Travel vaccinations

Vaccinations are an integral part of pre-travel care. Gaps in routine vaccination should be closed. In particular, measles and influenza are important in the context of travel medicine. Vaccinations against yellow fever and meningococcal disease may be required for international travel. This article provides information on these and other travel vaccinations against hepatitis A, typhoid fever, rabies, Japanese encephalitis and cholera. Yellow fever endemic areas are located in Africa and in South America; there is no yellow fever in Asia. The meningococcal vaccine (A, C, W, Y) is required for pilgrims to Saudi Arabia. Additionally, it is recommended for travellers visiting the African "meningitis belt" during the dry season. A polio booster is required for countries with endemic wild-type polio virus (WPV) or circulating vaccine derived poliovirus (cVDPV). Hepatitis A is a common vaccine-preventable infection in travellers. The hepatitis A vaccination should therefore be recommended to all travellers going to endemic areas. South Asia is the most important region where travel-associated typhoid fever is acquired and where at the same time antimicrobial resistance is emerging. Two different vaccines against typhoid fever are available in Germany. The vaccine efficacy is 50-70% for both vaccines. Contacts with potentially rabid animals are a common travel-related problem. At the same time, vaccines for state of the art postexposure care are not provided in many countries. According to recent WHO recommendations, two vaccinations are sufficient for pre-travel priming against rabies. Japanese encephalitis is rare in travellers. Vaccination should be offered in case of travel to rural and peri-urban areas. Cholera is extremely rare in travellers going to endemic areas. Cholera vaccination is therefore usually not indicated in the context of travel medicine.