Pakistan travel health — vaccines, polio, and what you actually need

The realistic vaccine list

For most adults travelling to Pakistan from the UK, the vaccine and prep list looks like this:

• Hepatitis A. Strongly recommended for almost all travellers. Single-dose protection lasts around 12 months; a booster at 6–12 months gives long-term protection.
• Typhoid. Strongly recommended for almost all travellers, particularly given the XDR typhoid situation. Single dose is effective.
• Polio. A booster is recommended for stays of 4 weeks or more, and sensible for shorter trips if your routine status is out of date. See the polio section below.
• Hepatitis B. Recommended for stays of 4 weeks or more, anyone in healthcare roles, anyone with a chronic condition needing potential local medical care, and for many VFR trips.
• Diphtheria, tetanus, polio (combined booster). If your routine status is out of date (more than 10 years since last booster), refresh.
• Influenza. Seasonal flu vaccination if your trip overlaps with flu season.
• Rabies. Pre-exposure rabies vaccination is worth considering for stays in rural areas, working with animals, long stays, or where post-exposure care would be difficult to access. It's a 3-dose course; budget time accordingly.
• Cholera. Risk-based — not usually required for short trips to major cities, more relevant for stays in flood-affected or post-disaster areas or for healthcare workers.
• Yellow fever. Not required for Pakistan itself, but if you're transiting through or coming from a yellow fever country, you may need a certificate to enter Pakistan. Check the current Saudi/Pakistan transit requirements.
• Routine UK schedule up to date. MMR, especially, is worth confirming.

The polio situation in 2026

Pakistan is one of the last two countries in the world with ongoing wild poliovirus transmission. The WHO continues to monitor and update guidance for travellers.

The practical implications:

• For stays of 4 weeks or more, the WHO recommends polio vaccination at least 4 weeks before departure. An IPV booster (single dose) is the usual UK approach.
• For stays of more than 4 weeks, the WHO recommends an additional dose of polio vaccine 4–12 months before any onward international travel — and some travellers may need an exit polio vaccination certificate to leave Pakistan. This is fluid and we check the current status at the consultation.
• For shorter trips, a polio booster is still sensible if your routine UK status is out of date (it tends to be — the last routine UK booster is usually around age 14).
• Combined Td/IPV vaccine is the standard UK option for adults due a booster.

Don't skip this conversation — polio is rare globally but the entire point of vaccinating travellers to endemic countries is to keep it that way.

Food, water, and the gut

Traveller's diarrhoea is the single most common complaint among returning Pakistan travellers, and the most preventable. The basics still apply:

• Bottled or properly filtered water for drinking, including for brushing teeth.
• Avoid ice unless you're confident about the water source.
• Hot, freshly cooked food. Avoid food sitting at ambient temperature for long periods.
• Fruit you peel yourself.
• Be cautious with unpasteurised dairy.
• Salads and raw vegetables are higher-risk — think about who washed them and in what.

VFR trips often relax these defaults because the food is home-cooked by family. That's reasonable in many cases, but worth being thoughtful about, especially in the first few days as your gut adapts.

It's also worth carrying oral rehydration salts (ORS) for any diarrhoea episodes, and discussing whether a stand-by antibiotic for traveller's diarrhoea is appropriate for your trip (it depends on length, region, and your medical history).

Air quality — a 2026 concern

Air quality in major Pakistani cities, particularly Lahore, has become a meaningful health concern. Winter air quality (November–February) regularly reaches hazardous levels (AQI 300+), with smog driving up rates of respiratory illness, eye irritation, and asthma exacerbations.

If you're travelling in the smog season:

• Pack any usual asthma or COPD medication in adequate quantity and check inhaler technique before you go.
• Consider taking a well-fitting N95/FFP2 mask for use outdoors on bad days.
• Plan to limit outdoor exposure on the worst-AQI days; check AQI apps in real time.
• If you have a heart or lung condition, talk to your usual clinician before travel about whether the timing is appropriate.

Mosquito-borne disease and bite prevention

Dengue (daytime-biting) and malaria (dusk/night-biting in malarial areas) are both relevant. Bite prevention covers both:

• DEET-based repellent (20–50%) on exposed skin, reapplied as instructed.
• Long sleeves and trousers at dawn, dusk, and at night.
• Treated bednets for rural stays without screened/air-conditioned accommodation.
• Air-conditioned or well-screened rooms where possible.

If you're staying in a malarial area, chemoprophylaxis (preventive tablets) may be appropriate. The drug, dose, and start/stop timing depend on region and personal factors — set in your consultation.

Heat and hydration

Summer temperatures in much of Pakistan are extreme, with regular heatwaves above 45°C. Practical points:

• Hydrate proactively, not reactively. Carry water with you on outings.
• Avoid the hottest part of the day (typically 11am–3pm) for outdoor activity where possible.
• Light, loose clothing; hat; sunscreen.
• Recognise signs of heat exhaustion early (heavy sweating, weakness, headache, nausea) and move to a cool environment, hydrate, rest.
• Heatstroke is a medical emergency (very high body temperature, confusion, no sweating despite heat).

Chronic conditions and regular medication

If you take regular medication, bring enough for the full trip plus at least a week's buffer, in original packaging, with a copy of your repeat prescription. Some medications are difficult or impossible to source locally. Insulin, biologics, and refrigerated medicines need specific travel planning.

If you have a chronic condition that might need acute care abroad (cardiac, severe respiratory, brittle diabetes, anything immunosuppressive), check your travel insurance covers it adequately and that your destination has accessible care if needed.

The next step

The most useful single step is a travel health consultation 6–8 weeks before you fly — longer if you need a multi-dose vaccine course like hepatitis B or rabies. Bring your passport, any previous vaccination records, a rough itinerary (which cities, urban vs rural, length of stay), and a list of any current medications. We'll work through the realistic vaccine list, sort the polio booster, and cover the non-vaccine prep that often makes the biggest practical difference.