Appendix B: Travel Vaccine Summary Table

Table B-1 is a quick reference for administering or prescribing travel-related vaccines. Before administering any vaccine, please pay particular attention to the dose and whether it is to be administered intramuscularly or subcutaneously. Also review detailed instructions, contraindications, precautions, and side effects under the specific vaccines discussed in this book or in the manufacturer’s prescribing information. For other immunizations, refer to the corresponding disease section in Chapter 4.

Table B-1. Travel vaccine summary
Vaccine	Trade Name (Manufacturer)	Age	Dose	Route	Sched-Ule	Booster
Cholera CVD 103-HgR vaccine	Vaxchora (PaxVax)	18–64 y	100 mL (reconstituted)	Oral	1 dose ¹	Undetermined ²
Hepatitis A vaccine, inactivated	Havrix (GlaxoSmithKline)	1–18 y	0.5 mL (720 ELISA units)	IM	0 and 6–12 mo	None
Hepatitis A vaccine, inactivated	Havrix (GlaxoSmithKline)	≥19 y	1 mL (1,440 ELISA units)	IM	0 and 6–12 mo	None
Hepatitis A vaccine, inactivated	Vaqta (Merck & Co., Inc.)	1–18 y	0.5 mL (25 U)	IM	0 and 6–18 mo	None
Hepatitis A vaccine, inactivated	Vaqta (Merck & Co., Inc.)	≥19 y	1 mL (50 U)	IM	0 and 6–18 mo	None
Hepatitis B vaccine, recombinant with novel adjuvant (1018)	Heplisav-B (Dynavax Technologies Corp.)	>18	0.5 mL (20 µg HBsAg and 3,000 µg of 1018)	IM	0, 1 mo	None
Hepatitis B vaccine, recombinant ³	Engerix-B (GlaxoSmithKline)	0–19 y	0.5 mL (10 μg HBsAg)	IM	0, 1, 6 mo	None
		0–10 y (accelerated)	0.5 mL (10 μg HBsAg)	IM	0, 1, 2 mo	12 mo
		11–19 y (accelerated)	1 mL (20 μg HBsAg)	IM	0, 1, 2 mo	12 mo
		≥20 y (primary)	1 mL (20 μg HBsAg)	IM	0, 1, 6 mo	None
		≥20 y (accelerated)	1 mL (20 μg HBsAg)	IM	0, 1, 2 mo	12 mo
Hepatitis B vaccine, recombinant ³	Recombivax HB (Merck & Co., Inc.)	0–19 y (primary)	0.5 mL (5 μg HBsAg)	IM	0, 1, 6 mo	None
		11–15 y (adolescent accelerated)	1 mL (10 μg HBsAg)	IM	0, 4–6 mo	None
		≥20 y (primary)	1 mL (10 μg HBsAg)	IM	0, 1, 6 mo	None
Combined hepatitis A and hepatitis B vaccine	Twinrix (GlaxoSmithKline)	≥18 y (primary)	1 mL (720 ELU HAV + 20 μg HBsAg)	IM	0, 1, 6 mo	None
Combined hepatitis A and hepatitis B vaccine	≥18 y (accelerated)	1 mL (720 ELU HAV + 20 μg HBsAg)	IM	0, 7, and 21–30 d	12 mo
Japanese encephalitis vaccine, inactivated	Ixiaro (Valneva)	2 mo-2 y	0.25 mL	IM	0, 28 d	≥1 year after primary series ⁴
		3-17 y	0.5 mL	IM	0, 28 d	≥1 year after primary series ⁴
		18-65 y	0.5 mL	IM	0, 7-28 d	≥1 year after primary series ⁴
		>65 y	0.5 mL	IM	0, 28 d	≥1 year after primary series ⁴
Meningococcal (serogroups A, C, W, and Y) polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D) ⁵	Menactra (Sanofi Pasteur)	9–23 mo	0.5 mL	IM	0, 3 mo	If at continued risk ⁷
	Menactra (Sanofi Pasteur)	≥ 2 y	0.5 mL	IM	1 dose ⁶	If at continued risk ⁷
Meningococcal (serogroups A, C, W, and Y) oligosaccharide diphtheria CRM¹⁹⁷ conjugate vaccine (MenACWY-CRM) ⁵	Menveo (GSK)	2 mo	0.5 mL	IM	0, 2, 4, 10 mo	If at continued risk ⁷
		7–23 mo	0.5 mL	IM	0,3 mo (2nd dose administered in 2nd year of life)
		≥ 2 y	0.5 mL	IM	1 dose ⁶
Polio vaccine, inactivated	Ipol (Sanofi Pasteur)	≥18 y	0.5 mL	SC or IM	1 dose if patient has completed a pediatric series	Repeat boosters may be needed for long-term travelers to polio-affected countries; see Chapter 4, Polio
Rabies vaccine (human diploid cell)	Imovax (Sanofi Pasteur)	Any	1 mL	IM	Preexposure series: days 0, 7, and 21 or 28 d	None; see Chapter 4, Rabies for postexposure immunization
Rabies vaccine (purified chick embryo cell)	RabAvert (Novartis)	Any	1 mL	IM	Preexposure series: days 0, 7, and 21 or 28 d	None; see Chapter 4, Rabies for postexposure immunization
Typhoid vaccine (oral, live, attenuated)	Vivotif (PaxVax)	≥6 y	1 capsule ⁸	Oral	0, 2, 4, 6 d	Repeat primary series after 5 y
Typhoid vaccine (Vi capsular polysaccharide)	Typhim Vi (Sanofi Pasteur)	≥2 y	0.5 mL	IM	1 dose	2 y
17D yellow fever vaccine	YF-Vax (Sanofi Pasteur)	≥9 mo ⁹	0.5 mL ¹⁰	SC	1 dose	Not recommended for most ¹¹
Abbreviations: ACIP, Advisory Committee on Immunization Practices; ELU, ELISA units of inactivated HAV; HAV, hepatitis A virus; HBsAg, hepatitis B surface antigen; IM, intramuscular; U, units HAV antigen; SC, subcutaneous.
¹ Must be administered in a health care setting.
² In a clinical trial, vaccine efficacy was 90% at 10 days postvaccination and declined to 80% at 3 months postvaccination in prevention of severe diarrhea after oral cholera challenge. Long-term immunogenicity is unknown. Clinicians advising travelers who are at continued or repeated risk over an extended period may consider revaccination, although the appropriate interval and efficacy are unknown.
³ Consult the prescribing information for differences in dosing for hemodialysis and other immunocompromised patients.
⁴ If potential for Japanese encephalitis virus exposure continues.
⁵ If an infant is receiving the vaccine before travel, 2 doses may be administered as early as 8 weeks apart.
⁶ For people with HIV, anatomic or functional asplenia, and people with persistent complement component deficiencies (C3, C5-9, properdin, factor D, and factor H or people taking eculizumab [Soliris]) should receive a 2-dose primary series 8–12 weeks apart.
⁷ Revaccination with meningococcal conjugate vaccine (MenACWY-D or MenACWY-CRM) is recommended after 3 years for children who received their last dose at <7 years of age. Revaccination with meningococcal conjugate vaccine is recommended after 5 years for people who received their last dose at ≥7 years of age, and every 5 years thereafter for people who are at continued risk.
⁸ Must be kept refrigerated at 35.6°F–46.4°F (2°C–8°C); administer with cool liquid no warmer than 98.6°F (37°C).
⁹ Ages 6–8 months and ≥60 years are precautions and age <6 months is a contraindication to the use of yellow fever vaccine.
¹⁰ YF-Vax is available in single-dose and multiple-dose (5-dose) vials.
¹¹ For full details regarding revaccination, see “Vaccine Administration” in Chapter 4, Yellow Fever.

Author

Johanzynn Gatewood

Appendix B: Travel Vaccine Summary Table