Is it recommended to get vaccinations before visiting India?

On NHS Fit for travel we can find the following information about immunisations for India:

• Courses or boosters usually advised: Hepatitis A; Tetanus; Typhoid.
• Other vaccines to consider: Cholera; Diphtheria; Hepatitis B; Japanese Encephalitis; Rabies.

You should also consider suitable antimalarial tablets, if travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered. Malaria is a serious and sometimes fatal disease transmitted by mosquitoes and causes symptoms that typically include fever, fatigue, vomiting, headaches (sometimes muscle pains, diarrhoea, generally feeling unwell) and in severe cases it can cause yellow skin, seizures, coma or death.

The risk is highest in north-eastern states including Assam and Orissa. It may be considered for certain groups who may be at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen.

For full list of high risk areas, please check India Malaria Map at NHS site.

The risks to health whilst travelling will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveller. So it is recommended that you consult with your General Practitioner or Practice Nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets.

See also:

• Malaria Travel Health Advice at Fit For Travel (NHS) including country specific malaria information and malaria maps.
• Malaria and Travelers at Centers for Disease Control and Prevention (CDC) to find out whether malaria is a problem in the country where you will be traveling.

Indian immigration officials only really care about yellow fever vaccination certificates if you have travelled or were in transit within past week in any region with high yellow fever risk. This is a prerequisite for clearing immigration checkpoints so don’t ignore it; albeit this is something that will affect only a small set of travellers to India as there aren’t many direct flights from South America or Africa.
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World Health Organisation also only lists information about malaria and yellow fever. A more pragmatic advice on vaccinations needed for India can be found on NHS Fit For Travel:

Courses or boosters usually advised: diphtheria; tetanus;
poliomyelitis; hepatitis A; typhoid (polio not required for Andaman
and Nicobar islands).

Vaccines sometimes advised: hepatitis B; rabies;
Japanese encephalitis; cholera.

Assuming you have followed your country’s standard immunisation course, whether you really need a vaccination depends. If you’re going for a couple of days or a short 1-2 week trip, you probably don’t need any of these.

For longer term travellers:

• If you plan to travel by trains or local public transport, I’d highly recommend getting a tetanus booster. Especially on public buses many surfaces are made of sheet metal and chances are that if it’s old, it’s going to have sharp corners you might jab yourself on. This is probably erring too much on the side of caution; still, you’re better off getting one than panicking once you’re on the road and not near a major city.
• Any of the water-borne disease vaccinations such as cholera, typhoid, hepatitis A/B: this really depends. Some travellers are made of sterner stuff and can walk away with Delhi belly at worst. Others are not – I’ve contracted typhoid twice in India, for instance (not when travelling though, grew up there). This is a call you need to take. If you plan to travel a lot to semi-urban/rural areas, then this will be sensible precaution to take.

Also, if you plan to travel for a longer term but haven’t had time yet to get your vaccinations before flying in, consider getting vaccinated in India. You’ll probably fly into a major city like Delhi, Mumbai, Bangalore, Hyderabad, Chennai, or Kolkata and the standard of healthcare is generally pretty good in all these cities. Cost of private outpatient healthcare is relatively very cheap in India and you can just walk in without an appointment and get your vaccinations for a fraction of the cost of getting it in your home country. Most private clinics and practices have English-speaking staff and good standards of quality control. If pressed for ideas, just search online for ‘Apollo Clinic’ or ‘Max Medicentre’ in the particular city you’re staying in – these are well-known private clinic chains. (Prices are slightly higher than usual at these chain private clinics.)

My first port of call for vaccinations is the World Health Organisation (Apologies, can’t link directly to India, select it from the drop down).

Essentially they’re concerned if you’ve come from a Yellow Fever area, and should have both the book + stamp to prove vaccination, and of course have had the vaccination. Of course if you’ve not been to those countries, then it’s not as important. They recommend not getting the Yellow Fever vaccination for India.

The other concern is Malaria. Below 2000m it exists throughout the country. Unfortunately there’s no vaccination, and some strains are even resistant to some drugs. You’ll need to look at what area you’re going to, and then find out if it’s worth getting a drug to take while in that area (they’re simple tablets). Your GP or travel doctor can advise.

Personally if there’s a risk of Malaria, I take the pills. They’re cheap, don’t seem to give me side effects, and I’ve seen people who have had Malaria and would rather not take that risk.