With summer around the corner and many countries opening up their borders, thousands of people may be considering overseas trips for the first time since the pandemic began. That means they must also consider whether they’ve received all the recommended vaccinations for their destination. The key is to start preparing early.

Importance of Planning for Travel Immunizations

Avoiding serious illness is the most important reason to ensure you get all the recommended vaccines before traveling, but there are other reasons too:

• It may be more difficult to get good-quality healthcare—or any healthcare—in the country you’re visiting.

• Your health insurance may not cover overseas healthcare costs, which can add up quickly if you need to stay in the hospital.

• You may not be allowed to return to the US while infected with certain diseases until you are no longer contagious.

The CDC recommends getting all your immunizations at least one month before traveling for several reasons:

• Some vaccines require multiple doses with several weeks between each dose.

• Most vaccines need at least two weeks to become fully effective. You are not immune immediately after vaccination.

• You may need to visit a special clinic for certain vaccines your primary care provider doesn’t stock at their office.

• If you need the yellow fever vaccine, you need time to find a place that stocks it.

Be Up to Date on Routine Vaccines

While the prevalence of most vaccine-preventable diseases is similar throughout the US, other countries may have a higher risk of certain diseases, including some infections no longer seen in the US. That means that before looking into vaccines recommended for a specific destination, it’s worth ensuring you’ve received all the routine immunizations recommended for your age.

The CDC recommends all adults have received the following vaccines, either in childhood or as an adult:

• Tetanus, diphtheria, pertussis (Tdap)

• Measles, mumps, rubella (MMR) if born in 1957 or later

• Varicella, or chickenpox, if you haven’t had the disease already

• Hepatitis B

• Influenza

Those aged 50 and older should get the shingles vaccine, and those 65 and older should get the pneumococcal vaccine. The HPV vaccine is recommended for those up to age 26. People ages 27 to 45 may choose to get the HPV vaccine if they did not receive it in adolescence. Adults with immune-compromising conditions may have special vaccine recommendations that you can learn more about on the CDC website.

Most Common Travel Vaccines

The vaccines recommended for each country you plan to visit can be found on individual country pages on the CDC’s Traveler’s Health Destinations page. Each country page has a “Vaccines and Medicines'' link to the right of the country map. The most common vaccines recommended for different countries included hepatitis A (and hepatitis B if you haven’t gotten it as a routine immunization), typhoid, and yellow fever vaccines.

Hepatitis A

The hepatitis A vaccine is recommended for travel to nearly every country. Full hep A immunization involves two shots, though the first dose offers enough protection to travel initially if received at least two weeks before traveling. The second dose is due six to 12 months later. Two doses provide long-term protection against hepatitis A.

Typhoid

The typhoid vaccine protects against typhoid fever, caused by the Salmonella typhi bacteria common in countries with poor sanitation, especially in Africa and the southern half of Asia. Two options exist for typhoid vaccination, though not all are recommended for everyone, and not all are available everywhere.

The inactivated typhoid vaccine is a shot you need to get at least two weeks before traveling. Its protection lasts two years. The live oral vaccine involves taking four refrigerated pills over eight days, one every other day. The last must be taken at least one week before traveling, and the protection lasts five years.

Yellow Fever

Yellow fever is caused by a virus carried by mosquitoes in multiple African and South American countries. One dose of the yellow fever vaccine offers lifetime protection, but you need to get it at least ten days before traveling. It’s important to note that proof of yellow fever vaccination is required if you’re arriving from a country with circulating yellow fever.

Other Vaccines

People traveling to countries with an active cholera outbreak should get the cholera vaccine if available. Rabies vaccines are only recommended for people who will likely be in close contact with animals, such as the following:

• Veterinarians or scientists working with animals

• Campers, cave explorers, or others exploring the wilderness

• Visitors to farms or rural areas

Be Up to Date With Your Covid-19 Vaccine

Rates of Covid-19 continue to vary significantly by country, with some experiencing lower levels and others experiencing some of the highest levels since the pandemic began. Conditions can also change rapidly while you’re in a country—including the emergence of new variants—so it’s important for your protection to be fully vaccinated against Covid.

Plus, many countries require proof of Covid vaccination. Some will accept proof of infection or a recent negative test instead of vaccination proof, but not all will, and again, conditions and requirements can change between now and when your trip begins.  

Being fully up to date with Covid-19 vaccination means receiving the initial series of doses and any booster shots you are eligible for. The initial series includes two doses of either mRNA vaccine, Pfizer or Moderna, or one dose of the Johnson & Johnson vaccine. The CDC recommends mRNA vaccination over the J&J vaccination unless you cannot get the mRNA vaccine due to an allergy or other reasons.

You are fully vaccinated two weeks after receiving your last dose. You qualify for your first booster five months after an mRNA vaccination or two months after the J&J shot. The booster should be either of the mRNA vaccines. If you’re 50 or older and have already received one booster, you qualify for a second booster four months after the first booster.

US citizens and permanent residents do not need to show proof of vaccination to return to the US after being overseas. However, many other countries require proof of vaccination to enter. The US State Department has a webpage with the most current information on Covid-19 related entry and exit requirements for each country. You can also check the CDC’s Covid-19 Travel Recommendations by Destination webpage to see the Covid-19 risk level in different countries.