Guidance

Infectious Diseases Vaccinations (non travel)

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Introduction

Vaccines and immunisations which are required in the case of a localised outbreak

Introduction

The only instances where vaccination and immunisation is required in respect of the diseases listed below, to persons who do not intend to travel abroad, are set out in General Medical Services Statement of Financial Entitlements Directions 2026

Anthrax

Four doses of the vaccine (plus an annual reinforcing dose) are to be offered to persons who are exposed to an identifiable risk of contracting anthrax. Those who are exposed to an identifiable risk will mainly be those persons who come into contact with imported animal products that could be contaminated with anthrax.

Hepatitis A

(a) A course of immunisation is to be offered to persons who are resident

1. in residential care; or
2. in an educational establishment, who risk exposure to infection and for whom immunisation is recommended by the local Director of Public Health.

(b) The number of doses of vaccine required will be dependent upon the chosen vaccine and should be sufficient to provide satisfactory long-term protection against the disease.

Paratyphoid

No vaccine currently exists for the immunisation of paratyphoid.

Rabies (pre-exposure)

(a) Three doses of Rabies vaccine are to be offered to the following persons:

1. laboratory workers handling rabies virus;
2. bat-handlers;
3. persons who regularly handle imported animals, for example, those:

(aa) at animal quarantine stations;

(bb) at zoos;

(cc) at animal research centres and acclimatization centres;

(dd) at ports where contact with imported animals occurs and this may include certain HM Revenue and Custom Officers;

(ee) persons carrying agents of imported animals; and

(ff) who are veterinary or technical staff in animal health.

      (iv) animal control and wildlife workers who regularly travel in rabies enzootic areas; and

      (v) health workers who are at risk of direct exposure to body fluids or tissue from a patient with confirmed or probable rabies.

(b) Reinforcing doses are to be provided at recommended intervals to those at continuing risk.  See Immunisation against infectious diseases – The Green Book.

Typhoid

1. a) a course of typhoid vaccine is to be offered to the following persons:

I. hospital doctors, nurses and other staff likely to come into contact with cases of typhoid; and

II. laboratory staff likely to handle material contaminated with typhoid organisms.

The number of doses (including reinforcing doses) required will be dependent on the chosen vaccine and is to be offered so as to provide satisfactory protection against the disease.

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Vaccines and immunisations which are required in the case of a localised outbreak

The General Medical Services Statement of Financial Entitlements Directions 2026 advises:

“In the event of a localised outbreak of any of the diseases listed in paragraph 8, NHS England must consider its response to that localised outbreak and contractors must offer and provide vaccines and immunisations in accordance with any directions given by NHS England in response to the outbreak, and those directions may make recommendations as to additional categories of persons who should be offered immunisation.

The diseases referred to in paragraph 7 are—

(a) Anthrax;

(b) Diphtheria;

(c) Meningococcal Group C or MenACWY as appropriate;

(d) Poliomyelitis;

(e) Rabies;

(f) Tetanus; and

(g) Typhoid.

Contractors who offer and provide vaccines and immunisations in respect of the diseases mentioned in paragraph 8 must have regard to the guidance and information on vaccines and immunisations procedures set out in “Immunisation against infectious diseases – The Green Book” which is published by the Department of Health.

Contractors who offer immunisation in the circumstances set out in paragraph 7, are not required, by virtue of this Section, to carry out a contact tracing or trace back exercise.”

The vaccines and immunisations set out above are paid under the Global Sum Payment provisions (Part 1 of the SFE) and are not eligible for an item of service (IoS) fee.

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