The Ultimate Caribbean Travel Guide: 5 Things a Liverpool Pharmacist Wants You to Know Before You Fly

**1. Hepatitis A and typhoid come down to your itinerary, not to the island's name.**

Both are spread through contaminated food and water, and the thing that moves them up or down is not which island you've chosen but how you'll be living on it. Hepatitis A is the one we advise most often across the region, and it's a sensible thing to have for travel to the Dominican Republic, Jamaica, Cuba and Haiti, and for anyone eating outside a resort anywhere in the islands. It's a single dose that works quickly, with a booster 6-12 months later that takes you to around 25 years - so for anyone who travels regularly it's a once-in-a-lifetime job rather than a recurring cost.

Typhoid is more selective. It comes into play for longer stays, for the Dominican Republic, Haiti and rural Jamaica, and above all for people visiting friends and relatives, who eat in homes and neighbourhoods rather than hotels and consistently have higher exposure than tourists do. For a seven-night all-inclusive in Barbados or St Lucia with a couple of organised excursions, typhoid is frequently not indicated, and we will say so.

Before you assume you need either, check your records. A lot of people were vaccinated for a previous trip and have simply forgotten - hepatitis A in particular may still be covering you years later.

**2. Dengue is the infection you are most likely to actually meet, and there is no tablet for it.**

This is the part of Caribbean travel health that deserves more attention than it gets. Dengue is present across the region and moves in cycles, with outbreaks in different islands in different years and cases generally rising through the wetter months from around June to November. It causes a nasty febrile illness, and while most people recover, a minority become seriously unwell.

The practical thing to understand is that the mosquito which carries dengue - and chikungunya, and Zika - bites during the day, with peaks in the morning and late afternoon. So the standard holiday habit of putting repellent on at dusk protects you against the wrong insect. Use a repellent containing 50% DEET from the morning onwards, reapply after swimming, use air conditioning or screens, and be particularly deliberate on days out inland or in towns.

There is a dengue vaccine licensed in the UK, but it is not a routine recommendation for a Caribbean holiday. It is a considered decision, weighted heavily by whether you have had dengue before and by how long and how often you will be in dengue areas - anyone presenting it as a standard Caribbean vaccine is overselling it. If you develop a fever while you're there or in the two weeks after you get home, seek medical advice and say where you've been, and tell the clinician before taking any anti-inflammatory painkillers.

**3. Zika is quiet in the headlines but still matters if you're pregnant or planning to be.**

There is nothing to vaccinate against here, which is precisely why it gets skipped - and it is one of the few things about a Caribbean trip that can genuinely change your plans rather than your shopping list.

Zika transmission continues at low levels in parts of the region. For most travellers it is a mild illness or none at all. In pregnancy it can seriously affect the developing baby, so UK guidance advises against non-essential travel to risk areas while pregnant, recommends condom use during and after travel, and sets out a waiting period before trying to conceive - a couple of months for women and longer for men. Those intervals and the list of risk areas are reviewed, so we'll check the current position for your specific islands and dates at the appointment.

If you're pregnant, trying, or your partner is, tell us at the start of the consultation rather than the end. It changes the conversation more than anything else on this page.

**4. Yellow fever in the Caribbean is a paperwork question, not a disease question.**

There is no yellow fever transmission in the Caribbean islands. What several of them do have is an entry requirement for an international certificate from travellers who are arriving from, or who have recently transited, a country with yellow fever risk - much of tropical South America and sub-Saharan Africa. The thresholds are set island by island, some count an airport transit beyond a set number of hours, and the details change.

So the trigger is your route in the days before you arrive, not the island itself. If you're flying Liverpool or Manchester to the Caribbean and back, this almost never applies to you. If you're combining the islands with Brazil, Guyana, Colombia, Venezuela or a West African leg, or if a repositioning cruise has called somewhere on that list, it very much can.

To be clear about what we do and don't do: yellow fever vaccine and the international certificate can only be given at a NaTHNaC-designated Yellow Fever Vaccination Centre. We will tell you if your route needs one and point you to the official register at nathnacyfzone.org.uk/find-a-centre. Requirements change, so we check your exact route, in order, with dates, at the appointment.

**5. Cruise itineraries are their own case, and that's more of a Liverpool problem than most cities have.**

With a cruise terminal in the city, we regularly see people sailing from Liverpool or flying out to join a ship, and a multi-island itinerary needs handling differently from a single-destination trip.

The governing principle is that the strictest requirement anywhere on your itinerary effectively applies to the whole trip. One port with a yellow fever certificate rule triggered by an earlier call sets the standard for everyone on board, and cruise lines enforce this themselves - they can and do refuse boarding on documentation grounds, because they carry the cost of a refused landing. Bring the full port list in the order you'll visit, not just the headline destinations.

Against that, shore time genuinely does lower some risks: a few hours in port with lunch back on the ship is much less food-and-water exposure than a fortnight staying locally, which is why typhoid often isn't indicated for a cruise that would warrant it for a land trip to the same islands. Inland excursions, street food and beach dogs pull it back the other way. And the illnesses that actually spread on ships are gastroenteritis and respiratory infections - hand hygiene beats hand gel for norovirus, and reporting illness to the ship's medical centre rather than hiding it is the right call, both for other passengers and because onboard care is chargeable and your insurer will want it documented.

**The practical bit**

Aim for 4-6 weeks before you fly or sail. That's enough for any course vaccines and for a hepatitis A dose to be well established, and 6-8 weeks is better if your trip is combined with a South American or African leg where a yellow fever certificate might be required.

Malaria is a good example of why "the Caribbean" is not a single answer. Jamaica, Barbados, St Lucia, Cuba, Antigua and most of the islands do not require malaria prevention tablets. Haiti and parts of the Dominican Republic do carry a risk, and tablets are advised for some routes there. If you're offered tablets for a Barbados holiday, that isn't a risk assessment. Where they are indicated, the clinic is run by an Independent Prescriber, so they're assessed, prescribed and dispensed in the same visit rather than sending you back to your GP.

Bring the resort or address, the full list of islands and ports in order, how long you're staying, whether you're staying with family, and any vaccine records you have. We're open weekdays until 6pm and on Saturday mornings, and we can usually see you the same day with about two hours' notice.

This guide is written and reviewed by the pharmacists who run the clinic, against current NaTHNaC and UKHSA Green Book guidance. It is general information, not a personal recommendation - your own risk assessment happens at the consultation.

Guidance we work from

Frequently Asked Questions