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Immunizations and Antibiotics for Oversea Travel (cont.)

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 of age. Breastfeeding is a way to protect infants 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 of age. It is now part of routine vaccinations. The disease is much less severe in children younger than 5 years of age compared with adults. For children younger than 2 years of age, 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 of age 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 Prevention

  • Malaria does not have a vaccine. Medication must be taken to protect against infection. Some countries have resistance to one or more of the drugs used to prevent malaria. The CDC has a web site where travelers or their physicians can check on resistance patterns and recommended medication for prevention (
    ). Each of the drugs also has advantages and disadvantages, and travelers may, when multiple options are available, pick an option that better fits their particular situation. The following table was adapted from the CDC web site for malaria (
  • Everyone in malaria-prone areas should wear DEET insect repellent (for example, Ultrathon) and should seek blood evaluation for possible treatment if symptoms develop. Another repellant is Picaridin, which does not smell as strong as the DEET but requires more frequent application. Permethrin-containing repellent (for example, Permanone) can be applied to clothing, shoes, tents, gear, and mosquito nets, but permethrin is not approved for direct application onto skin. Commercially available clothing that is impregnated with permethrin will withstand multiple washings while maintaining effectiveness. Most repellents are safe for children over 2 months of age.
Medically Reviewed by a Doctor on 11/20/2017

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