Encourage patients to contact you as soon as they know their travel destinations outside of the U.S. Advance notice is important because some vaccinations need time before they reach full protection, or may require two or more shots administered over a couple of weeks' time.
Information you should screen your traveling patients for
- Departure date
- Expected lengths of stay
- If they are, or may become, pregnant during travel or within three months afterward
- If they are, or will be, breastfeeding during travel or shortly after
- If they are under treatment for a chronic health condition, particularly HIV infection or other condition that compromises immune systems
- If they have already received the recommended "domestic" vaccinations:
- influenza - in the fall of each year
- pneumococcal - for those at risk, every ten years
- Hepatitis A or B - for those at risk
- varicella (chicken pox) - two doses if you have never had chicken pox
- measles mumps rubella (MMR) at some time in your life
- tetanus and diphtheria (Td) booster within the past ten years
- Whether they have already received vaccinations for travel to this or other destinations during their adulthood.
- Any prescription medications they need refills for to cover the duration of their travel
- Will they need proof of immunizations before being able to return to the United States? Their travel agents should have this information if not known.
Some of the common travel immunizations include:
- Polio - one dose of the inactivated polio vaccine (IPV) for travelers over 18 who already received the oral polio vaccine or inactivated polio vaccine at some time in their lives. Needed for developing countries in Africa, Asia, Middle East, Indian subcontinent, and the majority of the new independent states in the former Soviet Union.
- Measles - for persons born after 1957. (This should be their second dose in a lifetime.)
- Yellow fever - needed for certain parts of Africa and South America.
- Hepatitis A and/or immune globulin - recommended for travelers to all areas except Japan, Australia, New Zealand, Northern and Western Europe, and North America (excluding Mexico).
- Hepatitis B - recommended for those spending more than six months in areas with a high rate of hepatitis B and who will have frequent close contact with local people.
- Typhoid - recommended for areas where food and water precautions are indicated, such as in developing countries.
- Meningococcal - needed for sub-Saharan Africa during the dry season (December - June)
- Japanese Encephalitis or tick-borne encephalitis - recommended for long-term travelers to areas of risk.
All of these vaccines can be safely administered at one physician visit except for yellow fever and cholera. (Immune globulin diminishes the effectiveness of live-virus MMR and varicella vaccines if given simultaneously.)
Additional information is available from the CDC on Travel Health and Immunizations.
Search this point-of-care decision support tool today. A free benefit of ACP membership.
Internal Medicine 2014 Advance Program Now Online
Details about Internal Medicine 2014's robust offerings are now available on our Website! Use the online Schedule Planner to build and save your own schedule.
New from ACP: Free High Value Care Cases
Free MOC and CME Credit with easy online submission
HVC Cases provide:
Get started now with your ACP user name and password!