From the Guidelines
When traveling internationally, it is essential to receive the recommended vaccines to prevent serious diseases and reduce the risk of morbidity, mortality, and compromised quality of life. The most recent and highest quality study, 1, provides guidance on the recommended adult immunization schedule, including vaccines for hepatitis A and B, typhoid fever, yellow fever, Japanese encephalitis, rabies, meningococcal disease, and COVID-19.
Key Vaccines for International Travel
- Hepatitis A vaccine is recommended for most travelers to developing countries, requiring two doses six months apart for long-term protection 1.
- Typhoid vaccination is advised for travelers to areas with poor sanitation, available as either an oral vaccine (four capsules taken every other day, providing protection for five years) or an injection (one dose, protecting for two years) 1.
- Yellow fever vaccination is required for entry into certain countries in Africa and South America, with proof documented on an International Certificate of Vaccination 1.
- Meningococcal vaccine is recommended for adults with certain medical conditions, such as anatomic or functional asplenia, and for travelers to countries with high or intermediate endemicity of meningococcal disease 1.
Consultation and Timing
It is crucial to consult a travel medicine specialist or healthcare provider 4-6 weeks before travel to determine the necessary vaccines based on the destination, planned activities, and health status. Completing vaccinations at least 2-4 weeks before departure is recommended, as some vaccines require multiple doses or time to become effective 1.
Additional Considerations
- Routine vaccinations, such as measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis, varicella, polio, and yearly flu shots, should also be up to date 1.
- The risk of disease and the need for vaccination should be assessed individually, taking into account the traveler's health status, destination, and planned activities 1.
From the FDA Drug Label
Typhoid vaccination is not required for international travel, but is recommended for travelers to such areas as Africa, Asia, and Central and South America where there is a recognized risk of exposure to S typhi. Selective immunization against typhoid fever is recommended under the following circumstances: 1) travelers to areas where a recognized risk of exposure to typhoid exists, particularly ones who will have prolonged exposure to potentially contaminated food and water
The recommended vaccines for traveling out of the country include Typhoid vaccines, such as Typhim Vi and Ty21a, for travelers to areas with a recognized risk of exposure to S typhi, particularly those who will have prolonged exposure to potentially contaminated food and water.
- Travelers to areas such as Africa, Asia, and Central and South America should consider typhoid vaccination.
- Typhoid vaccination is especially recommended for travelers who will have prolonged exposure to potentially contaminated food and water 2.
From the Research
Recommended Vaccines for Traveling Out of the Country
The following vaccines are recommended for travelers:
- Hepatitis A vaccine: protects against hepatitis A, a disease prevalent in many countries 3, 4, 5
- Typhoid fever vaccine: protects against typhoid fever, a disease common in endemic countries 3, 4, 5, 6
- Yellow fever vaccine: protects against yellow fever, a disease prevalent in certain countries 3, 5
- Hepatitis B vaccine: protects against hepatitis B, a disease with a significant global distribution 6
- Japanese encephalitis vaccine: protects against Japanese encephalitis, a disease prevalent in certain countries 3
- Rabies vaccine: protects against rabies, a disease prevalent in many countries 3
- Diphtheria vaccine: protects against diphtheria, a disease with a significant global distribution 3
- Tetanus vaccine: protects against tetanus, a disease with a significant global distribution 3
- Polio vaccine: protects against polio, a disease with a significant global distribution 3
Combination Vaccines
Combination vaccines are available to protect against multiple diseases:
- A combined vaccine against typhoid fever and hepatitis A is available and has been shown to be safe and effective 4
- A combined vaccine against hepatitis A, hepatitis B, and typhoid fever is also available and has been shown to be safe and effective 6
Administration of Vaccines
The administration of multiple vaccines at the same time has been shown to be safe and effective:
- The concurrent administration of hepatitis A vaccine with other vaccines, such as typhoid fever, yellow fever, and Japanese encephalitis, does not compromise the immune response to these vaccines 3, 5
- The administration of a combined vaccine against hepatitis A, hepatitis B, and typhoid fever has been shown to be safe and effective, with high seroconversion rates against all three diseases 6