Routine Immunizations

(First of three parts)

No one likes getting shots. Travelers are particularly averse to jabs. So why bother? Protection.

Immunization, which is interchangeable with “vaccination,” aims to protect you from disease which can be debilitating or fatal. This is done by introducing a weakened or inert (read: dead) form of the germ (and, soon, cancer) so that your immune system sees the enemy and prepares for battle before the war begins. When the real thing gets into your body, your immune system has had time to make bullets specifically aimed at that germ, and so you have either no illness at all or a mild one.

While many people are against vaccination on an emotional level, the plain fact is that in the past hundred years our life spans have doubled because of basic public health measures, which include vaccinations. In other words, immunization is great insurance.

When you travel, you may encounter germs which can threaten your health. Some of those threats exist domestically, and you don’t need to travel far to get sick. We can break down the types of vaccines into three simple categories: routine, travel-specific and required.

Routine vaccines are those which one typically receives during childhood and school years. Some of these are good for several years, with occasional booster doses needed, and others last decades. Travelers should have routine immunizations updated before traveling abroad.

Here are the main routine immunizations and their schedules:

  • Tetanus/diphtheria — One booster dose every five to 10 years, depending upon if injured.
  • Pertusis — This disease is increasing in adults, and a single booster dose (usually combined with tetanus and diphtheria) should provide good protection.
  • Polio — One single dose as an adult if going to a risk-country.
  • Measles/mumps/rubella — If born before before 1957 or after 1970, no booster is likely to be needed; between those years, an adult should have a single booster. If pregnancy is planned, it is wise for a woman to get blood tests to verify immunity.
  • Hepatitis B — If the series has been completed, a blood test should be done about a year later to verify it took hold. If it did not, the series should be repeated.
  • Varicella (Chicken Pox) — Adults at risk need two doses four to eight weeks apart.
  • Influenza — This should be had annually, as the vaccine formula changes annually, and it is particularly important for travelers. Please note that the peak flu season in the Southern Hemisphere is opposite ours; it is during our summertime.
  • Pneumococcal — This vaccine protects against 23 different strains of the pneumococcus, which can cause a life-threatening pneumonia and other serious illnesses. It is recommended for all citizens over the age of 65, whether or not they are traveling. Travelers with chronic illness or lung weakness should also get this immunization.

Ideally, you should get immunizations at least a month prior to departure, but in most cases you can still get excellent protection if they’re administered in shorter time frames.

Whether or not you need a booster will vary with several factors: the last time you had a dose, whether or not you completed the primary series, the type of travel you will be doing (will you be at higher risk of injury or sickness from the local population or co-travelers?), the destination (will medical care be readily available and will it be safe and competent?), the season (certain diseases peak during different seasons) and, of course, your underlying health.
Many of these immunizations are important whether you are staying at home or traveling to Europe or the developing world.

This topic highlights the importance of seeking professional and expert help before travel. A travel-medicine specialist will know about any disease outbreaks around the globe, what precautions to take and which vaccines to recommend, whether you are traveling on business, pleasure, adventure, study or on a mission.

You can find a list of such specialists online at two places: and With sensible immunizations and proper education, you will be healthier and safer.

(Continue to part 2)

Healthy travels!

—Travel & Health is written by Alan M. Spira, M.D., DTM&H, FRSTM