Do You Need Vaccinations Before Traveling Abroad?

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Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

Travelers to other countries often face health issues they wouldn't ordinarily experience at home. To minimize your risks of becoming seriously ill when traveling abroad, you should find out in advance whether any specific immunizations may be recommended for travel to the region of the world you'll be visiting. It's also a good time to review your own immunization history.

According to the U.S. Centers for Disease Control and Prevention (CDC), it's best to schedule a visit to your doctor or travel medicine clinic 4-6 weeks before an international trip. Since your body needs time to build up immunity after receiving a vaccine and many vaccines are given in a series over time, getting an early start on your immunizations is the best way to protect yourself. Even if you are making a last-minute trip or plan to leave in less than four weeks, you should still check with your doctor to see if any vaccines or preventive medications might be recommended.

The CDC divides travel vaccinations into three categories: routine, recommended, and required. The only vaccine classified as "required" by International Health Regulations is the yellow fever vaccination for travel to certain countries in sub-Saharan Africa and tropical South America.

"Routine" vaccinations are those that are normally administered, usually during childhood, in the United States. These include immunizations against:

• diphtheria,
  
  
• tetanus,
  
  
• pertussis,
  
  
• measles,
  
  
• mumps,
  
  
• rubella,
  
  
• varicella,
  
  
• poliomyelitis,
  
  
• hepatitis B,
  
  
• Haemophilus influenzae type b,
  
  
• rotavirus, and
  
  
• pneumococcus.

International travelers should make sure that these vaccinations are up to date and that no boosters are required, since many conditions which are rare in the U.S. due to immunity in the general population may be more common in other countries.

"Recommended" vaccinations are given to protect travelers from illnesses that occur routinely in other parts of the world. Doctors determine which vaccines are recommended for international travel on an individual basis, taking into consideration your destination, whether you will be spending time in rural areas, the season of the year you are traveling, your age, your overall health status, and your immunization history.

Some examples of vaccines that may be recommended for international travelers (remember you may need more, fewer, or different vaccinations, depending on your individual circumstances) include:

• Hepatitis A - This condition is spread by person-to-person contact, through contaminated water, shellfish harvested in contaminated water, or other food products contaminated during preparation or handling. Hepatitis A may be contracted where sanitation conditions may be lacking.
  
  
• Rabies - Rabies virus is endemic in dogs in many countries throughout the world, including, but not limited to, parts of Thailand, Viet Nam, Brazil, China, the Philippines, Sri Lanka, and Indonesia.
  
  
• Typhoid fever - This condition may be contacted in many areas of the world through contaminated drinking water or food, or by consuming food or beverages that have been handled by an infected person.

Many travelers to tropical countries are concerned about the possibility of contracting malaria, a potentially fatal infection transmitted by the bite of a female Anopheles mosquito. While malaria is most common in Africa, the disease occurs in over 100 countries. While there is no vaccination available to prevent malaria, your doctor can prescribe preventive, or prophylactic, antimalarial medications if you are traveling to an at-risk area.