Note: Just like advice for prevention of malaria, there are many conflicting issues regarding vaccinations from nation to nation. We have followed the Atlanta based Centres for Disease Control, The Health Protection Agency of the UK and The Ontario based International Association for Medical Assistance to Travellers and our own experience in making these recommendations. Talk to us at the Travel And Mountain Medicine Center if you have questions.

One Intramuscular injection booster needed every 10 years. COMMENTS: The combined vaccine is preferred in all instances. Diphtheria is not uncommon in Nepal. Tetanus is significantly more common in the Terai region of Nepal than in Kathmandu.

For previously immunised adults entering an area where polio is endemic one oral booster gives life long immunity. Injections are not available. COMMENTS: The risk of naturally acquired polio outweighs the risk of oral vaccine induced polio. However, in some one who is immune compromised (cancer, removal of spleen) oral polio booster should not be given. Injectable POLIO vaccine is NOT available.

The “shot” to prevent Hepatitis A would be at the top of the list of “must take” vaccines for Nepal. Depending on the vaccine strength may require 2 vaccinations. Vaccination is very effective and provides life long immunity.

Three doses on day 0,7 and 28 for the mouse brain vaccine. Booster every two year. Ixiaro ( non mouse brain vaccine) is given on day 0 and 28 only. COMMENTS: Japanese B Encephalitis found in the Terai region of Nepal. Disease also prevalent in Kathmandu. Good idea to take this if staying in Nepal more than a month.

Injection: 1 injection is good for 3 years Oral: 3 doses on day 1,3 and 5. COMMENTS: Common cause of fever in Nepal is typhoid. Sometimes the parenteral (injection) kind causes fever, chills and soreness in the injection site although this newer TYPHIM vi (typhoid vaccine) does this less often. Aspirin or Paracetamol may help significantly. Efficacy rate: about 70%. Oral vaccine as good as parenteral with obviously fewer side effects but oral vaccine needs refrigeration and 2 to 3 doses are required.

Single dose, good for 2 years. COMMENTS: Pain at injection site. There is antibiotic treatment for meningococcal meningitis but it may also be rapidly fatal. Although CDC took this out from the list of vaccine for Nepal for tourist, we still recommend this because it is endemic here. We do not know of the presence if any of Y and W-135 types of the bacteria here.

  • Rabies is an important problem in Nepal and preexposure vaccinations can be very useful for visits over 1 month. There is no cure for rabies. PRE EXPOSURE (i.e. before a bite): Intramuscular, 3 injection on day 0,7 and day 28. Then, booster after 1 year, then every 3-year. COMMENTS: Pre exposure “shots” eliminates needs for rabies immune globulin (serum) in the event of a bite by a rabid animal (e.g. dog or monkey-at the ‘Monkey Temple’). (The rabies immune globulin is very expensive. It may easily cost US$ 800-1000). In addition, fewer post exposure vaccines required after pre exposure vaccinations taken. POSTEXPOSURE (i.e. after a bite): If pre-exposure shots are not taken: 4 Intramuscular injections of human diploid cell vaccine over 14 days in addition to human rabies immune globulin serum in most cases. If pre-exposure shots are taken : additional rabies vaccine to be administered on day 0 and day 3. COMMENTS: Please note the difference between rabies immune globulin (serum) which is ready made antibodies (passive immunization) and the Vero Rab / Rabipur vaccine which stimulates antibody production in your body and may take about eight to ten days for the vaccine to produce immunoglobulin.

Injections in day 0, after 1 month and after 6 months. Gives good immunity. COMMENTS: Recommended for health workers who come in contact with blood and body fluids. Hepatitis B infection can cause long-term liver complications. In America now given to newborns, with other standard vaccines. Vaccination is very effective.

Not recommended. COMMENTS: Very low efficacy of the vaccine. Foreigners hardly ever get cholera in Nepal. The disease is treatable with fluids and electrolyte. This vaccine has been dropped by the WHO in 1988. However, because poorly informed border officials may argue about this may be prudent for travellers to have a validated cholera certificate.

Primary Vaccination: Two dosages of MMR at least one month apart. COMMENTS: Measles and mumps are commonly seen in Nepal. If not vaccinated previously this is recommended for Nepal. However, rubella vaccine should not be given to women planning to be pregnant at least within the next three months.

Make sure you had all your primary vaccines like DPT as these disease like diphtheria are manyfold more prevalent in Nepal than in the west.

This vaccine is recommended to all travellers and it is available in the clinic. Time to take Influenza vaccine is best between October and November but it can be taken from October (present year) to April (next year)

This vaccine is beneficial to travellers over 50 years.

If you have not had chickenpox as a child, it is a very good idea to take this vaccine if living or travelling to South Asia. Two doses of varicella-containing vaccine are now recommended for all susceptible person older than one year without contraindication.

0.5 ml given sub cutaneously. Vaccine good for 10 years.It is available in the clinic COMMENTS: Yellow fever is limited to Africa, South America. A live virus vaccine, it is contraindicated in immunecompromised travellers or infants < 6 months. Relative contraindication in people > 60 years. Yellow fever is the only WHO required vaccine for entry into certain countries

Effective vaccine to avoid post herpetic neuralgia for people > 60 years. Not available in the clinic.