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What vaccinations do I need to have before traveling abroad?
Once you decide that your travel plans will take you beyond the US borders,
it’s wise to make an appointment with your physician or a travel medicine
clinic to discuss your immunization needs. Whether or not you will need
particular vaccines will depend on several factors, including:
- Your risk of exposure to diseases in the countries to be visited
- Your age, current health status, and vaccination history
- The presence of additional individual risk factors, such as if you are
pregnant, have pre-existing cardiovascular disease, or have HIV or AIDS
- Reactions to previous vaccine doses and your allergy history (including
medication allergies)
- The risk of infecting others
- Length of visit
Some vaccinations are simply recommended while others are required if
traveling to specific countries. The World Health Organization and the Centers
for Disease Control and Prevention recommend that all travelers be up-to-date
with the routine schedule of childhood vaccinations and booster shots. These
routine vaccines include:
- Diphtheria/tetanus/pertussis (DTP)
- Hepatitis B (HBV)
- Haemophilus influenzae type b (Hib)
- Measles/mumps/rubella (MMR)
- Poliomyelitis
Examples of mandatory vaccines include yellow fever – if traveling to
central and south America or Africa – and meningococcal disease –which is
required by Saudi Arabia for pilgrims visiting Mecca annually [Hajj] or at any
time [Umrah] and/or Medina. Other vaccines, for example, to protect against
rabies or typhoid fever, may be recommended depending on your travel itinerary.
Ask your doctor about your specific needs.
What is a travel medicine clinic?
A travel medicine clinic is an office staffed by doctors and nurses who have
a special interest or special training in travel and tropical medicine. The
types of services offered at travel clinics can vary widely, but may include the
provision of:
- pre-travel consultations and vaccinations
- official vaccine certificate documentation or letter of
exception (which is necessary for entry into countries)
- any necessary prescriptions
- post-travel medical consultations, evaluation and care, if
necessary
- onsite diagnostic laboratory services
The Cleveland Clinic has an International Travelers’ Health Clinic. To make
an appointment, call (216) 444-8845. Many state and local health departments
also offer travel immunization services. Check your white pages for office
locations. In addition, two organizations, the International Society of Travel
Medicine and the American Society of Tropical Medicine and Hygiene provide
travel clinic directories at their web sites, respectively at: http://www.istm.org/
and http://www.astmh.org/.
Seeking out specialist assistance is highly recommended given the rapidly
changing nature of infectious concerns and recommendations when traveling to
international destinations. Moreover, specialized education can enhance the
likelihood of event-free travel. The Cleveland Clinic International Travelers’
Health Clinic provides a thorough review of your itinerary, and gives both
general and individualized printed information to assist your travel
preparation.
In addition to the information provided by a travel medicine clinic, where
else can I find out each country’s immunization recommendations and
requirements?
Several government, national, and international organizations provide
information and other assistance. Many of these groups provide easy access
through their Internet sites. If you do not have home Internet access, visit
your public library to gain access. These groups include:
Centers for Disease Control (CDC) and Prevention
Current outbreak bulletins on diseases of concern for international travelers
as well as vaccination information and other travel-related health news are
available from the CDC. Contact the CDC at:
By phone: 877-394-8747 (877-FYI-TRIP)
By computer with Internet access: http://www.cdc.gov/travel
World Health Organization
World Health Organization vaccination requirements and recommendations are
listed at the WHO site (http://www.who.int/ith/preface.html). Visitors to this
site can use the toolbox to search for requirements and recommendations
according to country names or by disease.
International Association for Medical Assistance to Travelers
Vaccine requirements and recommendations can also be found at this site at
www.iamat.org/pdf/WorldImmunization.pdf
American Citizens Services and Crisis Management (ACS)
The ACS is an office of the Overseas Citizens Services, which is within the
State Department’s Bureau of Consular Affairs. The ACS assists in all matters
involving protective services for Americans abroad. The ACS issues facts sheets
on every country in the world called Consular Information Sheets, which contain
information on the entry requirements and other details relevant to travel in a
particular country. This office also issues travel warnings.
Consular Information Sheets and travel warnings can be obtained in the
following ways:
By computer with Internet access: http://travel.state.gov
By voice: 202-647-5225 (from a touchtone phone)
By fax: 202-647-3000
By mail, write to: Office of Overseas Citizens Services, Bureau of
Consular Affairs, Room 4811, US Department of State, Washington, DC 20520-4814
(send a self-addressed, stamped business-size envelope)
In person: available at any of the 13 regional passport agencies, at US
embassies and consulates abroad, through the airline computer reservation
systems
How much time do I need to plan for prior to my departure in order to receive
any necessary vaccines?
Consult a travel medicine clinic 4 to 6 weeks before your departure. Keep in
mind that a vaccine’s protective effect takes some time to develop following
the vaccination and that some vaccines may require more than one dose. Therefore
more than one office visit may be required. However, when urgent travel issues
arise it remains prudent to arrange a travel medicine specialist visit even up
to the day before departure.
If needed, all commonly used vaccines can be given on the same day. However,
certain vaccines that typically cause local reactions should (if possible) be
given on separate office visits. Fortunately, a number of combined vaccines are
now available that provide protection against more than one disease. Combination
vaccines are just as safe and effective as individual single-disease vaccines
and offer the convenience of fewer injections.
Do I need to present any vaccine-related official paperwork as I cross
country borders?
All travelers, adults and children included, will need a written record of
all vaccines administered, preferably using the International Certificate of
Vaccination (which is required in the case of yellow fever vaccination) as well
as any letter of exemption. The International Certificate of Vaccination must be
completed and printed in English and French (an additional language also may be
used). Separate certificates should be issued to each member of the traveling
party. The certificate is considered valid only if the vaccine used has been
approved by the World Health Organization and if it was given at a designated
center (approved by the health administration for your geographic area of the
county). An authorized person must sign the certificate; a rubber stamp
signature is not acceptable. The certificate is valid for 10 years, beginning 10
days after the date of vaccination. The Cleveland Clinic International Travelers’
Health Clinic will provide this documentation at the time of your visit.
When calling for an appointment, ask your doctor if he or she can provide you
with this necessary official certificate.
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