Polio Vaccine Guidance for Travelers and Note on Travel to Israel, the West Bank, and Gaza
- CDC recommends that all international travelers be fully vaccinated against polio.
- A single lifetime polio vaccine booster dose is recommended for adult travelers to countries with evidence of wild poliovirus (WPV) circulation (during the last 12 months). This includes Israel, the West Bank, and Gaza where environmental surveillance indicates WPV circulation, though no human polio cases, during this time period.
- A single lifetime adult polio vaccine booster dose is also recommended for travelers with a high risk of exposure to someone with imported WPV infection when traveling to some countries that border areas with WPV circulation.
Destination-Specific Recommendations for Polio Vaccine
CDC’s recommendations for polio vaccine are listed in the table below. Additionally, the World Health Organization (WHO) has recommended that certain countries require residents and long-term travelers (staying >4 weeks) to show proof of polio vaccination when departing that country to prevent the exportation of WPV. The polio vaccine must be received between 4 weeks and 12 months before the date of departure from the polio-infected country. See our Clinical Update: Interim CDC Guidance for Travel to and from Countries Affected by the New Polio Vaccine Requirements.
|Country||CDC Recommendation for Health Protection of Travelers|
|Single lifetime IPV (inactivated polio vaccine) booster dose recommended for adults who received routine vaccination series as children; routine series recommended for unvaccinated or incompletely vaccinated children and adults and those with unknown vaccination status.|
|Polio vaccine recommended for travelers to these countries or provinces who will be in situations with a high risk of exposure to someone with imported poliovirus. These situations include working in health care settings involving direct patient contact, refugee camps, or other humanitarian aid settings. Single lifetime IPV booster dose recommended for adults who received routine vaccination series as children; routine series recommended for unvaccinated or incompletely vaccinated children and adults and those with unknown vaccination status.|
CDC Polio Vaccine Recommendations
Before traveling to areas with WPV circulation during the past 12 months, CDC recommends all travelers ensure that they have completed the recommended age-appropriate polio vaccine series and have received a single adult IPV booster dose, if necessary.
Three countries are still endemic for polio (Afghanistan, Nigeria, and Pakistan). Countries where WPV has circulated during the past 12 months include those 3 endemic countries and countries with polio outbreaks or environmental evidence of active WPV circulation during this time (Cameroon, Ethiopia, Equatorial Guinea, Iraq, Israel, Somalia, and Syria). WHO operationally considers outbreaks inactive 6 months after the latest evidence of WPV circulation.
In addition, travelers working in health care settings, refugee camps, or other humanitarian aid settings in these and certain neighboring countries (those with evidence of historical cross-border transmission) might be at particular risk for exposure to WPV. Adults working in these settings should also be up-to-date with the recommended age-appropriate polio vaccine series, including a single adult IPV booster dose.
See our Clinical Update: Interim CDC Guidance for Travel to and from Countries Affected by the New Polio Vaccine Requirements for certain travelers.
Note on Travel to Israel, the West Bank, and Gaza
CDC recommends that all travelers to Israel, the West Bank, and Gaza be fully vaccinated against polio and practice good personal hygiene and cleanliness. In addition, adults should receive a single lifetime IPV booster dose before traveling to Israel, the West Bank, and Gaza. See the Vaccine section in Chapter 3, Poliomyelitis, CDC Health Information for International Travel, for specific vaccination details.
On June 3, 2013, the WHO Disease Outbreak News reported detection of WPV type 1 in samples of sewage from Rahat, a Bedouin village in the Southern District of Israel. During the subsequent months, additional testing identified more WPV-positive sampling sites in the Southern and Central Districts and positive results from sporadic samples taken in the Haifa, Tel Aviv, and Jerusalem Districts. WHO also indicated that positive stool specimens had been collected from some healthy children who had been fully vaccinated with IPV. (See the WHO reports from 2013: June 3, July 15, and August 15.)
During mid-September 2013–March 2014, positive specimens continued to be found from a few sites in the Southern District, with most recent positive sample collected during the week of March 30, 2014. Positive environmental samples have also been intermittently detected in the West Bank and Gaza, with the most recent positive sample collected during the week of January 5, 2014. (See the Global Polio Eradication Initiative report.)
No human polio cases have been identified in Israel or in the West Bank and Gaza to date. Childhood vaccination coverage in Israel with 4 doses of IPV is very high (92%–98%); in the West Bank and Gaza, more than 98% of children have received their complete course of polio vaccinations. Israel, the West Bank, and Gaza also have an extensive system of environmental surveillance (testing sewage samples for poliovirus). In response to the positive environmental surveillance results, the Israeli and Palestinian Authority Ministries of Health initiated vaccination campaigns for children. Since January 1, 2014, the Israeli Ministry of Health has recommended 2 doses of bivalent oral polio vaccine (bOPV) for all children in Israel at 6 and 18 months of age, in addition to the routine 4-dose IPV schedule. The Palestinian Authority Ministry of Health has continued with their routine immunization schedule for polio, using a combination of trivalent oral polio vaccine (tOPV) and IPV.
- Clinical Update: Interim CDC Guidance for Travel to and from Countries Affected by the New Polio Vaccine Requirements
- Interim CDC Guidance for Polio Vaccination for Travel to and from Countries Affected by Wild Poliovirus (MMWR, July 11, 2014)
- CDC HAN 362: Guidance to US Clinicians Regarding New WHO Polio Vaccination Requirements for Travel by Residents of and Long-term Visitors to Countries with Active Polio Transmission
- Poliomyelitis in CDC Health Information for International Travel-“Yellow Book”
- CDC Polio Homepage
- CDC Travelers’ Health Polio Disease Page
- Polio Vaccine Questions and Answers
- Vaccine Information Statements (VIS)
- Food and Water Safety
- Global Polio Eradication Initiative--Data and Monitoring
- Immunization Schedules (CDC's National Center for Immunization and Respiratory Diseases)
- Poliomyelitis in Epidemiology and Prevention of Vaccine-Preventable Diseases -“Pink Book”
- Polio-Immediate Notifiable Disease