Appendices Appendices
Appendix B: Travel Vaccine Summary Table
Table B-01 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-01. 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 dose1 | Undetermined2 |
| Hepatitis A vaccine, inactivated | Havrix (GlaxoSmithKline) | 1–18 y | 0.5 mL (720 ELISA units) | IM | 0 and 6–12 mo | None |
| ≥19 y | 1.0 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 |
| ≥19 y | 1.0 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, recombinant2 | 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, recombinant2 | 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) | 1.0 mL (720 ELU HAV + 20μg HBsAg) | IM | 0, 1, 6 mo | None |
| ≥18 y (accelerated) | 1.0 mL (720 ELU HAV + 20μg HBsAg) | IM | 0, 7, and 21–30 d | 12 mo | ||
| Japanese encepha- litis vaccine, inactivated |
Ixiaro (Valneva) | 2 mo–2 y | 0.25 mL | IM | 0, 28 d | ≥1 year after primary series4 |
| 3–17 y | 0.5 mL | IM | 0, 28 d | ≥1 year after primary series4 | ||
| 18–65 y | 0.5 mL | IM | 0, 7–28 d | ≥1 year after primary series4 | ||
| >65 y | 0.5 mL | IM | 0, 28 d | ≥1 year after primary series4 | ||
| Meningo- coccal polysaccharide diphtheria toxoid conjugate vaccine (MenACWY-D)5 |
Menactra (Sanofi Pasteur) |
9–23 mo | 0.5 mL | IM | 0, 3 mo | If at continued risk7 |
| ≥2 y | 0.5 mL | IM | 1 dose6 | If at continued risk7 | ||
| Meningo- coccal oligosaccharide diphtheria CRM197 conjugate vaccine (MenACWY-CRM)5 |
Menveo (GSK) |
2–12 mo | 0.5 mL | IM | 0, 2, 4, 10 mo | If at continued risk7 |
| 7–23 y | 0.5 mL | IM | 0,3 mo (2nd dose administered in 2nd year of life) | |||
| ≥2 y | 0.5 mL | IM | 1 dose6 | |||
| 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 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 See Chapter 4, Rabies for postexposure immunization |
| Typhoid vaccine (oral, live, attenuated) | Vivotif (PaxVax) | ≥6 y | 1 capsule8 | 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 |
| Yellow fever | YF-Vax (Sanofi Pasteur) | ≥9 mo9 | 0.5 mL10 | SC | 1 dose | Not recommended for most9 |
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.