Common pre-travel vaccines4–6
Table below outlines common pre-travel vaccines that may be recommended to travellers. In the sections that follow focuswill be on three high-impact infections—malaria, typhoid, and yellow fever. Click to View↗
▶ Common Pre-travel Vaccines Reference table Full view ↗
| Vaccine-preventable illness | Vaccines | Examples of endemic area(s) | Estimated duration of protection |
|---|---|---|---|
| Cholera |
|
Haiti; South & Southeast Asia; sub-Saharan Africa | Variable; up to ~2 years in adults for inactivated vaccine |
| COVID-19 | Intramuscular (IM) vaccines (e.g., mRNA vaccines encoding SARS-CoV-2 spike) | Worldwide endemicity | Protection wanes; booster timing per current public-health guidance/variants |
| Hepatitis A |
|
Africa, Asia, Central & South America | After series completion, antibodies generally persist for many years |
| Hepatitis B |
|
Parts of Africa and East Asia | Usually considered long-lasting; some individuals have inadequate response |
| Influenza | Quadrivalent inactivated vaccines | Worldwide endemicity | Waning begins ~3–4 months; annual vaccination to match circulating strains |
| Japanese encephalitis |
|
China; Indian subcontinent; SE Asia; eastern Indonesia (incl. Bali); PNG; parts of Australia | Vaccine-dependent; ≥5 years in adults for live attenuated vaccine |
| Measles, mumps, rubella | Live attenuated combination vaccine (SC/IM) | Worldwide endemicity | Largely lifelong after full course for measles/rubella; mumps immunity may wane |
| Meningococcal disease | Monovalent & quadrivalent conjugate vaccines (IM) | Sub-Saharan Africa (meningitis belt) and other risk settings | Variable—check product and program guidance |
| Mpox | Non-replicating MVA-BN (JYNNEOS/IMVANEX) vaccine | Central & West Africa; outbreaks elsewhere | Further data needed; studies show protection signal up to ~2 years after primary course |
| Poliomyelitis |
|
Africa and Asia (residual risk; importations elsewhere) | Children: at least 4 years; Adults: ~10 years (program-dependent) |
| Rabies | Inactivated vaccine (IM) | All continents except Antarctica (hosts vary by region) | Variable; lower responses in immunocompromised—follow titer guidance |
| Tetanus, diphtheria, pertussis | Various combination vaccines (some include IPV, Hib, HepB) | Tetanus & pertussis: worldwide; Diphtheria: Asia/South Pacific, Middle East, Eastern Europe | Follow national schedules/handbooks for booster timing and products |
| Typhoid fever |
|
Africa, Latin America, Asia | Parenteral: ~3 years; Oral: duration uncertain—boost per policy |
Malaria7–9
Malaria is a life-threatening disease caused by the protozoan parasite Plasmodium, transmitted primarily through the bite of infected female Anopheles mosquitoes.
Prevention:
Mosquito Bite Avoidance: Use insect repellents containing DEET, picaridin, or IR3535. Employ insecticide-treated mosquito nets and wear protective clothing.
DEET: N,N-diethyl-m-toluamide
IR3535: Insect Repellent 3535, chemical name is EBAAP, which stands for Ethyl Butyl Acetyl Amino Propionate.
Chemoprophylaxis: Medication regimens vary based on travel destination, duration of stay, patient’s medical history, and Plasmodium species endemic to the region.
Daily Regimens: Atovaquone-proguanil, doxycycline, primaquine, tafenoquine.
Weekly Regimens: Chloroquine, mefloquine (suitable during pregnancy).
Treatment:
First-line Treatments (CDC Recommendations): Atovaquone–proguanil (daily dosing for 3 days) or artemether-lumefantrine (twice daily dosing for 3 days).
Radical cure: refers to a complete eradication of all malaria parasites from the body, including the dormant liver stages (called hypnozoites) that are specific to:
- Plasmodium vivax
- Plasmodium ovale
Why Is Radical Cure Important?
After treating the blood-stage infection (which causes fever and other symptoms), some malaria species like P. vivax and P. ovale can hide in the liver in a dormant form (hypnozoites). These can reactivate weeks or months later, causing relapse
The table below shows the WHO recommendations in different clinical scenarios:
▶ Malaria TreatmentQuick reference Full view ↗
| Clinical scenario | Recommended medication(s) | Duration |
|---|---|---|
| Uncomplicated P. falciparum | Artemether–lumefantrine (ACT) | Oral only for 3 days (total 6 doses) |
| Uncomplicated P. vivax / P. ovale | Chloroquine (blood-stage) + Primaquine (radical cure) |
|
| Severe malaria (any species) | IV/IM artesunate then complete with a standard oral ACT |
|
| Radical cure (for P. vivax relapse) | Primaquine or Tafenoquine |
|
▶ Dosing Quick reference Full view ↗
| Clinical situation | Preferred regimen & dose |
|---|---|
| Uncomplicated P. falciparum | Artemether–lumefantrine (20/120 mg): 4 tablets initially; 4 tablets at 8 hours; then 4 tablets BID for 2 more days (total 6 doses = 24 tablets). Take with food (fat) to enhance absorption. |
| Uncomplicated P. vivax / P. ovale (blood-stage) | Chloroquine: 10 mg base/kg initially, then 5 mg/kg at 6, 24, and 48 hours (follow local max adult dose limits). |
| Severe malaria (any species) | IV artesunate: 2.4 mg/kg at 0, 12, and 24 hours, then daily until oral therapy is possible; complete a full oral course afterward (e.g., artemether–lumefantrine). |
| Radical cure for P. vivax / P. ovale | Primaquine: 0.25–0.5 mg base/kg once daily for 14 days; or Tafenoquine: single 300 mg dose given with blood-stage treatment (e.g., chloroquine or an ACT). G6PD testing required |
Important Consideration: The medication used for treatment should differ from prophylactic medication to avoid resistance.
Typhoid Fever10–12
Typhoid fever, caused by Salmonella enterica serotype Typhi, is primarily spread through contaminated food or water.
Prevention:
Safe Food and Water Practices: Drink bottled or treated water, avoid raw foods, and maintain rigorous hand hygiene.
Vaccination: Recommended for travelers 2 years and older visiting high-risk areas. Click to View ↗.
Oral Vaccine: 1 capsule every other day (total 4 capsules), booster every 5 years.
Intramuscular Vaccine: Single injection, booster every 2 years.
Treatment:
Empirical Antibiotic Therapy (Guided by travel history)
Standard: Azithromycin combined with ceftriaxone.
Regions with known extensively drug-resistant (XDR) typhoid—e.g., parts of Pakistan and Iraq:
Uncomplicated disease: azithromycin monotherapy is reasonable.
Complicated disease (sepsis, ileus, GI bleeding, encephalopathy): escalate to a carbapenem (e.g., meropenem/ertapenem) and early infectious disease consultation.
Directed Therapy: Based on culture and susceptibility results.
As soon as culture and sensitivity results are back, switch quickly to a single antibiotic that the bug is shown to be sensitive to. Treat for 7–14 days (longer if the illness is severe or there are complications). Avoid fluoroquinolones for infections picked up in South Asia unless the report proves the germ is sensitive to them.
Supportive care: fluids, nutrition, acetaminophen for fever; monitor for GI bleeding, ileus, encephalopathy.
Yellow Fever13,14
Yellow fever is a viral disease transmitted through mosquito bites, primarily by Aedes mosquitoes.
Prevention:
Mosquito Avoidance: Effective use of insect repellents, protective clothing, and mosquito nets.
Vaccination: Recommended for travelers aged 9 months and older traveling to endemic areas. Click to View ↗
Typically, a single lifetime dose is sufficient.
Treatment:
No specific antiviral treatment available
Supportive Care: Includes hydration, analgesics (paracetamol recommended; avoid aspirin due to risk of bleeding), antipyretics, and rest.
▶ Typhoid Vaccines Pre-travel Full view ↗
| Region | Vaccine name (type) | Route | Minimum Age | Primary Schedule | Booster Interval |
|---|---|---|---|---|---|
| U.S. (CDC/ACIP) | Typhim Vi® (Vi capsular polysaccharide) | IM | ≥ 2 years | 1 × 0.5 mL ≥ 2 weeks before travel | Every 2 years if risk continues |
| Vivotif® (Ty21a live oral) | Oral capsules | ≥ 6 years | 4 caps on days 0, 2, 4, 6; finish ≥ 1 week pre-travel | Every 5 years if risk continues | |
| Australia | Typhim Vi® (ViCPS) | IM | ≥ 2 years | Single 0.5 mL dose | ~2–3 years (per ongoing risk) |
| Vivotif® (Ty21a) | Oral capsules | ≥ 6 years | 3–4 caps on alternate days (many use 4 for longer cover) | ~3–5 years (course-dependent) | |
| Europe/UK | Typhim Vi® / Typherix® (ViCPS) | IM | ≥ 2 years | Single dose | ~3 years if risk persists |
| Vivotif® (Ty21a) | Oral capsules | ≥ 6 years | 3–4 caps on alternate days | ~3–5 years if risk persists | |
| WHO / Global (programs) | TCV (e.g., Typbar TCV®, TYPHIBEV®, SKYTyphoid™, etc.) | IM | ≥ 6 months | Single dose (routine in endemic areas) | Booster not routinely established; follow local policy |
▶ Yellow Fever Vaccines Entry-requirement Full view ↗
| Region | Vaccine name (strain) | Route | Minimum Age | Primary Schedule | Booster Interval |
|---|---|---|---|---|---|
| U.S. (CDC/ACIP) | YF-VAX® (17D) | SC | ≥ 9 months | Single 0.5 mL dose ≥ 10 days pre-exposure/entry | Not routine; consider after ≥ 10 years for high-risk/lab |
| Australia | Stamaril® (17D) | SC | ≥ 9 months | Single dose at approved centres (ICVP issued) | No routine booster; special cases per risk |
| Europe/UK | Stamaril® (17D) | SC | ≥ 9 months | Single dose | No routine booster; consider ≥ 10 years for high-risk |
| Global / IHR | 17D-based vaccines | SC | ≥ 9 months | Single dose; ICVP (“yellow card”) valid from day 10 | Certificate validity is for life (IHR, 2016-) |
Conclusion
Effective prevention and timely management of travel-related diseases are essential for safeguarding traveler health. Adhering to vaccination guidelines, practicing mosquito bite prevention, maintaining hygiene, and selecting appropriate chemoprophylaxis and treatment regimens based on updated international recommendations can significantly reduce the risk of severe disease outcomes during travel.