What vaccinations or medications are recommended for children aged 10 and 14 traveling to Punta Cana with their immunocompromised mother?

From the Guidelines

For a trip to Punta Cana with an immunocompromised mother, children aged 10 and 14 should be up-to-date on routine vaccinations including MMR, DTaP/Tdap, varicella, and annual flu shots, as recommended by the most recent guidelines 1. To minimize the risk of illness, the following vaccinations and medications are recommended:

• Hepatitis A vaccine (two doses, 6 months apart) to protect against hepatitis A virus, which can be spread through contaminated food and water 1.
• Consider typhoid vaccination (either oral Vivotif taken 4 doses over 7 days, or injectable Typhim Vi) to protect against typhoid fever, although the risk is relatively low in Punta Cana 1.
• Malaria prophylaxis is not typically needed for Punta Cana, but insect repellent with 20-30% DEET should be used to prevent mosquito-borne illnesses like dengue fever and Zika.
• The children should practice careful food and water hygiene, including drinking only bottled water and avoiding uncooked foods.
• Since their mother is immunocompromised, it's especially important that the children be fully vaccinated to create a protective "bubble" around her.
• The family should consult with a travel medicine specialist 4-6 weeks before departure, as recommendations may change and the mother's specific condition might require additional precautions 1. Some key points to consider:
• Live-virus vaccines should be avoided in immunocompromised individuals, but inactivated vaccines such as Hepatitis A and typhoid vaccines are safe and recommended 1.
• The children's vaccination status should be reviewed and updated before travel to ensure they are protected against vaccine-preventable diseases.
• The family should be aware of the risks of travel-related illnesses and take necessary precautions to minimize their risk.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Vaccination Recommendations for Children Traveling to Punta Cana

• Children aged 10 and 14 traveling to Punta Cana should be up to date on their routine vaccinations, including measles, mumps, rubella; hepatitis A and B; polio; meningococcal; coronavirus disease 2019 (COVID-19); and influenza 2
• Additionally, travel-specific vaccination recommendations should be considered, such as dengue, cholera, typhoid, tick-borne encephalitis, yellow fever, Japanese encephalitis, and rabies 2
• The Centers for Disease Control and Prevention website (https://wwwnc.cdc.gov/travel) can be consulted for travel vaccine recommendations 2

Considerations for Immunocompromised Travelers

• Immunocompromised individuals, such as the mother in this case, may require special consideration when traveling to areas with a high risk of infectious diseases 3
• Consultation with a healthcare professional is necessary to assess the individual's health risks and provide guidance on preventive measures and presumptive treatment 3

Vaccine Options for Dengue and Other Arboviruses

• The recombinant tetravalent vaccine Dengvaxia® is available for the prevention of severe dengue and hospitalization in seropositive subjects, but its use should be determined on a case-by-case basis 4
• There are currently no effective treatments or vaccines with proven activity against Zika virus (ZIKV) or chikungunya (CHIKV) 4

Combined Vaccines for Travelers

• Combined vaccines, such as those against typhoid fever and hepatitis A, can provide dual protection and improve compliance and coverage for travelers 5, 6
• These vaccines have been shown to be safe and effective in healthy adults, with high seroconversion rates and minimal adverse events 5, 6