Vaccination (Single-dose vaccines): Recommended for travelers to areas with an outbreak. May be considered for certain travelers visiting or moving to an area with elevated risk for a longer period of time (e.g., 6  months or more).

--Two vaccines are available: live-attenuated (IXCHIQ) and virus-like particle (VIMKUNYA). More information: Chikungunya Vaccine Information for Health Care Providers.

Vaccination: Recommended for adults who are traveling to areas of active cholera transmission.

--Administer at least 10 days before travel.

Consultation: Advise patient to wash hands frequently and avoid unsafe food and water.

Contaminated food & water

Vaccination (2-dose vaccine): Recommended for most travelers.

--Administer 2 doses, at least 6 months apart.
--At least 1 dose should be given before travel.

Consultation: Advise patient to wash hands frequently and avoid unsafe food and water.

Vaccination (3-dose vaccine): Recommended for all non-immune travelers, but especially those who are traveling to a country with hepatitis B prevalence ≥2%.

--Administer doses at 0, 1, and 6 months.
--Accelerated schedule is available.

Consultation: Advise patient to practice safe sex and avoid contaminated needles and blood products.

Vaccination (2-dose vaccine): Recommended for travelers moving to an endemic country in Asia or the western Pacific to live, longer-term travelers (e.g., trips lasting >1 month), or frequent travelers.

May also be considered for shorter-term (e.g., less than 1 month) travelers to endemic areas  during Japanese encephalitis virus transmission season if their itinerary or activities will increase their risk (e.g., spending substantial time outdoors in rural or agricultural areas, or staying in accommodations without air conditioning, screens, or bed nets). 

--Dose schedules vary for children aged 2 months to 17 years, adults aged 18-65 years, and adults aged 65 years and older. Guidance: Table 4.7.2 | Yellow Book

--Complete initial vaccine series at least 1 week before travel.

--A booster dose (third dose) may be given at least 1 year after completion of the primary series if ongoing exposure or re-exposure to JE virus is expected.

Consultation: Advise patient to prevent mosquito bites.

Medication: Consider malaria prophylaxis for travelers to areas with malaria transmission, which include parts of Africa, Latin America, parts of the Caribbean, South Asia, East Asia, the Middle East, Eastern Europe, and the South Pacific.

--Choosing a medication for prophylaxis must take into account the traveler’s medical history and current medications, as well as malaria drug resistance in the area(s) of travel.

Consultation: Advise patient to avoid mosquitoes. Advise pregnant women to avoid travel to areas with malaria transmission if possible.

Vaccination: Recommended for travelers to areas in the “meningitis belt” of sub-Saharan Africa, particularly during the dry season (December through June), when the disease is more common.

Required for travelers to Saudi Arabia for the Hajj. See Saudi Arabia: Hajj/Umrah Pilgrimage for more information.

--Administer at least 10 days before travel.

Consultation: Advise patient to wash hands often and avoid touching face and activities with risk of saliva exchange.  

• Plan to spend a lot of time outdoors or in high-risk environments (such as adventure travelers or cavers)
• Will be handling animals (such as veterinarians, animal handlers, field biologists, or laboratory workers working with animal specimens)
• Are children who may be at higher risk because they are more likely to approach animals and less likely to report bites
• Will be traveling to rural areas (because treatment might not be available)

--Begin vaccine series at least 21 days before travel.
--Administer doses at 0, 7, and 21 days or 28 days.

Consultation: Advise patient to avoid contact with animals. The risk of rabies is extremely small for travelers who know the risk, have a plan for getting care if they are bitten, and have travel health insurance to pay for treatment (and, potentially, evacuation to an area where treatment is available).

Vaccination (3-dose vaccine): Recommended for people moving or traveling to an endemic area who will have extensive exposure to ticks based on their planned outdoor activities and itinerary. May also be considered for people traveling or moving to an endemic area who might engage in outdoor activities where ticks are likely to be found.

--Dose schedules vary for children aged 1 to 15 years and people aged 16 years and older. Guidance: Table 4.18.2 | Yellow Book

--A booster dose (fourth dose) may be administered at least 3 years after completion of the primary series if ongoing exposure or re-exposure to TBE virus is expected.

Consultation: Advise patient to prevent tick bites

Vaccination (with oral or injectable vaccines): Recommended for travelers going to a country that is endemic for typhoid.

---Administer injectable vaccine at least 2 weeks before travel.
--Complete 4 doses of oral vaccine (taken 2 days apart) at least 10 days before travel.

Consultation: Advise patient to wash hands frequently and avoid unsafe food and water.

Vaccination (Single-dose vaccine): Recommended for travelers to certain parts of South America and Africa.

--Administer at least 10 days before planned arrival (this is an international country requirement).

• Find the nearest clinic for referrals.

Consultation: Advise patient to avoid mosquitoes. Patient should also be advised to carry proof of vaccination (yellow card) when traveling to certain destinations that require yellow fever vaccination for entry.