International Travel: Vaccinations

With package tours and international trips becoming less expensive than stays at many traditional U.S. vacation spots, more Americans are opting to take time off overseas. While this may seem like an even trade, world travelers run the risk of contracting exotic diseases such as malaria, typhoid fever and yellow, especially if they’ll be visiting tropical areas and third-world countries.

Each part of the world has its own risks, but there are ways you can prepare. First, learn all you can about the risks indigenous to your destination. For instance, influenza season differs in the Northern and Southern Hemispheres. Check the season for where you’re going and, if necessary, get a shot.

Chances are you'll need some kind of vaccine. According to Richard Snepar, M.D., an infectious disease physician who consults patients about travel-related illnesses, vaccinations fall into three categories: childhood vaccinations, legally required immunizations, and recommended immunizations.

Childhood Vaccinations
Snepar recommends that before you travel, consult with a physician who will review your childhood vaccinations and administer the necessary treatments. This category includes:

• Measles-mumps-rubella (MMR) vaccine -- for people born after 1956 who don't have documentation of two doses of the vaccine
• Polio shots -- recommended for travelers to places where the disease is endemic, such as India, Nigeria, Pakistan, Egypt, Afghanistan, Niger and Somalia
• Chicken pox -- recommended for those who never contracted the disease and for children ages 1-12, to ward off chickenpox; children 13-and-older and women of child-bearing age who have not had chickenpox should receive two doses administered four to eight weeks apart
• Pneumococcal vaccine -- for travelers older than 65 years of age, and younger adults with chronic cardiopulmonary disease, asplenia, cirrhosis, or diabetes mellitus

Legally Required Immunizations
This group includes vaccines necessary to gain legal entrance into a country. For instance, if you're traveling to a country in the yellow fever zone, you'll most likely need a vaccine. Research your destination first. Determine which, if any, vaccines are necessary to gain entry.

Sometimes travelers returning from disease-zone countries are required to get a vaccine to prevent disease introduction back home. Find out what you'll need both coming and going.

Recommended Immunizations
Vaccines in this category are not required but are good to get. For instance, you may want to get a tetanus shots if five or more years have elapsed since your last vaccination.

Other immunizations often recommended include:

• Diphtheria toxoids boosters
• Vaccinations against hepatitis A, B, and C viruses
• Human immunodeficiency virus (HIV)

Consult a Doctor
Determining which vaccines you need could become confusing. That's why you should see a doctor before your trip. A physician will advise you on what immunizations would be prudent, based on your itinerary, country of destination, and region of the world. A comprehensive evaluation would include a review of possible stopovers and activities. For instance, if you're going someplace where you'll come into contact with animals, a rabies vaccination may be advisable. A physician would also consider your accommodations. A typhoid vaccination may be recommended for travelers who may be exposed to contaminated food and drink. The amount of contact you will have with local residents could also determine your need. For instance, a Japanese encephalitis vaccine would be advisable for travelers planning long trips to rural areas in Southeast Asia or the Indian subcontinent during transmission season.

Finally, give yourself enough time between your trip and the vaccinations. Physicians recommend getting your shots at least four weeks in advance.