Specific Vaccine Notes

• Most vaccine courses can be interrupted without the need for extra doses. (Typhoid is an exception).
  
  
• Typhoid vaccination is not required for international travel but is recommended for anyone older than 2 years. Breastfeeding infants is a way to protect them against infection from water sources. Infants who are not breastfed should have carefully prepared formula and food.
  
  
• The hepatitis A vaccination should be given to travelers older than 2 years. The disease is much less severe in children younger than 5 years compared with adults. For children younger than 2 years, the hepatitis A immunoglobulin should be given to confer passive immunity and protection.
  
  
• Some African countries require proof of yellow fever vaccination prior to entering the country. Note that infants younger than 9 months cannot be immunized for this because of the risk of contracting encephalitis. Travelers with infants in this age group are strongly advised against traveling to areas with endemic yellow fever.
  
  
• Malaria does not have a vaccine. Medication must be taken to protect against infection. Sub-Saharan Africa has the species Falciparum, which has a high rate of resistance to chloroquine, the drug used to provide protection. Asia and South Asia have the Vivax species (which is very sensitive to chloroquine). People traveling in areas endemic with Falciparum should take other medications prescribed by a doctor (not for pregnant women or children younger than 8 years).
  
  
• Everyone in malaria-prone areas should wear DEET insect repellent and should seek blood evaluation for possible treatment if symptoms develop.