What You Need to Know Before Traveling Abroad
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 a travel health expert to discuss your general health and 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 a condition that might weaken your immune system such as cancer or HIV
- 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 (Tdap)
- Hepatitis B (HBV)
- Haemophilus influenzae type b (Hib)
- Measles/mumps/rubella (MMR)
- Poliomyelitis (IPV)
Examples of required or mandatory vaccines include yellow fever – if traveling to parts of South America or Africa – and meningococcal vaccine, which is required by Saudi Arabia for pilgrims visiting Mecca and/or Medina for the annual (Hajj) or at any time (Umrah). Other vaccines, for example, to protect against Hepatitis A or typhoid fever, may be recommended depending on your travel itinerary. Ask your travel health specialist about your specific needs.
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 and useful 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, are wise to take a written record of vaccines administered. The International Certificate of Vaccination is required in the case of yellow fever vaccination, or a letter of exemption when appropriate. The International Certificate of Vaccination must be completed and printed in English or 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 country). 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 Clinics are approved yellow fever vaccination sites and will provide this documentation at the time of your visit.
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 include the provision of:
- pre-travel consultations and vaccinations
- official vaccine certificate documentation or letter of exception (which is necessary for entry into certain countries)
- any necessary prescriptions
- post-travel medical consultations, evaluation and care, if necessary
- on site diagnostic laboratory services
Cleveland Clinic has a group of International Travelers' Health Clinics. To make an appointment, call:
- Main Campus G-21 216.444.8845
- Garfield Heights 216.587.5431
- Willoughby Hills Family Health Center 440.943.2500
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: www.istm.org/ and www.astmh.org/, respectively.
Seeking out specialist assistance is highly recommended given the rapidly changing nature of infectious disease concerns and protective recommendations when traveling to international destinations. 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. Our focus is to meet the individual needs of each traveler.
Can't my own doctor get me ready to travel?
Travel-related illness can change rapidly with ever-increasing global travel. Therefore, a visit to a specialized clinic that focuses on international travel will ensure you get all you need and avoid immunization and medications you do not need. Data shows you are much less likely to get ill while traveling after seeing a travel health expert. Empowering you to travel well and enjoy your time abroad is our goal and our privilege.
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:
By computer with Internet access at www.cdc.gov/travel or by phone at 877.394.8747 (877.FYI.TRIP)
World Health Organization
World Health Organization vaccination requirements and recommendations are listed at the WHO site (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 fact 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: www.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
- Markle WH, Akinmerese O. Chapter 51. In: South-Paul JE, Matheny SC, Lewis EL, eds. CURRENT Diagnosis & Treatment in Family Medicine. 3rd ed. New York: McGraw-Hill; 2011. Travel Medicine Accessed 11/1/2013.
- American College of Physicians. Travel Immunization Accessed 11/1/2013.
- U.S. Department of State. International Travel Accessed 11/1/2013.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 10/31/2013...#12569