10 Tips for Vaccinating Children for Foreign Travel

1. Inform your pediatrician about your travel plans as soon as you finalize them.

While most overseas trips require no vaccines, others may require several, sometimes multi dose vaccines given over many months. In addition, there are new, improved formulations of vaccines that are especially beneficial for teenagers traveling overseas, a pertussis (whooping cough) containing one, and one against meningitis. Also, a second dose of varicella (chicken pox) is recommended to improve protection.

2. If possible, postpone travel until infants are at least six months of age.

By this age children have received most of their primary immunizations. Waiting is especially important for travel to developing countries.

3. The poorer the country, the greater the risk of contracting vaccine-preventable diseases.

Risk factors include close association with local children and crowding (attending large gatherings, especially ones where there are visitors from many different countries. In recent years there have been outbreaks of meningitis and pertussis among visitors on the Hajj, the annual pilgrimage to Mecca in Saudi Arabia.

4. Stick to accepted immunization schedules for optimum results.

Some parents ask that immunizations be postponed when children have minor illnesses or that one vaccine be given at a time. Some parents refuse certain vaccines. There is no evidence to support these requests. Delaying vaccination only delays protection.

5. Vaccinating children for travel helps protect non-traveling family members and other close contacts.

Non-vaccinated children have brought back from overseas measles, hepatitis A and B and pertussis and infected friends and relatives.

6. If a recommended immunization is contraindicated for medical reasons, carry a letter stating the reasons.

Yellow fever vaccine should not be given to individuals who are allergic to eggs, for example. Some countries demand this vaccine as a condition of entry. A formal letter from your health care provider will help prevent hassles with customs officials.

7. See an expert in travel medicine for travel-related vaccines.

Most health care providers who administer vaccines are well informed about recommendations for routine immunizations. But they may not be totally familiar with requirements for travel, especially travel to developing countries. While lists exist for immunizations recommended for each country, in many cases vaccines are necessary only for specific regions of that country, for prolonged stays, or in certain seasons. Influenza vaccine is recommended for children 6 months or older on cruise ships, for example.

8. Carry your children’s vaccination record.

Carry copies in your hand luggage and elsewhere. Make sure that they are legible and contain the specific name of the vaccine, not a trade name which may only be used in your home country.

9. Optimally vaccinated children virtually never need booster doses overseas.

Especially in poor countries, health care workers are prone to give injections; they give tetanus after every accident, for example. The people they are accustomed to treat are often poorly immunized and may have no records. These are the same countries where the sterility of needles and syringes may be suspect. In fact, children properly immunized against tetanus do not need booster doses for many years. When injections are suggested overseas, ask if you can first speak to your health care providers back home. Children remaining overseas for prolonged periods should have booster doses during visits home.

10. Update your own vaccinations for family trips.

Traveling with children is more likely to expose you to local children and their diseases. Many countries, including ones in Europe, do not vaccinate every child against measles, chickenpox and rubella, for example. These diseases are far more problematic for adults than for children, especially if you are or contemplating becoming pregnant. Some measles vaccines given in the 1960s may no longer be protective. In recent years outbreaks of measles have occurred in Germany, Japan and Ireland. If you are not sure about these and other diseases, blood tests determine immunity. Or, you can receive a booster dose; such doses cause no problem if you are already immune.