VACCINES
Hepatitis A - contracted from contaminated food and water. Often encountered in countries with poor sanitation and hygiene. Requires a series of 2 doses with an initial injection followed by a booster in 6 - 12 months. It should be given 4 weeks before departure. The vaccine provides protection for 10 years. If departure is to occur in less than 2 -4 weeks, gammaglobulin may be substituted for Hepatitis A vaccine.
Hepatitis B - mostly transmitted by blood or through sex with an infected individual. A series of 3 doses is required, with the initial dose followed by a second in 1 month and the third administered in 6 - 12 months. immunization provides protection for up to 15 years. A combination vaccine of A and B (Twinrix vaccine) can be given in 3 does with the initial dose at day 0, the second dose in 1 month and the third dose in 6 months.
Diphtheria - often spread through a cough or sneeze. Risk levels are high in some eastern European countries. One vaccine can protect you against diphtheria and tetanus (Td). Most Td combination vaccines have a reduced content of diphtheria in them. The combination vaccine provides protection for 10 years against both tetanus and diphtheria. Generally, the Td form is given to individuals over 7 years of age.
Meningococcus - spread from infected persons via coughs or sneezes. Vaccination can help protect you against certain strains found in Africa and the Middle East. An initial dose is given with a booster every 3 years. This vaccination should be given no less than 2 weeks before departure.
Japanese Encephalitis - spread by mosquitoes during the rainy seasons in SE Asia and the Far East. Vaccination is recommended for individuals planning to stay in high risk areas or on extended visits 2 or more weeks. Three doses is required on day 0, day 7 and on day 28 with a booster the first year followed by one every 3 years. Receiving 2 doses before departure is recommended.
Tetanus - spread when spores enter the body from contaminated soil by way of a cut or scratch. The risk is worldwide and a vaccination is good for 10 years.
Typhoid - spread by contact with contaminated food or water in countries with poor sanitation and hygiene practices. One dose of this vaccine protects you for 3 years. Since it provides protection after 7 days, it should be given at least 1 week before departure.
Polio - a viral infection which may lead to paralysis. This is becoming more of a risk in developing countries. Check to see if you have an up-to-date vaccination. There are several strains of related enteroviruses that are spread through contaminated food and water. There are two forms of the vaccine. The IPV vaccine is the one of choice for most travelers. It requires on dose at least 4 weeks before departure and a booster every 4 - 6 years.
Tick-borne Encephalitis - spread by tick bites often in forested areas of Europe. It requires 3 doses, the first two 4-6 weeks apart. A third dose should be given at 9-12 months. The second dose should be given before departure to ensure protection. The vaccines provide immunity for 3 years.
Yellow Fever - spread by mosquitoes. Some countries require vaccination at least 10 days prior to entry and no more than 10 years since your last vaccination. Two doses are required. Check www.cdc.gov for up-to-date news on hotspots. Keep your vaccination record with your passport.
Rabies - spread by a bite from a rabid animal which is often fatal. Consider vaccination if traveling to rural areas of undeveloped countries. This requires 3 doses at day 0, day 7, and day 28 with a booster every 2 - 3 years. Modern boosters are well tolerated.
Malaria - spread by mosquitoes in warm climate countries. There is currently no vaccine against the disease. Ask our travel clinic staff for suggestions on oral medications and follow the instructions given.
Avian Influenza - a vaccine containing the H5N1 influenza virus strain is currently under development and is not available at this time. Areas of Southeast Asia have recently experienced outbreaks of this disease.
Pneumococcus - a worldwide health problem. There is an increasing pneumococcal resistance to antibiotics. If you have a chronic health condition, consider vaccination. It is recommended for those 65 years and older and re-vaccination is recommended after 3 - 6 years. One dose is given 2 weeks before departure.
REMEMBER TO GET YOUR VACCINE BOOSTERS
Influenza - traveling to different countries puts people at risk since they are exposed to crowded places. Those most at risk have preexisting health conditions. One dose at least 2 weeks before departure is recommended. Those who are immuno-compromised should receive a second dose 4 weeks after the first.
Cholera - those most at risk are emergency relief and health workers in refugee situations. Cholera is spread through contaminated food and water. Two doses are required. Protection is provided 6 months after the second dose. A booster is needed every 3 years.
Measles - is a highly contagious disease and is found worldwide. Transmission is by respiratory droplets. All travelers over 6 months of age should be immunized if there is no history of immunity. One dose is required 4 weeks prior to departure. The dose gives protection for 20 years. Those who receive a dose at 6 - 8 months of age need a second dose at 12 - 15 months of age. Moderately immune-compromised people should receive the vaccine; however, pregnant individuals should avoid the vaccine since it is a live virus.
Haemophilus Influenza Type B - a worldwide problem, especially in developing countries. It is a common cause of bacterial meningitis and other life-threatening conditions. There is a risk increase in countries with a high occurrence. Doses are given at 6 weeks, 10 weeks, and 14 weeks of age but may be given to children up to the age of 5 years. The full course is given up to the date of departure.
Tuberculosis - spread by direct airborne droplets through a cough or sneeze. There has been a resurgence of tuberculosis in the USA and throughout the world. Most at risk are long-term travelers with lengthy layovers. Healthcare and relief workers will receive some level of protection from the BCG vaccine (although this vaccine is not usually given in the United States). A booster should be given at least 4 weeks before departure.
Most vaccines can be given at the same time if injection sites are at least 2 cm apart. Some combination vaccines are also available.
VACCINATIONS RECOMMENDED FOR TRAVELERS
Routine vaccinations:
Diphtheria, tetanus, Pertussis, Hepatitis B, Haemophilus Influenza Type B, Measles, Poliomyelitis
Vaccines for Selective Use:
Cholera, Influenza, Tick-borne Encephalitis, Meningococcal disease, Pneumo-coccal disease, Hepatitis A, Japanese Encephalitis, Rabies, Tuberculosis, Typhoid Fever, Yellow Fever
Mandatory in Certain Countries:
Yellow Fever, Meningococcal disease
