Appendix B: Travel Vaccine Summary Table

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 3.

Table B-1. Travel vaccine summary
VaccineTrade Name (Manufacturer)AgeDoseRouteScheduleBooster
Cholera CVD 103-HgR vaccineVaxchora (PaxVax)18–64 y100 mL (reconstituted)Oral1 doseUndetermined 1
Hepatitis A vaccine, inactivatedHavrix (GlaxoSmithKline)1–18 y0.5 mL (720 ELU)IM0, 6–12 moNone
≥19 y1 mL (1,440 ELU)IM0, 6–12 moNone
Hepatitis A vaccine, inactivatedVaqta (Merck & Co., Inc.)1–18 y0.5 mL (25 U)IM0, 6–18 moNone
≥19 y1 mL (50 U)IM0, 6–18 moNone
Hepatitis B vaccine, recombinant 2Engerix-B (GlaxoSmithKline)0–19 y (primary)0.5 mL (10 µg HBsAg)IM0, 1, 6 moNone
0–10 y (accelerated)0.5 mL (10 µg HBsAg)IM0, 1, 2 mo12 mo
11–19 y (accelerated)1 mL (20 µg HBsAg)IM0, 1, 2 mo12 mo
≥20 y (primary)1 mL (20 µg HBsAg)IM0, 1, 6 moNone
≥20 y (accelerated)1 mL (20 µg HBsAg)IM0, 1, 2 mo12 mo
Hepatitis B vaccine, recombinant 2Recombivax HB (Merck & Co., Inc.)0–19 y (primary)0.5 mL (5 µg HBsAg)IM0, 1, 6 moNone
11–15 y (adolescent accelerated)1 mL (10 µg HBsAg)IM0, 4–6 moNone
≥20 y (primary)1 mL (10 µg HBsAg)IM0, 1, 6 moNone
Combined hepatitis A and B vaccineTwinrix (GlaxoSmithKline)≥18 y (primary)1 mL (720 ELU HAV + 20 μg HBsAg)IM0, 1, 6 moNone
≥18 y (accelerated)Same as aboveIM0, 7, 21–30 d12 mo
Japanese encephalitis vaccine, inactivatedIxiaro (Valneva)≥17 y0.5 mLIM0, 28 d>1 y after primary series 3
3–16 y0.5 mLIM0, 28 dAwaiting FDA assessment
2 mo–2 y0.25 mLIM0, 28 dAwaiting FDA assessment
Meningococcal polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D) 4Menactra (Sanofi Pasteur)9–23 mo0.5 mLIM0, 3 moIf at continued risk 5
2–55 y0.5 mLIM1 dose
Meningococcal oligosaccharide diphtheria CRM197 conjugate vaccine (MenACWY-CRM) 4Menveo (GSK)2–12 mo0.5 mLIM0, 2, 4, 10– 13 moIf at continued risk 5
7–23 mo0.5 mLIM0, 3 mo (2nd dose administered in 2nd year of life)
2–55 y0.5 mLIM1 dose
Meningococcal polysaccharide vaccine (MPSV4)Menomune (Sanofi Pasteur)≥2 y0.5 mLSC1 doseIf at continued risk 6
Polio vaccine, inactivatedIpol (Sanofi Pasteur)≥18 y0.5 mLSC or IM1 dose if the patient has completed a pediatric seriesRepeat boosters may be needed for long-term travelers to polio-affected countries; see Chapter 3, Poliomyelitis
Rabies vaccine (human diploid cell)Imovax (Sanofi Pasteur)Any1 mLIMPreexposure series: 0, 7, and 21 or 28 dNone; see Chapter 3, Rabies for postexposure immunization
Rabies vaccine (purified chick embryo cell)RabAvert (Novartis)Any1 mLIMPreexposure series: 0, 7, and 21 or 28 dNone; see Chapter 3, Rabies for postexposure immunization
Typhoid vaccine (oral, live, attenuated)Vivotif (PaxVax)≥6 y1 capsule 7Oral0, 2, 4, 6 dRepeat primary series after 5 y
Typhoid vaccine (Vi capsular polysaccharide)Typhim Vi (Sanofi Pasteur)≥2 y0.5 mLIM1 dose2 y
Yellow feverYF-Vax (Sanofi Pasteur)≥9 mo 80.5 mLSC1 doseNot recommended for most 9
Abbreviations: ELU, ELISA units of inactivated HAV; HAV, hepatitis A virus; HBsAg, hepatitis B surface antigen; IM, intramuscular; U, units HAV antigen; SC, subcutaneous.
1 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.
2 Consult the prescribing information for differences in dosing for hemodialysis and other immunocompromised patients.
3 If potential for Japanese encephalitis virus exposure continues. Data on the response to a booster dose administered ≥2 years after the primary series are not available.
4 If an infant is receiving the vaccine before travel, 2 doses may be administered as early as 8 weeks apart.
5 Revaccination with meningococcal conjugate vaccine (MenACWY-D or MenACWY-CRM) is recommended after 3 years for children who were previously vaccinated at ages 2 months through 6 years. Revaccination with meningococcal conjugate vaccine is recommended after 5 years for people who were previously vaccinated at ages 7–55 years and every 5 years thereafter for people who are at continued risk.
6 Revaccination with meningococcal polysaccharide vaccine is recommended for adults aged >55 years who remain at increased risk 5 years after the last dose. For adults aged >55 years who have received meningococcal conjugate vaccine previously or for whom multiple doses are anticipated (such as people with asplenia), meningococcal conjugate vaccine is preferred.
7 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).
8 Special considerations apply in deciding whether to administer yellow fever vaccine to people aged <9 months or ≥60 years. Please review Chapter 3, Yellow Fever before administration.
9 In 2014, the World Health Assembly (of the World Health Organization) adopted the recommendation to remove the 10-year booster dose requirement from the International Health Regulations as of July 2016. As of that time, a completed International Certificate of Vaccination or Prophylaxis is considered valid for the lifetime of the vaccinee. However, it is uncertain when and if all countries with yellow fever vaccination entry requirements will adopt this change. In February 2015, the Advisory Committee on Immunization Practices (ACIP) approved a new recommendation that a single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. The ACIP also identified specific groups of travelers who should receive additional doses and others for whom additional doses may be considered. For full details see Chapter 3, Yellow Fever.

Author

David R. Shlim