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Routine Vaccinations

Ensuring that a traveler’s routine vaccines are current prior to departure is crucial because many diseases that are common in the United States, and even those that are no longer common, remain prevalent in other countries.

Hepatitis A (HAV)
US travelers visiting developing countries are at considerable risk for exposure to Hepatitis A virus. All travelers to regions with high or intermediate levels of hepatitis A endemicity should receive an age-appropriate dose of hepatitis A vaccine prior to departure. Travelers 12 months to 40 years of age should receive a dose of vaccine as soon as travel is considered.

Hepatitis B (HBV)
Current recommendations are for children and adolescents to be vaccinated against hepatitis B virus. Travelers to areas with intermediate-to-high levels of endemic HBV transmission should be vaccinated. Ideally, vaccination should begin 6 months prior to departure; however, an accelerated 2-month vaccination schedule is available for travels who time from does not accommodate the normal schedule.

The Advisory Committee on Immunization Practices now recommends that everyone who is 6 months of age and older receive an annual influenza immunization. Risk for influenza is particularly high for individuals traveling within the Northern Hemisphere during the winter months, to the Southern hemisphere from April to September, and to the tropics throughout the year. Travel in crowded conditions increases a person’s risk for exposure to viruses causing influenza.

Tetanus, Diphtheria, and Pertussis
In general, adults who have received the primary vaccination series against tetanus and diphtheria should be reimmunized against those diseases every 10 years, regardless of travel. This is particularly important for travelers to areas where diphtheria is endemic and/or for those who will be at high risk for tetanus-prone injuries in isolated areas where access to a vaccine would be problematic. To ensure adequate protection against petussis, Tdap is recommended for adolescents 11 through 18 years of age and should replace a single dose of Td for adults 19 through 64 years of age who have no received Tdap previously.

Measles, Mumps, and Rubella (MMR)
Measles is no longer endemic in the United States, but approximately 20 million cases occur annually elsewhere in the world. A high proportion of measles case within the United States in the past few years have been associated with unvaccinated US and foreign travelers bringing the disease into the country. Those who received a single-dose measles vaccination in childhood should be immunized again, preferably with MMR vaccine, prior to travel. Those with no history of measles immunization or laboratory evidence of immunity should receive 2 doses of MMR vaccine, separated by at lease a month.

Inactivated Poliovirus (IPV)
All travelers should have completed their primary IPV immunization series. Adults planning to visit areas where polio is a risk should receive an additional on-time dose of IPV vaccine prior to travel. Polio remain endemic in India, Pakistan, Afghanistan, and Nigeria. Other countries including Nepal, Indonesia, and several African countries have reported circulation of imported poliovirus in recent years.

Any traveler without documentation of infection with, or immunization against, varicella should either undergo serologic testing or receive 2 doses of the vaccine, unless contraindicated.

*Information extracted from reference material provided by the Monthly Prescribing Reference, an education service by Sanofi Pasteur Inc. A full list of reference material may be provided upon request.