Tick-borne encephalitis


You can reduce your risk of developing tick-borne encephalitis (TBE) by getting vaccinated and taking precautions to avoid tick bites when in high risk areas.

TBE vaccination

Vaccination against TBE is recommended for anyone who may be at risk of TBE through their work or travels. It provides protection for more than nine out of every 10 people who have it.

The vaccination isn't available on the NHS, so you'll need to pay for it privately. The cost of the vaccination course can vary, but it's usually around £50-70 per dose.

The vaccination is given as an injection and three doses are needed for full protection. The second dose is given one to three months after the first, and the third dose is given five to 12 months after the second.

If necessary, the course can be accelerated, with the first and second doses given two weeks apart. This shorter course offers rapid short-term protection for at least nine in every 10 people who have it. If you have this accelerated schedule, you should have the third dose five to 12 months after the second as usual if you continue to be at risk.

Booster doses are recommended if you continue to be at risk. For people between 16 to 60 years of age, the first booster dose should be given three years after the third standard dose. Further booster doses should then be given every five years after the last booster dose. For people over 60, the intervals between booster doses shouldn't exceed three years.

Side effects and precautions

Any reactions to the TBE vaccination are usually mild and don't last long. You may experience temporary swelling and redness and pain at the site of the injection. You may also have a high temperature (fever) for a day or two after the first dose.

Most people can have the TBE vaccination safely, but you should tell the doctor or nurse before being vaccinated if you:

  • have a fever
  • have a condition, or are receiving treatment, that affects your immune system
  • have a condition that affects your brain or central nervous system
  • are pregnant or breastfeeding

In these circumstances you may still be able to have the vaccine, but your doctor or nurse will need to check with a travel medicine specialist before giving it to you.

You shouldn't have the vaccine if you've had an allergic reaction to eggs (as the vaccine contains egg protein) or any of the other vaccine components in the past.

Preventing tick bites

Even if you've been vaccinated against TBE, it's still important to take steps to reduce your risk of being bitten by a tick because the vaccine isn't 100% effective.

The best way to reduce your risk of getting TBE is to avoid getting bitten by a tick when you're in areas where there's a high risk of TBE infection. You should:

  • wear long-sleeved tops and long trousers tucked into your socks (you can also treat your clothes with insecticides such as permethrin)
  • wear light-coloured clothes so ticks are easier to spot and brush off
  • apply insect repellent containing DEET to exposed skin
  • regularly check your body for ticks – common places to find them are the hair line, behind the ears, around the elbows, the backs of the knees, the groin and the armpits

There's also a risk of being infected if you drink milk or eat dairy products from an infected animal, so you should avoid eating and drinking all unpasteurised milk and dairy products in countries where there's a high risk of TBE.

You should also be aware that tick bites can spread other illnesses, such as Lyme disease, which you can get after being bitten by a tick in the UK. Therefore, follow the advice above to prevent tick bites when you're in an area of the UK where ticks are commonly found.

Read about who's at risk and where ticks are found in the UK.

What to do if you find a tick

After a tick has attached itself to you, it may not start feeding for several hours. After feeding, adult ticks can be about the size of a coffee bean, but tick larvae can be tiny.

If you find a tick on your body, remove it as quickly as possible. You should:

  • use tweezers or a special tick remover and wear gloves or cover your fingers with tissue to avoid touching the tick
  • grab the tick as close to the skin as you can, and gently pull straight up until all parts are removed
  • avoid twisting or jerking the tick as you're removing it because it may cause the mouthparts to break off and remain in your skin after the tick has been removed
  • avoid squeezing the body of the tick and the contents of its stomach into the site of your bite

After removing the tick, wash your hands with soap and water and clean the tick bite with soap and water or an antiseptic, such as an iodine scrub.

Seek medical advice as soon as possible if you've been bitten by a tick in a TBE risk area and you haven't been vaccinated against TBE, or if you develop a rash or fever after being bitten.

DEET insect repellents

The chemical DEET (diethyltoluamide) is often used in insect repellents. It's not recommended for babies who are less than two months old.

DEET is safe for older children, adults and pregnant women if you follow the manufacturer's instructions. You should:

  • use it on exposed skin
  • avoid spraying it directly onto your face (spray into your hands and pat onto your face)
  • avoid contact with your lips and eyes
  • wash your hands after applying it
  • not apply it to broken or irritated skin
  • make sure you apply DEET after applying sunscreen, not before

Page last reviewed: 09/12/2015
Next review due: 09/12/2018