£350 jabs bill required a cash injection

It's vital to budget for vaccinations when you first plan your trip, says Natalie Graham

When my daughter went to visit a friend in Botswana she had not reckoned on a £350 bill for travel jabs before she even left home. The cost was a hefty blow, just weeks before her flight.

Ideally, seek advice on immunisation at the time of planning your overseas trip, so you can space out the injections and the cost. Don't leave it to the last minute and have multiple jabs very close together.

Dr John Knottenbelt, medical director of a walk-in medical centre in Finchley, north London, advises: 'You may end up spending £300 or £400 on injections but they could save your life, and the cost is a lot less than being evacuated home.'

First contact your doctor's surgery to find out which injections you need. You will not have to pay for updating cover against polio, diphtheria, tetanus, typhoid, and hepatitis A.

You pay a consultation fee if you go to a travel clinic in a health centre where you are not registered, but you don't pay for NHS injections.

Be sure you get proper advice, and discuss your particular needs. Risk assessment is the most important thing.

You will have to pay for immunisation against rabies, yellow fever, hepatitis B, malaria and meningitis A, C, W and Y.

The rabies vaccine costs £45.90 per dose and you need three doses, usually within a month. Immunisation after a bite from a rabid animal is not to be recommended. Immunity lasts for three years.

Yellow fever requires a designated yellow fever centre because the vaccines have short expiry dates and require special storage conditions. Yellow fever requires one jab, which costs around £50, and provides immunisation for 10 years.

Any gap-year student living with local people should have hepatitis B injections. The three doses (£25.50 each) are given over six months. Immunity lasts up to five years.

For malaria most people opt for Malarone - although what you take is also dependent on where you're travelling, so ask your doctor for advice. It is probably the most generally applicable, though the cost is high (£43.12 for 12 tablets). You only need to start it one day before going into the area, and you carry on for one week after coming back, which is highly convenient.

Doxycycline (£24.35 for 50 tablets) is not always suitable to combat malaria if you are going into tropical heat because it is sun-sensitive. It can also make oral contraceptive pills less effective. You take these two days before you go away and continue for four weeks after leaving a malarial area.

The third anti-malaria drug is Mefloquine, also known as Lariam (£32.67 for packet of eight). You take just one tablet a week instead of one a day and carry on for four to six weeks after leaving the area. But anyone with clinical depression, psychoses or epilepsy must not use this drug.

Immunisation against meningitis A, C, W and Y, costs £33.90, and covers you for three to five years. To find out where new outbreaks of the disease have occurred, a few weeks before you travel check NHS website, www.fitfortravel.scot.nhs.uk If it does not answer all your questions on immunisation guidelines, try www.doctortoday.co.uk

· Cost of injections based on those from a travel clinic in Twickenham, London.

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