Vaccine Recommendations For Travelers Under 2 Years Old
Routine childhood
immunizations should be up to date or accelerated prior to travel.
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. The number of doses of routinely recommended vaccines a child needs
depends on his or her age.
Infants
and children up to 2 years of age should have received at least 3, and
preferably 4 doses, of diphtheria, tetanus and acellular
pertussis (DTaP) vaccine
by 2 years of age. One dose of DTaP affords little
protection, 2 doses provide some protection and 3 doses 70 percent to 80
percent protection. Parents must be aware that a child with less than the
minimum of 3 recommended doses of DTaP may not be
protected from pertussis. Travelers should consider
receiving the remaining doses of the vaccine at the recommended intervals (at
least one month between each of the first 3 doses; six months between the third
and fourth dose) while abroad.
Measles,
mumps and rubella (MMR) vaccine should be administered to all children 12 months
of age or older. Measles vaccine or MMR may be given to infants 6 to 11 months
of age who are going to areas of high risk for measles. Infants less than 6
months of age are protected by maternally derived antibodies.
Three
doses of inactivated polio vaccine (IPV) are recommended for all infants and children by 2
years of age. If an unvaccinated child is traveling in less than four weeks to
an area where polio is known to be present, a single dose of oral polio vaccine
(OPV) is recommended. If four or more weeks is
available before travel, IPV is recommended, with four weeks separating the 3
doses.
Three
doses of hepatitis B vaccine are recommended for all children by 2 years
of age. The vaccination series may be begun at birth. The first 2 doses should
be separated by at least four weeks. The third dose should follow the second
dose by at least two months, and be given at least four months after the first
dose. The third dose should not be given before 6 months of age.
Three
or 4 doses (depending on the brand of vaccine used) of Hib
vaccine are recommended by age 2 years. The vaccine can be given as early
as 6 weeks of age, and each of the first 2 or 3 doses should be separated by at
least four weeks. The last (third or fourth) dose of the series should be given
on or after 12 months of age.
The
following immunizations may be recommended:
Immune
globulin
for protection against hepatitis A is recommended for infants and children under 2 years of age traveling to areas of the world with
intermediate or high rates of hepatitis A. Hepatitis A vaccines are not
currently licensed for use by children under 2 years old.
For
typhoid fever, breast-feeding is likely to protect infants. Careful
preparation of formula and food from boiled or chlorinated water can help
protect non-breast-fed infants and children up to 2 years of age. The old, injectable killed typhoid fever vaccine is licensed for use
in children as young as 6 months of age. The new injectable
ViCPS typhoid vaccine is recommended for children
between 2 and 6 years of age traveling to areas where there is questionable
sanitation.
For
meningococcal vaccine, effectiveness of the vaccine in children is
dependent upon the child's age when the vaccine is administered. Protection may
not be completely effective in children vaccinated between 3 months and 2
years, especially for vaccination before 3 months of age. The vaccine may be
safely given to infants, but it may be less effective than in adults.
Yellow
fever
vaccine should not be administered to any infant under
4 months of age and children 4 to 6 months old should be considered only under very
unusual circumstances. Infants 6 to 9 months old can receive the vaccine if
they cannot avoid traveling to areas of risk and when a high level of
protection against mosquito bites is not possible. Infants 9 months or older
should be vaccinated as required or recommended for travel to
One
cholera vaccine, administered parenterally
with a 2-dose primary series, is currently licensed in the
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