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Get up-to-date on Vaccines before your holiday travel

Dr. M. Vijayalakshmi, M.D (Peds), M.D (USA), F.A.A.P

"Content Source: Advances in Vaccinology- Volume 1/ Issue 2/ 2007"

Get up-to-date on Vaccines before your holiday travel

It is the travel season again. And the reach and volume of holiday goers in India has grown significantly. More families travel during this season and to more distant places for their vacations.

Modern vaccines are effective and have a good safety profile. Preventional vaccination is the most effective medical intervention in saving lives and reducing the burden of infectious diseases to both the families and the society. For travelers, vaccination offers the possibility of avoiding a number of dangerous infections that may be encountered during travel.

Travelers, both children and adults are advised to review their vaccination history with their doctor prior to traveling, and undergo the necessary vaccinations. There is no single schedule for the administration of vaccines to travelers. Each schedule must be personalized according to the individual traveler’s immunization history, the countries or places to be visited, the type and duration of travel, planned activities and the amount of time available before departure.

The largest rates of growth in travel is experienced in East Asia And the Pacific. Vaccination is, in general, a highly effective method of preventing certain infectious diseases. For the individual, and for society in terms of public health, prevention is better and more cost-effective than cure or treatment of symptoms after the disease is contracted.

Pre-travel counseling and vaccinations form an important part of the preparations for holiday travel. Pre- travel precautions should include booster dose of routine vaccines if the regular schedule has not been followed, or a full course of primary immunization for people who have never been vaccinated. Since many travelers do not see their health care professional with enough lead time for standard vaccination schedules, some common travel vaccines have developed accelerated dosing schedules to allow patients to receive the vaccination series at an accelerated pace and therefore acquire some protection before travel. Combination hepatitis A and B vaccines is an example of this.

Routine, recommended and required vaccination

As suggested by several expert groups around the world ,travel vaccines can be grouped as those that are required,routine and recommended in certain circumstances.

Vaccines for Travelers

Category Vaccine
Routine Vaccination Diphtheria/tetanus/pertusis (DTP for children, Tdap for adults)
Hepatitis B(HBV)
Haemophilus influenzae type b (Hib)
Measles (MMR)
Poliomyelitis (OPV or IPV)
Recommended Vaccination Cholera
Influenza
Hepatitis A(HAV)
Japanese encephalitis
Meningococcal disease
Pneumococcal disease
Rabies
Tick-borne encephalitis
Tuberculosis (BCG)
Typhoid Fever
Yellow fever (for individual protection)
Required Vaccination in some countries Yellow fever (for protection in vulnerable countries)
Meningococcal disease(required by (Saudi Arabia for pilgrims visiting Mecca for the Hajj or for the Umrah.)

Routine Vaccination

Routine childhood immunizations recommended in national vaccination programs usually include those against diphtheria, tetanus, poliomyelitis, measles, and hepatitis B.

Hepatitis B is primarily a concern for travelers who fail to take appropriate precautions by avoiding unsafe sex, using nonsterile needles, or fail to use personal protective equipment when providing medical care. Minute quantities of the virus are often sufficient for transmission, and the exact mode of transmission remains unknown in many individuals. The vaccine should be considered for virtually all travelers to areas with moderate to high risk of infection. Travelers who have been immunized (children or adolescents) are protected. Because routine administration of hepatitis B vaccine to infants and / or adolescents was not initiated until the 1990s in most industrialized countries, many adults remain unvaccinated.

Recommended Vaccination

Hepatitis A: Recommended vaccines need be offered to travelers who are going to certain specified destinations. For recommended immunizations, it is useful to consider incidence rates and impact, as well as specific factors including the destination, whether the people will be spending time in rural areas, the season of the year people are traveling, the age, and the health status. Hepatitis A, with the exception of influenza, is the most common vaccine-preventable infection of travelers. Travelers from industrialized countries are likely to be susceptible to infection and should receive hepatitis A vaccine before traveling to countries with moderate to high risk of infection.

Although hepatitis A is rarely fatal in children and young adults, most infected adults and some older children become ill and are unable to work for several weeks or months. The case-fatality rate exceeds 2% among those over 40 years of age and may be 4% for those aged 60 years or more.

Even luxury tourists staying at superior tourist accommodation and practicing usual food consumption behaviors may be at risk for hepatitis A infection. Because of noncompliance with avoidance of potentially contaminated food and beverages, combined with the high incidence of hepatitis A and the considerable impact of this disease, it is recommended that most travelers receive the hepatitis A vaccine prior to departure.

Meningococcal disease: Vaccination for meningococcal disease should be considered for travelers to countries where outbreaks occur. Meningococcal disease has frequently been observed during or after the Hajj and to lesser extent during the Umrah pilgrimage to Mecca.

Typhoid vaccine:

Typhoid (typhoid fever) is a serious disease. It is caused by bacteria called Salmonella Typhi. Typhoid strikes about 21 million people a year around the world and kills about 200,000.

Typhoid vaccine is recommended for travelers to parts of the world where typhoid is common. (NOTE: typhoid vaccine is not 100% effective and is not a substitute for being careful about what you eat or drink.)

Influenza vaccine:

Flu season can begin as early as October and last as late as May. In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. The "flu shot"— an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months,

People at high risk for complications from the flu should take influenza vaccine, including:

  • Children aged 6 months until their 5th birthday
  • Pregnant women
  • People 50 years of age and older

Required Vaccination

The only vaccine required by international Health Regulations is yellow fever vaccination for travel to certain countries in sub-Saharan Africa and tropical South America. The international yellow fever vaccination certificate becomes valid 10 days after vaccination and remains valid for a period of 10 years.

AllForKids provides most age appropriate vaccinations. Please visit AllForKids Vaccination Page or please call 0484-2970890 / +91 9496665432 for appointments or more information.