Vaccine Recommendations For Travelers Aged 2 Years or Older
The following vaccines
should be reviewed with a health care provider as far in advance of travel as
possible to ensure the proper scheduling of recommended vaccines.
Primary
Vaccine Series
For
travelers older than 2 years of age the following immunizations normally given
during childhood should be up-to-date:
Children older than 2 years
should be "on schedule" with each vaccine's primary-series schedule,
while adults should have completed the primary series. The number of doses
needed depends on the child's age. If you are unsure about your vaccine
history, consult with your physician.
In
addition, adult travelers may want to consider
Booster
or additional doses
TETANUS
AND DIPHTHERIA
A
booster dose of adult tetanus-diphtheria (Td) is recommended every 10 years.
POLIO
For
persons who have received a complete series of polio vaccine (either IPV or
OPV), an additional single dose of vaccine should be received by persons 18
years of age and older traveling to the developing countries of Africa
(Southern, Central, East, West, and North), Asia (East and Southeast), the
Middle East and the Indian subcontinent, and the majority of the New
Independent States of the former Soviet Union. This additional dose of polio
vaccine is necessary for travelers to risk areas only once in adulthood.
Inactivated polio vaccine (IPV) is recommended for this dose.
MEASLES
Persons
born in or after 1957 should consider a second dose of measles vaccine before
traveling abroad.
The
following immunizations may be recommended:
All vaccines (except
cholera and yellow fever vaccines) may be safely administered simultaneously
without any decrease in effectiveness. Immune globulin (IG) may be
simultaneously administered at different body locations with an inactivated
vaccine such as DTaP, IPV, Hib, and hepatitis A and B vaccines. However, IG
diminishes the effectiveness of live-virus MMR and varicella vaccines if IG is
given simultaneously. IG does not interfere with either OPV or yellow fever
vaccine when given simultaneously.
Pregnancy
and immunizations
Women
who are pregnant or who are likely to become pregnant within three months
should not receive MMR or B vaccines. Yellow fever or polio (OPV) vaccines
should be given to pregnant women only if there is a substantial risk of
exposure. If given during pregnancy, waiting until the second or third
trimester minimizes theoretical concerns over possible birth defects.
Women
in the second and third trimesters of pregnancy have been found to be at
increased risk of complications from influenza. Because currently available
influenza vaccine is an inactivated vaccine, many experts consider influenza
vaccination safe during any stage of pregnancy. A study of influenza
vaccination of more than 2,000 pregnant women demonstrated no adverse fetal
affects associated with influenza vaccine. However, more data are needed. Some
experts prefer to administer influenza vaccine during the second trimester to
avoid a coincidental association with spontaneous abortion (miscarriage), which
is common in the first trimester, and because exposures to vaccines have
traditionally been avoided during this time.
No
convincing evidence for risk to the unborn baby from inactivated viral or
bacterial vaccines or toxoids administered to pregnant women has been
documented. These vaccines include: hepatitis A, hepatitis B, rabies,
injectable typhoid, meningococcal, pneumococcal, tetanus-diphtheria toxoid
(adult formulation) and IPV. Immune globulin can be given to pregnant women.
Specific information is not available on the safety of cholera vaccine during
pregnancy; therefore, it is prudent on theoretical grounds to avoid vaccinating
pregnant women.
All
vaccines may be administered safely to children of pregnant women and to
breast-feeding mothers.
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