Vaccines recommended for most India travellers

• Hepatitis A — endemic across India, transmitted via contaminated food and water. One dose gives ~1 year cover; a booster at 6–12 months extends protection to 25+ years.
• Typhoid — widespread in India, particularly in the monsoon season (June–September). Single dose, lasts 3 years.
• Tetanus, Diphtheria, Polio — boost if your last was more than 10 years ago. Usually given as a combined Td/IPV jab.
• MMR — India has had measles outbreaks recently. If you weren't fully MMR-vaccinated as a child, catch up.

Vaccines recommended for some travellers

• Hepatitis B — strongly recommended for longer stays (1 month+), anyone getting medical or dental treatment in India, students, healthcare workers, and any traveller with sexual contact with new partners. Three-dose schedule.
• Rabies (pre-exposure) — strongly recommended for trips outside major cities, anyone working with animals, children, and stays over 1 month. India has one of the highest rabies death rates globally — about 20,000 deaths a year.
• Japanese Encephalitis — for rural travel during transmission season (May–October), particularly West Bengal, Assam, eastern UP, Bihar, Andhra Pradesh. Two doses 28 days apart.
• Cholera — for aid workers, those staying with locals in rural areas, or in active outbreak zones.
• Influenza — for travel during local flu season (October–February).

Malaria in India — what to know

Malaria risk in India is significant but variable:

• Higher risk areas: Odisha, Chhattisgarh, Jharkhand, parts of Andhra Pradesh, Madhya Pradesh, Maharashtra, parts of the north-east.
• Lower risk areas: Most major cities (Mumbai, Delhi, Bangalore, Chennai, Kolkata cores). Mountain areas above 2,000m.
• Year-round transmission in most risk areas, with peaks during and after monsoon.
• Both P. vivax and P. falciparum present.

Antimalarials are usually recommended for rural travel and longer stays. The free consultation at Preston Clinic covers your specific itinerary — we generally recommend Malarone (atovaquone-proguanil) for short trips or Doxycycline for longer ones. Both prescribed and dispensed same-visit.

Dengue fever — increasingly common

Dengue is widespread across urban India, particularly during and after monsoon. Cases have risen sharply in 2024-25 in Delhi, Mumbai, and many southern cities. There's a vaccine (Qdenga) available privately in the UK for travellers — eligibility depends on prior dengue exposure and age. We can discuss at your consultation.

For most travellers, prevention focuses on mosquito-bite avoidance: DEET-based repellents (30%+), long sleeves at dusk and dawn (Aedes mosquitoes are day-biters), and air-conditioned or well-screened accommodation.

Food and water safety

Travellers' diarrhoea ('Delhi belly') is the most common illness affecting visitors to India. Practical prevention:

• Water: Bottled only (check the seal). No tap water, no ice (unless from a known safe source), no fountain drinks.
• Food: Hot, freshly cooked. Avoid buffets that have been sitting out. Avoid salads, raw vegetables, pre-cut fruit.
• Street food: The 'if it's hot off the heat right in front of you, it's probably fine' rule generally works. Avoid lukewarm or sitting-out food.
• Dairy: Pasteurisation isn't consistent. Stick to well-known commercial brands.

We supply oral rehydration sachets and short-course antibiotic options (azithromycin) for traveller's diarrhoea on request — useful to have in your travel kit just in case.

VFR (Visiting Friends and Relatives) travel — extra considerations

Travellers visiting family in India often underestimate health risks because 'I've been before and was fine'. Important context:

• Local immunity in family members doesn't mean you have it
• VFR travellers eat more local food, drink local water, and stay in domestic accommodation — higher exposure than tourist-bubble travel
• Family doesn't know what specific vaccines you've had as a UK resident
• Children visiting Indian grandparents are at particular risk because they want to play with stray animals (rabies) and eat anything (food/water)

If you're a VFR traveller, take the consultation seriously regardless of what family say.

Altitude considerations for Himalayan trips

If you're heading to Ladakh, parts of Himachal, Uttarakhand, Sikkim or any trek above 2,500m, altitude sickness is a separate consideration from vaccines. We can prescribe acetazolamide (Diamox) prophylactically and give written guidance on acclimatisation.