Chapter 117. Health Advice for International Travel (Part 2)

Immunizations for Travel Immunizations for travel fall into three broad categories: routine (childhood/adult boosters that are necessary regardless of travel), required (immunizations that are mandated by international regulations for entry into certain areas or for border crossings), and recommended (immunizations that are desirable because of travel-related risks). Vaccines commonly given to travelers are listed in Table 117-1.Table 117-1 Vaccines Commonly Used for TravelVaccinePrimary SeriesBooster IntervalCholera, live oral (CVD 103 - HgR)1 dose6 monthsHepatitis 1440 U/mL enzymeA(Havrix),2doses,6–12None requiredimmunoassay months apart, IMHepatitisA(VAQTA,2doses,6–12None requiredAVAXIM, EPAXAL)months apart, IMHepatitis A/B combined (Twinrix) ...
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Chapter 117. Health Advice for International Travel (Part 2) Chapter 117. Health Advice for International Travel (Part 2) Immunizations for Travel Immunizations for travel fall into three broad categories: routine(childhood/adult boosters that are necessary regardless of travel), required(immunizations that are mandated by international regulations for entry intocertain areas or for border crossings), and recommended (immunizations that aredesirable because of travel-related risks). Vaccines commonly given to travelersare listed in Table 117-1. Table 117-1 Vaccines Commonly Used for Travel Vaccine Primary Series Booster Interval Cholera, live oral (CVD 1 dose 6 months103 - HgR) Hepatitis A (Havrix), 2 doses, 6–12 None required1440 enzyme immunoassay months apart, IMU/mL Hepatitis A (VAQTA, 2 doses, 6–12 None requiredAVAXIM, EPAXAL) months apart, IM Hepatitis A/B combined 3 doses at 0, 1, None required(Twinrix) and 6–12 months or 0, 7, except 12 months (once and 21 days plus booster only, for accelerated at 1 year, IM schedule) Hepatitis B (Engerix B): 3 doses at 0, 1, 12 months, onceaccelerated schedule and 2 months or 0, 7, only and 21 days plus booster at 1 year, IM Hepatitis B (Engerix B or 3 doses at 0, 1, None requiredRecombivax): standard schedule and 6 months, IM Immune globulin 1 dose IM Intervals of 3–5(hepatitis A prevention) months, depending on initial dose Japanese encephalitis 3 doses, 1 week 12–18 months(JEV, Biken) apart, SC (first booster), then 4 years Meningococcus, 1 dose SC >3 yearsquadrivalent [Menimmune (optimum booster(polysaccharide), Menactra schedule not yet(conjugate)] determined) Rabies (HDCV), rabies 3 doses at 0, 7, None requiredvaccine absorbed (RVA), or and 21 or 28 days, IM except with exposurepurified chick embryo cellvaccine (PCEC) Typhoid Ty21a, oral live 1 capsule every 5 yearsattenuated (Vivotif) other day x 4 doses Typhoid Vi capsular 1 dose IM 2 yearspolysaccharide, injectable(Typhim Vi) Yellow fever 1 dose SC 10 years reactions occur only rarely. The vaccine is recommended for personsstaying >1 month in rural endemic areas or for shorter periods if their activities(e.g., camping, bicycling, hiking) in these areas will increase exposure risk. AVero cell vaccine may be licensed in the United States within the next 2 years. Cholera The risk of cholera (Chap. 149) is extremely low, with ~1 case per 500,000journeys to endemic areas. Cholera vaccine, no longer available in the UnitedStates, was rarely recommended but was considered for aid and health careworkers in refugee camps or in disaster-stricken/war-torn areas. A more effectiveoral cholera vaccine is available in other countries.