Travel Immunization

Planning on international travel?
Whether you are traveling for work or for pleasure, be sure to contact your internist if your journey will take you outside of the United States. You may require immunizations to protect you from infectious diseases common in the areas that you plan to visit, especially if your plans take you to developing countries.

As soon as you know your destinations, schedule an appointment with your internist. Timing is important because some vaccinations need time in your system before they reach full protection, or may require two or more shots administered over a couple of weeks.

Information your internist will need:

Destination(s)
Departure date
Expected lengths of stay
If you are, or may become, pregnant during your travel or within three months afterward
If you are, or will be, breastfeeding during your travel or shortly after
If you are under treatment for a chronic health condition, particularly HIV infection or other condition that compromises immune systems
If you have already received the recommended “domestic” vaccinations:
– measles mumps rubella (MMR) at some time in your life
– tetanus and diphtheria (Td) booster within the past 10 years
– influenza (in the fall of each year)
– pneumococcal (for those at risk, every 10 years)
– varicella/chicken pox (two doses if you have never had chicken pox)
Whether you have already received vaccinations for travel to this or other destinations during your adulthood.
In addition to providing the recommended immunizations, your internist can discuss other health concerns for travelers as well as provide a basic physical before your departure.

What immunizations might you need?

The immunizations you need depend on where you are going and what infectious diseases are prevalent in those areas. This information can change monthly, so it is important to talk to your internist even if you have traveled to your destination before. Some common immunizations include:

Polio: one dose of the inactivated polio vaccine (IPV) for travelers over 18 who already received the oral polio vaccine or inactivated polio vaccine at some time in their lives. Needed for developing countries in Africa, Asia, Middle East, Indian subcontinent, and the majority of the new independent states in the former Soviet Union.
Measles: for persons born after 1957. (This should be their second dose in a lifetime.)
Yellow fever: needed for certain parts of Africa and South America.
Hepatitis A and/or immune globulin: recommended for travelers to all areas except Japan, Australia, New Zealand, Northern and Western Europe, and North America (excluding Mexico).
Hepatitis B: recommended for those spending more than six months in areas with a high rate of hepatitis B and who will have frequent close contact with local people.
Typhoid: recommended for areas where food and water precautions are indicated, such as in developing countries.
Meningococcal: needed for sub-Saharan Africa during the dry season (Dec. – June).
Japanese encephalitis or tick-borne encephalitis: recommended for long-term travelers to areas of risk.
All of these vaccines can be safely administered at one physician visit except for yellow fever and cholera. (Immune globulin diminishes the effectiveness of live-virus MMR and varicella vaccines if given simultaneously.)

Remember: everyone is different. Be sure to talk to your internist for recommendations for your specific circumstances.

General health tips for travelers:

Make sure you have an adequate supply of all your prescriptions, with enough for several extra days in case your return home is delayed. It’s also a good idea to leave the medications in their original containers (with labels) and to carry medications in your carry-on baggage
Avoid uncooked foods while traveling (except for fruits and vegetables you have peeled yourself)
Use bottled water – even to brush your teeth
Bring:
– a spare pair of prescription glasses and/or contact lenses (or your written prescription)
– powdered Gatorade or oral rehydration salts (for diarrhea)
– insect repellant
– sunscreen
– hand sanitizer (moist wipes or liquid)
Carry a list of allergies, medications and dosages, and health conditions in your wallet or purse
Find out if you need proof of immunizations before being able to return to the United States from your destination (travel agents should have this information for you)
Keep a personal record of the immunizations you get and when you received them. If you are a frequent traveler, this can save you from having to repeat immunizations unnecessarily.

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