Special Note for Children Under the Age of 2
Parents of children under the age of 2 should consult their child's physician regarding the possibility of accelerating the routine schedule of childhood immunizations prior to travel abroad.
Of particular concern is the diphtheria and tetanus vaccinations. If you are planning travel to high-risk areas for diphtheria, which includes the former Soviet Union, Albania, Haiti, Dominican Republic, Ecuador, Brazil, Philippines, Indonesia, and many countries in Africa and Asia, your child may need a fourth dose of the DtaP, the diphtheria vaccine, prior to departure. Consult your physician for more information.
Special Vaccination Requirements
Special vaccination requirements before travel:
Before traveling to any destination outside the United States, it is important to review your vaccination schedule with your physician. This should be done as far in advance as possible so that any special vaccinations can be scheduled and administered. The Centers for Disease Control and Prevention (CDC) recommends that persons planning to travel review the vaccines below with their physician before travel begins.
What is a primary vaccine series?
Review your immunization history with your physician and be sure that infants and children are on schedule with their vaccine series. Adults should have completed the primary series; however, a booster of the adult tetanus-diphtheria (Td) is recommended every 10 years.
What additional vaccines are recommended?
The influenza (flu) vaccine is recommended by the CDC for persons at high risk, including young children, pregnant women, senior adults, and people with chronic health conditions. Pneumococcal vaccine is also recommended for persons 50 years or older and for other high-risk individuals (those with heart disease, cancer, diabetes, lung problems, kidney problems, or problems with their immune systems).
For persons who have received a complete series of the polio vaccine, persons over the age of 18 traveling to Nigeria, India, Pakistan, and Afghanistan should receive an additional single dose of the vaccine. Only one additional dosage during adulthood is needed for travelers to these risk areas.
Persons born in or after 1957 should consider receiving a second dose of measles vaccine before traveling abroad.
What other vaccinations may be needed?
Yellow Fever vaccination is required for travel to certain countries in Sub-Saharan Africa and tropical South America. A certificate of vaccination may also be needed.
Hepatitis B should be considered for persons who will be in an area where high rates of hepatitis B exist for more than six months. This includes Southeast Asia, Africa, the Middle East (except Israel), the islands of the South and Western Pacific, the Amazon region of South America, and certain areas in the Caribbean (such as the Dominican Republic and Haiti). Children who have not received this vaccine previously should do so.
Hepatitis A and/or immune globulin (IG) is recommended for travelers to all areas EXCEPT Japan, Australia, New Zealand, Northern and Western Europe, and North America (excluding Mexico). The CDC now recommends the hepatitis A vaccine for all children at age 1.
Typhoid vaccine is recommended for travelers spending time in areas where food and water precautions are recommended, including South Asia (which has some drug-resistant forms) and in developing countries in Asia, Africa, the Caribbean, and Central and South America.
Meningococcal vaccine is recommended for persons traveling to sub-Saharan Africa during the dry season (from December to June), to Saudi Arabia during the Haij, and especially if anticipating close contact with locals.
Japanese encephalitis or tick-borne encephalitis should be considered by those undertaking long-term travel or who plan to live in areas of risk, including rural farming areas.
Rabies vaccination may be needed if you will be in unprotected rural outdoor areas and may be exposed to wild animals.
Currently, the risk of cholera is thought to be low enough that the vaccine is generally not recommended. You may discuss this with your physician.
Malaria is prevented with medication that should be started prior to travel. Travelers to countries in Central Africa are advised to take anti-malarial medication.
All travelers should be immunized for measles, which is common in many parts of the world.
Many of these vaccines can be given at the same time without any decrease in their effectiveness. Consult with your physician for more information regarding the proper administration of these vaccines and medications.
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