TICK-BORNE

ENCEPHALITIS
VACCINE
Travel Vaccination
 TRAINING REQUIREMENTS
Before completing this module, please ensure that you have undertaken the
following training:

General Travel PGD

Vaccination Health training
training training
• Must have undertaken training in line with the National Minimum Standards and Core Curriculum for
Immunisation Training for Registered Healthcare Practitioners. Evidence of this training must be available
and may be requested. This should be done by:
‒ Completion of face to face training in administration of vaccines
o Training should include vaccinating via different routes and at different sites depending on age of patients seen in clinic
o For further information on immunisation training intervals during the COVID-19 pandemic see Guidance on immunisation training during
the COVID-19 pandemic
‒ First aid and management of anaphylaxis training
‒ Usually included with face to face training
‒ New Vaccinators - Online clinical knowledge vaccination training and assessment (we recommend the e-Learning for
Health Immunisations module)
‒ All vaccinators - Annual knowledge-based refresher training in vaccinations
‒ Annual refresher training in anaphylaxis and BLS
‒ Completion of Clinical Services Hub module Anaphylaxis and BLS annual update
• You must also complete the Clinical Service Hub module Vaccinations - General which covers more detailed
information about training, risk management, incident reporting and delivery of vaccination services using
Clinical Service Hub PGDs and Service Hub Manager
 General Travel
PGD
Vaccination Health
training
training training

• Undertake Specific Travel Health Training. Whilst there is no mandatory framework for
Travel Health Training, Good Practice Standards for Travel Medicine have been produced the
Royal College of Physicians and Surgeons of Glasgow (RCPSG)
‒ Initial knowledge of travel medicine
o Formal training by an accredited provider is required for all health professionals offering medical advice to
travellers. You should either complete the Neva Travel Health Training, undertake training through another
accredited provider that meets the Good Practice Standards, or you can obtain a travel medicines
qualification
‒ Obtain specific travel reference sources.
o Keep up to date with changes such as disease outbreaks and world events
o You may consider regularly checking websites such as WHO, NaTHNaC and TRAVAX subscribing to travel
health mailing lists, or joining the British Global and Travel Health Association
‒ Attend regular study days to maintain personal portfolio
o It is recommended that you attend local, national or international travel health study days/sessions AT
LEAST ANNUALLY. These could be online or face to face but should be interactive sessions, not pre-
recorded information or individual learning
• Safeguarding Level 3 training if offering services to children, or level 2 if not seeing children
• FGM training (free training is available here)
 General Travel
PGD
Vaccination Health
training
training training

• Complete Clinical Services Hub SPR

‒ Travel Service and Risk Assessment Training
• Complete this training package and associated assessment
LEARNING OBJECTIVES

• Understand the inclusion and exclusion criteria

for Tick-borne encephalitis vaccine (TicoVac)
• Understand the cautions for use of TicoVac
• Review the side effects and risk profile for TicoVac
• Understand the support for self care and advice
to give patients
TicoVac®
• Inactivated adsorbed vaccine for intramuscular injection into the deltoid
or anterolateral thigh in young children
– Vaccination should be given via deep subcutaneous injection if the patient is at
increased risk of bleeding
• 2 vaccines:
– TicoVac 0.5mL
• Adults and children aged 16 years and over
– TicoVac Junior 0.25mL
• Children aged 2 years and above and below 16 years of age
• Storage:
– Original packaging
– 2˚C to 8˚C
– Do not freeze
– Vaccine should be allowed to reach room temperature before administration
• Immunisation should be completed at least 2 week prior to potential
exposure
• See Neva Travel Health Training module for video on how to prepare the
vaccine
 CONVENTIONAL SCHEDULE
• Care should be taken to ensure the correct vaccine is chosen for the
patient’s age

If continuing
5 – 12 to be at risk:
Day 0 1 – 3 months
months Every 3
years

1st dose 2nd dose 3rd dose Booster doses

• Immunity should be achieved before the beginning of the seasonal tick

activity (spring)
– First and second doses should preferably be given in the winter months
• Ideally the 3rd dose should be given within the same tick season or before
the start of the following tick season
 RAPID SCHEDULE
• Rapid schedule can be used if patient is travelling before they could complete
the conventional schedule
• Care should be taken to ensure the correct vaccine is chosen for the patient’s
age

If continuing
5 – 12 to be at risk:
Day 0 Day 14
months Every 3
years

1st dose 2nd dose 3rd dose Booster doses

– First and second doses should preferably be given in the winter months
• Ideally the 3rd dose should be given within the same tick season or before
the start of the following tick season
INCLUSIONS
• For TicoVac:
– Adults and children aged 16 years and over at risk of TBE
• For TicoVac Junior:
– Children aged 1 year and above and below 16 years of age at risk of TBE
• Patients under the age of 16 years require consent from a parent or legal guardian
and the patient must be accompanied by a parent or legal guardian during the
consultation
• Those generally considered to be at increased risk include:
– All persons living in TBE risk areas
– Those at occupational risk in risk areas: farmers, forestry workers, soldiers
– Travellers at risk of disease
– Laboratory workers who may be exposed to TBE
• Please check the country information pages on Travel Health Pro if in England, Northern Ireland or
Wales or Travax if in Scotland
• If the vaccination is for travel purposes, then a full travel risk assessment using an
approved risk assessment form must be carried out and a copy of the risk
assessment form should be kept in the pharmacy in case of audit
EXCLUSIONS
For all vaccines:
• Moderate or severe illness, with or without fever. Vaccination should be postponed until after
recovery
• A confirmed anaphylactic or hypersensitivity reaction to the active component of the vaccine,
one of the excipients listed in the SPC or production residues
• Severe hypersensitivity to egg or chick proteins (anaphylactic reaction after oral ingestion of egg
protein)
• Patients on warfarin and have an INR outside of indicated therapeutic range
• Pregnancy
• Patient has an evolving neurological condition

For TicoVac:
• Children under 16 years of age

For TicoVac Junior:

• Children under 1 year of age
• Children aged 16 years and older
CAUTIONS FOR USE
• Not to be administered intravascularly or intradermally
• Patient’s with known or suspected auto-immune disease should be
advised that the vaccine may trigger episodes of auto-immune
disease
• Individuals with an evolving neurological condition should have
vaccination deferred until the neurological condition has resolved
or stabilised
• Appropriate medical treatment and procedures should always be
readily available in case of rare anaphylactic reactions or syncope
(fainting)
• The vaccine should be given by subcutaneous injection to the
following:
– Patients with thrombocytopenia or a coagulation disorder
– Patients taking warfarin or a DOAC
SIDE EFFECTS
Any drug may produce unwanted or unexpected adverse reactions. Detection and
recording of these through the Yellow Card scheme is of vital importance.

The following are commonly reported after all intramuscular injections:

• Pain, swelling or redness at the injection site, low grade fever, malaise, shivering,
fatigue, headache, myalgia and arthralgia
• A small painless nodule (induration) at the injection site
Immediate reactions such as urticaria, angio-oedema, bronchospasm and anaphylaxis
can occur.

Common side effects with TicoVac and TicoVac Junior:

• Nausea
• Decreased appetite (children only)
• Restlessness (children only)
• Sleeping disorder (children only)
• Vomiting (children only)

Uncommon and rare side effects can be found in the SPC.

ADVICE TO PATIENTS
• Vaccination does not provide complete protection
• Avoid known heavily tick-infested areas of forest and
woodland during spring, summer and autumn where
possible
• Bite avoidance methods:
– Loose fitting clothing with long sleeves and long trousers tucked
into socks
– Use effective insect repellents (DEET based)
• Check regularly for ticks
• Remove ticks ASAP using a pair of fine tipped tweezers of
tick remover
• Avoid unpasteurised dairy products
• Seek medical advice if signs of illness occur within 28 days
of a tick bite