Three diseases that have nothing in common except the needle
Tetanus comes out of soil and animal manure, through a cut or a puncture wound, and causes the muscle spasms that gave it the name lockjaw. It is not passed between people, so it does not matter how well vaccinated the country is - only how well vaccinated you are.
Diphtheria spreads person to person in droplets and coats the throat with a membrane that can close the airway. It reappears wherever vaccination coverage drops.
Polio is swallowed - food or water contaminated with faeces - and in a small proportion of cases paralyses permanently. It has been pushed back to a handful of countries, and keeping it there depends on travellers not carrying it back out.
Why we check this one first
Most people who were vaccinated as children in the UK had their last dose at around fourteen. If you are older than twenty-four, that cover has run out or is about to, and almost nobody has it in their diary.
So this is the first thing we look at in a travel consultation, before anything exotic. It is one injection, it is among the cheapest things on our list, and it covers the risk that is actually most likely to find you - standing on something sharp a long way from a hospital.
What we need from you
Any vaccination record you can lay hands on, even a partial one. A red book, a GP printout, a photograph of a card from another country - all of it helps.
If nothing exists, that is workable. Someone with no reliable history is treated as unvaccinated and offered a three-dose primary course rather than a single booster, and we will set out what that costs before you commit to it.

