Tick-borne Encephalitis (TBE) Vaccination

A viral infectious disease affecting the central nervous system that is transmitted through the bites of infected ticks which are commonly found in certain regions of Europe and Asia.

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Peak transmission is in early spring and summer, but can occur all year around. The ticks are found in forested and rural areas. The infection can also be acquired through drinking unpasteurised milk, especially goats milk.


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Transmission

Transmission occurs through the bite of an infected tick. Peak transmission is in early spring and summer, but can occur all year around. The ticks are found in forested and rural areas. The infection can also be acquired through drinking unpasteurised milk, especially goats milk.

What are the symptoms of TBE?

Symptoms can include fever, headache, fatigue, muscle pain, and in more severe cases, meningitis or encephalitis. The incubation period for the disease is between 2-28 days. The symptoms and severity depend on the infecting strain. There are three strains; European, Far Eastern and Siberian.

The symptoms of the European strain include-flu like illness with high fever. 30% develop signs and symptoms of meningitis and encephalitis with persisting neurological complications in 10-20%. The death rate from the European strain is around 1%.

The Far Eastern strain gives a more severe and prolonged illness with a mortality rate ranging between 5-20%.

Treatment

There is no specific treatment against Tick-borne encephalitis.

Prevention

There is a safe and effective vaccine against Tick-borne encephalitis. Additional measures include wearing covered footwear and long trousers and checking regularly for ticks after carrying out any outdoor activities in forested areas, such as hiking, camping or fishing.

The tick-borne encephalitis vaccine is between 98-99% effective against the European strains and is also thought to be as effective against other strains. It is an inactivated vaccine containing dead virus.

Can children have the TBE vaccine?

The vaccine can be given to anyone over the age of 1 year who is at risk of Tick-borne encephalitis due to:

  • Travel to endemic region during tick season (spring to early Autumn mainly) and involvement in outdoor activities.
  • Going to live in an endemic country.

Alternative Schedule – For Both Children and Adults

If there is insufficient time prior to travel to complete all three doses, a rapid schedule can be used. The schedule for this is:

  • Dose 1-day 0
  • Dose 2-14 days after 1st dose
  • Dose 3-5 to 12 months after 2nd dose.

Booster doses

For those at continuing risk, a booster dose is recommended at 3 to 5 yearly intervals.

Common and rare side effects of the TBE vaccine

Common side effects include pain and swelling at the injection site, fever, and headache. Rare side effects can include more serious allergic reactions.

The TBE vaccine is recommended for travellers to areas where TBE is common, particularly in parts of Central, Eastern, and Northern Europe, Russia, and parts of East and Southeast Asia. It’s also advised for people engaging in activities like hiking and camping in forested areas of TBE-endemic regions.

The protection offered by the TBE vaccine typically lasts for about 3 years. After completing the initial series, a booster dose is required for continued immunity.

A TBE booster is generally recommended every 3 to 5 years for those who continue to be at risk through travel or outdoor activities in endemic areas.

High-risk areas for TBE include forested regions of countries like Austria, the Baltic States, Czech Republic, Germany, Hungary, Poland, Russia, Northern China, and Japan.

The cost of a TBE vaccination is £74 per dose, 3 required. Initially, there is an additional base fee of £20 which covers time spent with one of our specially trained healthcare professionals who will carry out a risk assessment.

The TBE vaccine is usually not available for free on the NHS for travel purposes but may be obtained privately.

The vaccine can not be given to individuals with:

  • A history of severe allergic reaction to a previous dose of the vaccine or any of it’s components
  • A history of severe allergic reaction to egg
  • Acute illness associated with high fever (greater than 38.5 degrees Celsius).
  • Unstable neurological conditions, such as poorly controlled epilepsy.

Pregnancy

There is no specific data on the use of Tick-borne encephalitis vaccine in pregnant women. However, the evidence for inactivated vaccines in general do not show any harm to either the mother or foetus from receiving these types of vaccines. Therefore, the vaccine can be administered to pregnant women following a full clinical assessment if the risk of infection is considered to be high.

Breast Feeding

It is not known if the vaccine is excreted in breast milk. However, the evidence for inactivated vaccines in general do not show any harm to the infant from vaccinating breast feeding mothers. Therefore, the vaccine can be administered to breast feeding mothers if the risk of infection is considered to be high.

Common Side Effects

Injection site reactions-pain, swelling and redness.

Fever, nausea, headache and muscle ache can also occur, but are not as common.

How does TBE Interact with other vaccines?

There are no interactions with other vaccines and it can be given at the same time as other travel or childhood vaccines.

1) Is the vaccine safe?

The vaccine has been extensively studied during trails for safety and also post marketing following release of the vaccine. There have been rare cases of seizures associated with high fever following the vaccine. The fever following the vaccine tends to occur in the first 12 hours and resolves after 1-2 days.

2) What does the vaccine contain?

  • Human albumin
  • Sodium chloride
  • Disodium phosphate-dihydrate
  • Potassium dihydrogenphosphate
  • Water for injections
  • Sucrose
  • Aluminium hydroxide, hydrated
  • Chick protein (egg)
  • Trace amounts of latex are found in the vaccine packaging
  • Trace amounts of Neomycin and gentamicin (antibiotics)and formaldehyde (a preservative) may be found in the vaccine.

The vaccine does not contain Thiomersal or Gelatin.

3) How effective is the rapid schedule?

Two doses of the vaccine given 14 days apart provides around 90% protection. Therefore, two doses can be administered in travellers who do not have sufficient time before exposure for the conventional schedule. It is important that precautions are taken to prevent bites.

Written by Travel Health and Vaccination Lead Derek Evans

Edited on 03-11-2023
Next edit on 26-11-2024

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