Travel Vaccines

Key: IM = intramuscular; SC = subcutaneous

 ¹ Because some protection is provided by 1 or 2 doses, the vaccine series should be initiated, if indicated, even if it cannot be completed before departure. An approved accelerated vaccination schedule can be used for people traveling on short notice who face imminent exposure or for emergency responders to disaster areas.

 ² Adults aged 18–65yrs can receive the 2nd dose as early as 7 days after the 1st dose.

 ³ Recommended for persons moving to JE-endemic country to live longer-term (1 month or longer), frequent travelers, and shorter-term travelers with an increased risk based on travel duration, season, location, activities, and accommodations. Consider vaccination for travelers to endemic areas with uncertain travel plans.

 ⁴ Meningitis serogroup B disease is extremely rare in “meningitis belt” countries, therefore, MenB vaccine (Trumenba, Bexsero) is not recommended for travelers.

 ⁵ Children who completed the primary dose or series before 7yrs old should receive a booster dose after 3yrs and repeated every 5yrs thereafter if living or traveling to a hyperendemic area. If received the primary dose or series at ≥7 years of age, a booster dose should be given after 5yrs and every 5yrs thereafter.

 ⁶ Travelers to the Kingdom of Saudi Arabia for Umrah or Hajj must provide evidence of vaccination ≥10 days and no more than 3yrs (polysaccharide vaccine) or 5yrs (conjugate vaccine) before arrival.

 ⁷ Countries in the “meningitis belt” include Ethiopia, Sudan, Chad, Nigeria, Burkina Faso, Mali, Guinea, Senegal, Gambia, etc. Travelers to these areas should be vaccinated with MenACWY vaccine before travel esp. during the dry season (December-June).

 ⁸ Travelers with HIV, anatomic or functional asplenia, persistent complement component deficiencies (C3, C5-9, properdin, factor D or H), or on eculizumab therapy should receive 2-dose series 8–12wks apart. Although not indicated for use above age 55yrs, Menveo and Menactra are the recommended vaccines for this age group since Menomune is no longer available in the US.

 ⁹ If the age-appropriate series is not completed before travel, the remaining IPV doses to complete the series should be given when feasible, at the following intervals: for children, 1st dose at age ≥6wks; 2nd and 3rd doses should be ≥4wks after the previous doses; 3rd and 4th doses should be ≥6mos apart. For children completing the accelerated schedule, a dose at age ≥4yrs should still be given, as long as it has been ≥6mos after the previous dose.

¹⁰ Long-term travelers and residents may be required to show proof of polio vaccination (International Certificate of Vaccination or Prophylaxis) when departing from these countries. Polio vaccine must be received between 4wks and 12mos before the date of departure from the polio-affected country.

¹¹ Travelers visiting areas where rabies is enzootic and immediate access to medical care (eg, biologics) is limited. Preexposure vaccination may be recommended based on the occurrence of rabies in the country of destination, the intended activities of the traveler (eg, veterinarians, research workers, animal control) esp. in remote areas, duration of stay, and the likelihood of repeat travel to at-risk destinations or long-term travel to a high risk destination.

¹² Due to the risk of serious adverse events after vaccination, clinicians should only vaccinate those who are at risk of exposure to YF virus or who require proof of vaccination to enter a country. Contraindications to the vaccine include: acute hypersensitivity to egg or chick embryo protein, or any component of the formulation (eg, gelatin), infants <9mos, severe immunosuppression (eg, HIV, leukemia, lymphoma, thymic disease, generalized malignancy, or drug- or radiation-induced immunosuppression), breastfeeding to infants <9mos.

¹³ A proof of yellow fever vaccination (International Certificate of Vaccination or Prophylaxis) is required to enter the following African countries: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Republic of the Congo, Côte d’Ivoire, Democratic Republic of Congo, Gabon, Ghana, Guinea-Bissau, Mali, Niger, Sierra Leone, South Sudan, Sudan, Togo, Uganda; and French Guiana. Some countries require vaccination if traveling from a country with risk of YF virus transmission, including transit >12hrs in an airport located in a country with risk of YF virus transmission (eg, South Africa, Australia, Bahamas). For a list of country-specific entry requirements and recommendations, refer to the CDC Yellow Book.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.