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

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 r

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 Travel

Vaccine Primary Series Booster

Interval

Cholera, live oral (CVD

103 - HgR)

1 dose 6 months

Hepatitis A (Havrix),

1440 enzyme immunoassay

U/mL

2 doses, 6–12 months apart, IM

None required

Hepatitis A (VAQTA,

AVAXIM, EPAXAL)

2 doses, 6–12 months apart, IM

None required

Hepatitis A/B combined

(Twinrix)

3 doses at 0, 1,

and 6–12 months or 0, 7,

and 21 days plus booster

at 1 year, IM

None required

except 12 months (once

only, for accelerated schedule)

Hepatitis B (Engerix B):

accelerated schedule

3 doses at 0, 1,

and 2 months or 0, 7,

and 21 days plus booster

12 months, once only

at 1 year, IM

Hepatitis B (Engerix B or

Recombivax): standard schedule

3 doses at 0, 1, and 6 months, IM

None required

Immune globulin

(hepatitis A prevention)

1 dose IM Intervals of 3–5

months, depending on initial dose

Japanese encephalitis

(JEV, Biken)

3 doses, 1 week apart, SC

12–18 months (first booster), then 4 years

Meningococcus,

quadrivalent [Menimmune

(polysaccharide), Menactra

(conjugate)]

1 dose SC >3 years

(optimum booster schedule not yet determined)

Rabies (HDCV), rabies

vaccine absorbed (RVA), or

purified chick embryo cell

3 doses at 0, 7, and 21 or 28 days, IM

None required except with exposure

vaccine (PCEC)

Typhoid Ty21a, oral live

attenuated (Vivotif)

1 capsule every other day x 4 doses

5 years

Typhoid Vi capsular

polysaccharide, injectable

(Typhim Vi)

1 dose IM 2 years

Yellow fever 1 dose SC 10 years

reactions occur only rarely The vaccine is recommended for persons staying >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 A Vero 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 500,000 journeys to endemic areas Cholera vaccine, no longer available in the United States, was rarely recommended but was considered for aid and health care

workers in refugee camps or in disaster-stricken/war-torn areas A more effective oral cholera vaccine is available in other countries