Travel Medicine
Special Vaccination Requirements
Parents of children under the age of 2 should consult their child's physician regarding the possibility of accelerating the routine schedule of childhood immunizations prior to travel abroad.
Of particular concern is the diphtheria and tetanus vaccinations. If you are planning travel to high-risk areas for diphtheria, which includes the former Soviet Union, Albania, Haiti, Dominican Republic, Ecuador, Brazil, Philippines, Indonesia, and many countries in Africa and Asia, your child may need a fourth dose of the DtaP, the diphtheria vaccine prior to departure. Consult your physician for more information.
Before traveling to any destination outside the United States, it is important to review your vaccination schedule with your physician. This should be done as far in advance as possible so that any special vaccinations can be scheduled and administered. The Centers for Disease Control and Prevention (CDC) recommends that persons planning to travel review the vaccines below with their physician before travel begins.
Review your immunization history with your physician and be sure that children over the age of 2 are on schedule with their vaccine series. Adults should have completed the primary series; however, a booster of the adult tetanus-diphtheria (Td) is recommended every 10 years.
The influenza (flu) vaccine and pneumococcal vaccine are recommended for persons 50 years or older and for other high-risk individuals (those with heart disease, cancer, diabetes, lung problems, kidney problems, or problems with their immune systems).
For persons who have received a complete series of the polio vaccine, persons over the age of 18 traveling to Nigeria, India, Pakistan, and Afghanistan should receive an additional single dose of the vaccine. Only one additional dosage during adulthood is needed for travelers to these risk areas.
Persons born in or after 1957 should consider receiving a second dose of measles vaccine before traveling abroad.
The yellow fever vaccine is recommended for persons traveling to certain parts in sub-Saharan Africa and tropical South America.
Hepatitis B should be considered for persons who will be an area where high rates of hepatitis B exist for more than six months. This includes Southeast Asia, Africa, the Middle East, the islands of the South and Western Pacific, the Amazon region of South America, Greenland, Alaska, and northern Canada. Children who have not previously received this vaccine should do so also.
Hepatitis A and/or immune globulin (IG) is recommended for travelers to all areas EXCEPT Japan, Australia, New Zealand, Northern and Western Europe, and North America (excluding Mexico). The CDC now recommends the hepatitis A vaccine for all children at age 1.
Typhoid vaccine is recommended for travelers spending time in areas where food and water precautions are recommended (especially in India and Nepal).
Meningococcal vaccine is recommended for persons traveling to sub-Saharan Africa during the dry season (from December to June), to Saudi Arabia during the Haij, and especially if anticipating close contact with locals.
Japanese encephalitis or tick-borne encephalitis should be considered by those undertaking long-term travel or who plan to live in areas of risk, including rural farming areas.
Currently, the risk of cholera is thought to be low enough that the vaccine is generally not recommended. You may discuss this with your physician.
Many of these vaccines can be given at the same time without any decrease in their effectiveness. Consult with your physician for more information regarding the proper administration of these vaccines.
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