4-12 weeks.
Supply 1 0.5 ml prefilled syringe.
Tick-borne encephalitis vaccine: rapid schedule
Age from 16 years onwards
Tick-borne encephalitis vaccine: rapid schedule
Tick-borne encephalitis (inactivated) vaccine suspension for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection. Give two doses 2 weeks apart
Supply 1 0.5ml prefilled syringe.
Tick-borne encephalitis vaccine: booster dose
Age from 1 year to 15 years 11 months
Booster dose: tick-borne encephalitis vaccine (1 year to 15 years 11 months)
Tick-borne encephalitis (inactivated) vaccine suspension for injection 0.25ml pre-filled syringes
Give 0.25ml by intramuscular injection.
Supply 1 0.25 ml prefilled syringe.
Age from 16 years onwards
Booster dose: tick-borne encephalitis vaccine (16 years onwards)
Tick-borne encephalitis (inactivated) vaccine suspension for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection.
Supply 1 0.5ml prefilled syringe.
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