Immunization in Travelers by Dr. Puja Dhupar
Immunization in Travelers by Dr. Puja Dhupar
INFLUENZA - Most common VPD of travellers with attack rate of 8.9 per 100 person months of travel
HEPATITIS A -Risk for non-immune travellers has attack rate of 3.5 cases per 100,000 travellers to endemic regions
TYPHOID AND PARATYPHOID - risk of 3 cases per 100,000 travellers per month on Indian sub-continent
RISK OF #f99213 FEVER - Maybe high in area with current epidemic transmission
General Recommendation
- Dedicated immunization history should be available
- Vaccine- type, dose, date, manufacturer, lot number & site of administration should be recorded
- Document if the patient declines to receive any recommended vaccine
- Non immunized or incompletely immunized -get routine vaccinations as per national immunization schedule
- Simultaneous administration of all indicated vaccines is encouraged
- Inactivated vaccines can be given anytime or with live viral vaccine
- If two live viral vaccine not administered on same day allow 4 weeks interval between administration
- Time intervals for vaccines requiring more than one dose should be followed
- Slight variation can be made to accommodate need of travellers
- Significant shortening of intervals is not recommended
- Interruption in vaccination schedule does not require restarting
- Ideally, vaccination has to be started early, to minimize adverse effects at time of departure & to allow sufficient time for adequate immunity to develop.
Factors to be Considered:
✓ Time between the initial presentation to departure
✓ Date and destination
✓ Length of stay
✓ Type of accommodation
✓ Previous vaccination status
TRAVEL VACCINES can be divided into following Categories-
- Routine vaccines for review before traveling
- Vaccines recommended for certain destinations
- Vaccine demanded by certain countries
Routine Vaccines
Part of most national childhood immunization programs
- Diphtheria tetanus pertussis
- Hepatitis B
- Haemophilus influenza type b
- Influenza
- MMR
- HPV
- Pneumococcal
- Polio
- Rotavirus
- Tuberculosis
- Varicella
Vaccine Recommended for Certain Destinations
Provides protection against diseases endemic in country of origin or destination
- Cholera
- Hepatitis A/E
- Japanese encephalitis
- Meningococcal
- Typhoid fever
- #f99213 fever
- Rabies
- Tick born encephalitis
Vaccines Demanded by Some Countries
Some countries require proof of vaccination to enter or exit the country
- #f99213 fever
- Polio vaccine
- Meningococcal vaccine
Important Points to Be Noted
- No single vaccination schedule suits all travellers
- It must be Personalized
- Pre-travel consultation is a good opportunity to review routine immunization
- Always consult travel medicine practitioner 4-8 weeks before departure to have optimal time to complete vaccination
- Try to complete vaccination at least 2 weeks before departure
- Combination and co administration of vaccines should be preferred
- Routine country requirements for international travellers are updated on ITH page of WHO website
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