Special Vaccination Requirements

Special Note for Children Under the Age of 2

Parents of children under the age of 2 should consult their child's doctor 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 doctor for more information.

Before traveling to any destination outside the United States, it is important to review your vaccination schedule with your doctor. 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 people planning to travel review the vaccines below with their doctor before travel begins.

The primary vaccine series

Review your immunization history with your doctor and be sure that infants and children are on schedule with their vaccine series. Adults should have completed the primary series of all childhood vaccines; however, a booster of the adult tetanus-diphtheria (Td) is recommended every 10 years. If an adult younger than 65 has not yet received a tetanus booster shot also containing a petussis (Whooping cough) booster (Tdap), he or she should receive that vaccine instead of Td if he or she is due for a tetanus booster.

What additional vaccines are recommended?

The influenza (flu) vaccine is recommended by the CDC for everyone age six months and older on an annual basis.

Pneumococcal vaccine is also recommended for people 65 years or older and for other high-risk individuals [those with heart disease, cancer, diabetes, lung problems (including asthma), kidney problems, or problems with their immune systems].

For people who have received a complete series of the polio vaccine, those over the age of 18 traveling to areas of the world where polio is still a risk should receive an additional single dose of the vaccine. Only one additional dosage during adulthood is needed for travelers to risk areas.

People born in or after 1957 should consider receiving a second dose of  measles vaccine before traveling abroad.

What other vaccinations may be needed?

Yellow Fever vaccination is required for travel to certain countries in Sub-Saharan Africa and tropical South America. A certificate of vaccination may also be needed.

Hepatitis B should be considered for people who will be in an area where high rates of hepatitis B exist for more than six months. This includes Southeast Asia, Africa, the Middle East (except Israel), the islands of the South and Western Pacific, some areas of South America, and certain areas in the Caribbean (such as the Dominican Republic and Haiti). Children who have not received this vaccine previously should do so.

Hepatitis A and/or immune globulin (IG) is recommended for travelers to all areas where there is significant risk of hepatitis A, even for travelers staying in urban areas and luxury hotels in those regions.

Typhoid vaccine is recommended for travelers spending time in areas where food and water precautions are recommended, including South Asia (which has some drug-resistant forms) and in developing countries in Asia, Africa, the Caribbean, and Central and South America.

Meningococcal vaccine is recommended for people traveling to sub-Saharan Africa during the dry season (from December to June), to Saudi Arabia during the Hajj, 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.

Rabies vaccination may be needed if you will be in unprotected rural outdoor areas and may be exposed to wild animals.

Currently, the risk of cholera is thought to be low enough that the vaccine is not recommended, and is not available in the U.S.

Malaria is prevented with medication that should be started prior to travel. Travelers to countries with malaria are advised to take antimalarial medication.

All travelers should be immunized for measles, which is common in many parts of the world.

Many of these vaccines can be given at the same time without any decrease in their effectiveness. Consult with your doctor for more information regarding the proper administration of these vaccines and medications.


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