Travel Vaccinations

Travelers encounter infections that are absent or uncommon in their own country. The risk of travelers contracting infectious diseases depends on the destination, duration of the trip, and nature and conditions of travel. The risk of specific diseases may be increased during periods in which outbreaks of disease are occurring, such as with meningococcal disease in Sub-Saharan Africa. Immunizations are important for reducing risks of infections in travelers. Also, immunization is probably the most cost effective medical intervention. It provides a high level of immunity against a range of general and travel specific pathogens. There is an increasing range of vaccinations available as research and development of vaccines progresses. Some vaccines require multiple doses to induce long lasting protective immunity, and some will only induce protective immunity for a limited period of time. Many countries publish national guidelines regarding travel health information, and readers are encouraged to contact their local and national public health services. The two steps in immunizing travelers are to update routine immunizations and to provide travel-specific immunizations. To do the first, knowledge of a patient’s previous immunizations and medical history is necessary. For the second, detailed information about the journey, mode of travel and purpose of travel (e.g, medical or veterinary work, tourism, visiting relatives) is needed. Protection against vaccine-preventable childhood diseases is particulary important for children who visit developing countries. Vaccinating children for travel requires consideration of the development of the pediatric immune response and the rationale for vaccine use. Routine pediatric vaccinations may need to be accelerated for young children. Pretravel consultation is an opportunity to update the immunization status of adults. In this paper, vaccines for preventing enteric infections (polio, cholera, hepatitis A and typhoid), as well as those for hepatitis B, Japanese encephalitis, yellow fever, meningococcal diseases, varicella, rabies, lyme and tickborne encephalitis are reviewed.