Special Vaccine Requirements

Special Vaccine Requirements

Before traveling outside the U.S.,
it’s important for you to review your vaccine history and needs 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. Some must be given as much as 1 month before travel to
protect you. These vaccines are not for all people. There may be specific cases in which
they should not be used.

The primary vaccine series

Review your vaccine history with
your healthcare provider. Also 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 tetanusdiphtheria (Td) is recommended every 10 years. If you are an adult and
have not yet gotten a tetanus booster containing the pertussis (whooping cough)
vaccine known as Tdap, you
should get that shot 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

The CDC divides travel vaccines
into routine, recommended, and required categories. Your provider will review all
categories with you, specific to the place where you will be going.

You may need these vaccines:

  • A yearly influenza (flu)
    vaccine is advised by the CDC for everyone age 6 months and older.

  • Two pneumococcal vaccines
    about 8 weeks apart are also advised 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.

  • Babies, 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

  • Two doses of the measles-mumps-rubella (MMR) vaccine are
    advised for people born after 1956 who are traveling outside the U.S.

What other vaccines may be

  • Yellow fever
    vaccine may be needed for travel to certain countries in Africa and is
    advised for several places in South America. You may also need a certificate
    of vaccination.

  • Hepatitis B should be
    considered if you will be in a place 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
    parts of the Caribbean, such as the Dominican Republic and Haiti. Children
    who have not received this vaccine before should do so. For those who have
    completed the primary vaccine series, a booster is not recommended.

  • Hepatitis A vaccine is
    advised if you are going to a place where there is major 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 places 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 advised if you are going 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.
    There are 2 major types of meningococcal vaccine available. Your healthcare
    provider will decide if you need one or both based on the type of
    meningococcal disease outbreaks occurring in your area of travel.

  • Japanese encephalitis
    or tick-borne
    vaccine should be considered if you will be on a
    lengthy trip or you plan to live in places of risk, including rural farming

  • Rabies vaccine may be
    needed if you will be in unprotected rural outdoor areas where rabies is
    common and you may be exposed to wild animals.

  • The risk for cholera is very low
    for most travelers even if you are visiting places with epidemic cholera as
    long as you can follow standard precautions. This includes drinking and
    using safe water, cooking foods safely, and thorough hand-washing. A
    single-dose oral cholera vaccine is approved in the U.S. for travelers to
    places where cholera is active. If you are going to such an area, talk with
    your healthcare provider about whether it would be a good idea to get the
    cholera vaccine before travel. 

  • 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.