Special Vaccine Requirements
Before traveling outside the U.S., it's important for you to review your vaccine schedule with your healthcare provider. This should be done as far in advance as possible so that any special vaccines can be scheduled and given. The CDC recommends that if you are planning to travel, you should review the vaccines below with your healthcare provider at least 4 to 6 weeks before travel begins. Some vaccines can't be given at the same time as others. Some need more than 1 dose, and some must be given as much as 1 month before travel to protect you. These vaccines are not for all people, and there may be specific cases in which they should not be used.
The primary vaccine series
Review your immunization history with your healthcare provider 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. A booster of the adult tetanus-diphtheria (Td) is recommended every 10 years. If you have not yet received a tetanus booster containing the pertussis (whooping cough) vaccine known as Tdap, you should receive that vaccine instead of a Td booster alone. After the one-time administration of the Tdap vaccine, you should have the Td alone every 10 years.
What additional vaccines are recommended?
The CDC divides travel vaccines into routine, recommended, and required categories. Your provider will review all categories with you, specific to the area where you will be traveling.
The following is a list of vaccines to be considered:
A yearly influenza (flu) vaccine is recommended by the CDC for everyone age 6 months and older.
Two pneumococcal vaccines about 8 weeks apart are also recommended for people 65 years or older and for other people at high risk. This includes people with heart disease, cancer, diabetes, lung problems such as asthma, kidney problems, or problems with their immune system.
Infants, children, and adults traveling to countries where polio is still active, and staying for more than 4 weeks, should get age-appropriate polio vaccines or a polio booster within 12 months before travel.
Two doses of the measles-mumps-rubella (MMR) vaccine are recommended for people born after 1956 who are traveling outside the U.S.
What other vaccines may be needed?
Yellow fever vaccine may be needed for travel to certain countries in Africa and is recommended for several areas in South America. You may also need a certificate of vaccination.
Hepatitis B should be considered if you will be in an area where high rates of hepatitis B exist. This includes Asia, Africa, some areas of the Middle East, 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. For those who have completed the primary vaccine series, a booster is not recommended.
Hepatitis A, immune globulin (IG), or both are recommended if you are headed to an area where there is significant risk for hepatitis A. This is true even if you are staying in urban areas and luxury hotels in those regions. For those who have completed the primary vaccine series, you do not need a booster.
Typhoid vaccine is recommended if you will be in areas where food and water precautions are recommended. This includes South Asia, which has some drug-resistant forms, and in Asia, Africa, and Central and South America.
Meningococcal vaccine is recommended if you are traveling to sub-Saharan Africa during the dry season (December to June). It is needed for visitors to Saudi Arabia during the Hajj, especially if you think you will be in close contact with locals.
Japanese encephalitis or tick-borne encephalitis vaccine should be considered if you are will be on a lengthy trip or you plan to live in areas of risk, including rural farming areas.
Rabies vaccine may be needed if you will be in unprotected rural outdoor areas where rabies is common and may be exposed to wild animals.
Currently, the risk for cholera is very low if you are visiting areas with epidemic cholera as long as you take simple precautions. This includes drinking and using safe water, cooking foods safely, and thorough hand-washing. The cholera vaccine does not work very well. It is not recommended for most travelers, and is not available in the U.S.
Travelers to countries with malaria are advised to take antimalarial medicine. But none of the antimalarial medicines are completely effective. If you are in areas of risk, you must also use personal protective measures. These include using insect repellent, wearing long sleeves and long pants, and sleeping in a mosquito-free setting or using an insecticide-treated bed net.
Many of these vaccines can be given at the same time without any decrease in their effectiveness. Talk with your healthcare provider for more information about these vaccines and medicines.