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9 common questions about vaccines and travel

Joel Streed

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Travel does more than just transport you to a different place. It can broaden your perspective, increase your happiness, give you a chance to try new things, boost your creativity and help you recharge. Even planning a trip can be an exciting task. The anticipation of mapping an itinerary and scheduling your must-see attractions can bring a lot of joy and happiness.

One of the most important tasks before taking a trip is to make an appointment with a travel medicine specialist. These health care professionals help keep travelers safe and happy before and after their journeys.

Here are answers to common questions about travel medicine:

1. who should make an appointment with a travel medicine specialist.

Anyone planning a trip overseas can benefit from seeing a travel medicine specialist. However, a travel clinic appointment is critical if you are traveling to underdeveloped or developing countries where there's a higher risk of contracting severe communicable illnesses while abroad. It is also important for patients with certain medical conditions that make their immune systems weaker and more vulnerable to infectious diseases.

2. What vaccinations do I need to travel overseas?

All travelers should be vaccinated against the flu and current with COVID-19 vaccines and boosters.

In addition, it's important to complete the adult vaccination schedule that includes vaccinations for:

• Chickenpox (varicella)
• Diphtheria, tetanus and pertussis (DTP)
• Pneumococcal
• Measles, mumps and rubella (MMR)

Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary.

3. Are there travel destinations that have different vaccination recommendations?

Yes. Infectious diseases thrive in different climates. If you travel to a new climate, you may be exposed to diseases to which you don't have any immunity.

Some infections are more prevalent in tropical settings compared to temperate climates. For example, typhoid and hepatitis A are more common in Southeast Asia because these communicable diseases can be spread through contaminated water. Some areas of Africa and South America have a higher prevalence of yellow fever and malaria, which are mosquito-borne infections.

The  Centers for Disease Control and Prevention (CDC)  has good information online for travelers for each travel destination.

Recommended vaccines may include:

• Hepatitis A
• Hepatitis B
• Japanese encephalitis
• Yellow fever

4. Can my primary care provider give me travel vaccinations?

It depends on your travel destinations and vaccine recommendations. I recommend starting the conversation with your primary care provider and reviewing the  CDC recommendations .

If you have a complex itinerary with multiple countries or are traveling to Southeast Asia or Africa, it's better to make an appointment at the travel clinic. I also would recommend patients with organ transplants and immunocompromising conditions seek travel medicine consultation to reduce the risk of illness during travel. During that appointment, we will review your itinerary, provide necessary vaccinations and discuss ways to prevent mosquito-borne or tick-borne diseases.

5. How long before my trip should I go to the travel clinic?

Plan to have an appointment at least four weeks before you travel. Some vaccines require several weeks for immunity to develop, while others require more than one dose of vaccine for full protection.

If your trip is to an underdeveloped or developing country, you may need to schedule an appointment up to two months in advance to receive a complete set of immunizations. This gives your body time to produce the protective antibodies, so you are well protected when you land at your destination.

6. Can I only go to the travel clinic before I travel?

No. The Travel and Tropical Medicine Clinic is available before or after travel. The team can provide consultative services and treatment if you get sick after you return home.

7. I'm going to an all-inclusive resort. Will I have a lower risk of getting sick?

Maybe, but no traveler should take safety for granted. Even in an all-inclusive resort, knowing how food is prepared or the water supply quality is not possible. Mosquitos and other insects could still be a concern. It's important to take all necessary precautions and follow vaccination recommendations when you travel, regardless of your accommodations.

8. How do I lower my risk of malaria when traveling?

Malaria is a disease caused by a parasite. It's spread to humans through the bites of infected mosquitoes. Prophylactic malaria medications are available and are started before the travel, continued during the stay and for a certain duration after returning home. A travel medicine specialist can review the risks and benefits of all prevention and treatment options.

9. How do I stay healthy while traveling?

Nothing can ruin a trip like illness. Make sure all your vaccinations and boosters are up to date, and get any new vaccinations recommended for your destinations.

Food and water safety is important while traveling. Only eat well-cooked food. Avoid eating from roadside stands and uncooked foods, like salad and raw vegetables. Drink bottled beverages only, including bottled water. This is especially important if you travel in resource-limited regions, such as Southeast Asia or Africa.

Hand hygiene is important at home and overseas. Wash your hands often using soap and hot water. Avoid crowded places, follow respiratory etiquette and consider optional masking. Mosquitos and bugs can transmit parasites and diseases, like yellow fever and malaria. Use mosquito repellents. Mosquito nets may be appropriate in some parts of the world, as well.

As you make travel plans, schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.

Raj Palraj, M.D. , is a physician in  Infectious Diseases  and  Travel and Tropical Medicine  in  La Crosse , Wisconsin.

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Think Travel Vaccine Guide

As a health care provider, be sure to prepare your globe-trotting patients for travel by providing a quick pretravel risk assessment, consultation, and care. THINK TRAVEL:

• Ask your patients if they plan on any international travel .
• Make sure they are up- to- date on all routine vaccines before their trip.
• Hepatitis A
• Hepatitis B
• Yellow fever
• Japanese encephalitis
• Meningococcal diseases

For destination-specific vaccine recommendations, search CDC’s Destination pages.

Think about...

*Travelers may also need routine (non-travel) vaccines or boosters before travel including influenza; measles, mumps, and rubella (MMR); tetanus (Td or Tdap); varicella; pneumococcus; and polio. Check CDC’s Destination Pages for country-specific vaccine recommendations.

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Emory TravelWell Center

Health services for international travelers.

If you are traveling internationally or returning from a long trip, it’s important that you are up to date on vaccinations and knowledgeable about travel-related health concerns. Access travel medicine services at Emory’s TravelWell Center.

We collaborate with the Centers for Disease Control and Prevention (CDC) to provide the most up-to-date travel-related health care. We offer pre-travel consultations and expert evaluation and treatment for illnesses acquired abroad.

Important travel alerts:

• Travel and COVID-19
• Travel and Zika Virus

TravelWell Center Mission

The Emory TravelWell Center’s mission is to:

• Assist international travelers and institutions of all types in preparing for safe, enjoyable, and productive trips outside the U.S. with preventive vaccinations, medications, and advice for infectious, physical, and environmental hazards.
• Serve as an internationally recognized center for diagnosing and treating tropical and travel-related infections.
• Promote the science of travelers’ health, tropical medicine, and public health with training and research programs.

Travel Medicine Services for Individuals

We offer several travel medicine services for individuals. These include:

Pre-Travel Vaccinations and Consultations

Whether traveling abroad for business, service or pleasure, taking the proper precautions will help you have a safe, trouble-free, and successful journey. Our providers are recognized leaders in travel medicine. They can provide the appropriate travel vaccinations and prescriptions for your journey. They can also address any health-related questions or concerns about your trip.

Post-Travel Care and Tropical Diseases

Infections acquired overseas can be unusual and unfamiliar to physicians in the U.S. It’s critical—and often life-saving—to be evaluated by an expert in tropical diseases. Our infectious disease and tropical medicine-trained physicians have years of experience providing state-of-the-art care for those not feeling well after travel. Our affiliation with Emory University and collaborations with the CDC give us access to the country's most advanced diagnostic testing available.

Pre- and Post-Travel Physical Exams

Many international programs require physical exams and testing before travel. We provide these services and test for various infections among travelers returning from a long international trip or immigrants traveling from other countries.

Travel Medicine Services for Companies and Organizations

We work with many companies and other organizations that have international operations. If your institution has staff members who travel frequently, we can help keep your organization running smoothly.

Make an Appointment with Emory TravelWell Center

To make an appointment, please call 404-686-5885 .

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• Travel vaccinations

How long before you travel should you get vaccinated?

Peer reviewed by Dr Sarah Jarvis MBE, FRCGP Last updated by Julian Turner Last updated 28 Nov 2018

Being vaccinated against illness before travelling abroad may be inconvenient and mildly unpleasant, but don't be tempted to skip those injections - or to leave them until the last minute. We ask a GP and a specialist travel health nurse for their advice.

In this article :

How do vaccinations work, what kind of vaccinations do i need before travelling abroad, make sure you plan ahead, are there side-effects, what are the risks of not being vaccinated.

In November, a British man died after contracting rabies from a cat bite while visiting Morocco. According to reports, his life could potentially have been saved had he been given a course of the rabies vaccine in time.

While rare, tragic cases such as this are a timely reminder of the importance of being vaccinated before travelling to certain countries in order to protect yourself - and others - against a range of potentially serious diseases, such as rabies , yellow fever, typhoid and hepatitis A .

Continue reading below

Vaccination works by introducing a small amount of inactive/weakened bacterium or virus, or inactivated toxins, into the body, either orally or by injection. Sometimes the toxin or poison made by the bacterium or virus is given to the body. These methods are known as immunisation by a vaccine as opposed to immunity you get from your mother, for instance.

Because the agent in the vaccine is inactive or weak, you cannot get an infection from it. Instead, the vaccine kick-starts the body's immune system and our white blood cells start working, helping the body make antibodies that act like soldiers to fight infections from a specific bacterium or virus.

The good news is, if the exact same bacterium or virus enters our body again, these antibodies wake up and protect us from getting sick. This memory defence system is called immunity and sometimes it can be lifelong.

The vaccines you will need depend on your destination, personal health and planned activities, while the timescales in which they need to be taken prior to travel differ for each one.

Within 7-14 days of receiving a vaccination, the body will usually develop protection to help fight infection. However, some, such as rabies or hepatitis B vaccine, require multiple doses spread over several weeks to ensure adequate immunity.

"A vaccination for yellow fever, for example, is a mandatory requirement for travelling to some countries in Africa and South America," explains Lynda Bramham, travel health nurse specialist at the National Travel Health Network and Centre (NaTHNaC).

"However, the international certificate required for yellow fever does not become valid until ten days after the vaccine has been administered.

"Some vaccinations offer lifelong protection, whereas others require a booster dose after several months or years. For the flu vaccine, a dose is required every year.

"We advise those travelling outside the UK to get advice from their GP surgery or travel clinic at least 4-6 weeks before they are due to travel; those with complex medical needs should seek advice earlier."

Don't be tempted to leave getting vaccinated to the last minute as the body may not have enough time to produce antibodies, leaving you at risk of not being adequately immunised or protected.

Getting vaccines late also means if you were to develop side-effects, this could potentially happen when you are travelling or when you first get to your destination.

"It is advisable to start your vaccinations around eight weeks prior to travel, as it can take a few days to a few weeks for your body to make antibodies," states Dr Preethi Daniel from the London Doctors Clinic .

"Some people require immunisation well in advance, and some may require more than one injection in the course, so you need to allow time for this."

NaTHNaC advises those travelling outside the UK to get advice from their GP surgery or travel clinic at least 4-6 weeks before they are due to travel, while those with complex medical needs should seek advice earlier. It's probably worth going for an 8-week rather than a 4- to 6-week window, as earlier immunisation will never do any harm, whereas leaving it too late can.

However, even if time is short, it may still be worth getting advice. Some last-minute vaccinations are recommended as they may be effective before a disease with a long incubation period develops, and others may be worthwhile even if they don't provide immediate protection for the first part of your trip abroad. Other preventative measures can also be discussed.

'Immunisation Against Infectious Disease', also known as the Green Book , has the latest information on UK vaccines and vaccination procedures.

It is not uncommon for patients to develop mild, short-lived side-effects, such as myalgia (muscle pain), headache and low-grade fever, during the first five to ten days following vaccination.

Sometimes, people can also develop reactions to the ingredients that carry the vaccine, such as egg protein or gelatine, so always be sure to tell your nurse beforehand about any allergies before being vaccinated.

On very rare occasions, a severe allergic (anaphylactic) reaction may occur within a few minutes of the vaccination. Some vaccines can be contra-indicated (cannot be given) to certain individuals for medical reasons, and precautions should also be taken with some vaccines for certain risk groups - for example, pregnant women, individuals aged 60 and older, individuals living with HIV , or those whose immune system is weakened.

Without vaccination you will be unprotected with a risk of becoming infected and further transmitting the infection. Remember, vaccinations not only aim to reduce risks to the individual - they are also an important weapon in the fight to prevent transmission as part of wider disease control efforts.

"The public health risks of lack of vaccination can be separated into individual health risk (direct infection), and public health risk (onwards transmission)," Bramham confirms. "There are also associated costs to health systems if people are unvaccinated and become infected."

"While many vaccines provide high levels of protection, some are not as effective - typhoid vaccine, for example, provides around 70% protection over three years and therefore other infection prevention measures such as care with food, water and personal hygiene are important," she adds.

So, if in doubt, make an appointment with a GP surgery or travel clinic so that vaccines and other preventative measures can be discussed.

Article History

The information on this page is written and peer reviewed by qualified clinicians.

28 Nov 2018 | Latest version

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Torres JR , Taira BR , Bi A, et al. COVID-19 Vaccine Uptake in Undocumented Latinx Patients Presenting to the Emergency Department. JAMA Netw Open. 2024;7(4):e248578. doi:10.1001/jamanetworkopen.2024.8578

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COVID-19 Vaccine Uptake in Undocumented Latinx Patients Presenting to the Emergency Department

• 1 David Geffen School of Medicine, University of California, Los Angeles
• 2 Olive View-UCLA Medical Center, Los Angeles, California
• 3 School of Medicine, University of California, San Francisco

COVID-19 has disproportionately affected the US Latinx population, with significantly higher rates of infections, hospitalizations, and mortality. 1 , 2 Although the undocumented Latinx population in the US is growing, 3 there are limited data regarding their COVID-19 infection status, vaccination uptake, and perceptions about the COVID-19 vaccine.

We conducted this prospective, cross-sectional survey study from September 2, 2021, through March 31, 2022, at Olive View-UCLA Medical Center and San Francisco General Hospital, which serve large Latinx immigrant populations. After verbal consent, as approved by the institutional review boards of both facilities, a convenience sample of adult (aged ≥18 years) emergency department (ED) patients participated in structured interviews in English or Spanish. The study followed the STROBE reporting guideline.

We excluded patients who were critically ill, on psychiatric holds, or incarcerated or who had altered mentation. Participants were enrolled in 3 approximately equal groups based on self-reported race and ethnicity (non-Latinx [including Asian, Black, Native Hawaiian or other Pacific Islander, Middle Eastern, White, and other], legal Latinx resident or citizen, and undocumented Latinx).

Descriptive statistics were used to summarize participant responses, and comparisons were performed using bivariate hypothesis testing. Data were analyzed using Stata, version 16.1 (StataCorp LLC). Additional details on methodology and the survey instrument are provided in the eMethods in Supplement 1 .

This study included 306 participants (median [IQR] age, 51 [40-60] years; 146 female [48%], 157 male [51%], and 3 with missing sex data [1%]); 209 identified as Latinx (68%) and 34 as non-Latinx Black (11%), 43 as non-Latinx White (14%), and 20 as other race or ethnicity (7%). Among the undocumented Latinx group, 26 (25%) were uninsured, 99 (95%) reported Spanish as their primary language, and 31 (30%) used the ED as their usual source of health care ( Table 1 ).

Compared with the non-Latinx group, a prior COVID-19 infection was more likely reported by undocumented Latinx participants (odds ratio [OR], 3.42; 95% CI, 1.66-7.23) and legal Latinx residents (OR, 2.73; 95% CI, 1.32-5.83). Of all participants, 265 (87%) reported having received at least 1 COVID-19 vaccine and 41 (13%) reporting a decline in vaccination, with similar distributions for all 3 groups. The most common reason for declining vaccines was concern about potential side effects (15 participants [37%]). Compared with the undocumented Latinx group, the non-Latinx group was less likely to believe that undocumented immigrants could receive the COVID-19 vaccine in the US (OR, 0.09; 95% CI, 0.01-0.39), and 41 (13%) reported knowing undocumented people who did not obtain the vaccine because of fear of discovery and deportation ( Table 2 ). Among those who previously declined a COVID-19 vaccine, 9 (22%) expressed interest in receiving the vaccine while in the ED.

Among the population studied, a prior COVID-19 infection was most commonly reported by Latinx participants. Despite the health care access barriers undocumented Latinx individuals face, 4 we found no differences in the proportion who had received COVID-19 vaccines. Additionally, there were minimal perceptions of exclusion from eligibility for vaccination among this group. However, 13% of all participants knew people who were reluctant to get vaccinated due to concerns about their immigration status.

Limitations of our work include group differences in age, sex, and insurance status, factors that may have influenced their responses to key questions. Additionally, citizenship status and prior COVID-19 infection were self-reported, and we only sampled patients who sought care in the ED; thus, individuals who were most fearful of discovery of their immigration status may have been undercounted. Our study was also restricted to 2 EDs affiliated with teaching hospitals in California; therefore, generalizability may be limited. Overall, our findings highlight the utility of EDs for greater inclusion of the undocumented immigrant population in public health surveillance research.

Accepted for Publication: February 28, 2024.

Published: April 26, 2024. doi:10.1001/jamanetworkopen.2024.8578

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Torres JR et al. JAMA Network Open .

Corresponding Author: Jesus R. Torres, MD, MPH, MSc, David Geffen School of Medicine, University of California, Los Angeles, 1100 Glendon Ave, Ste 1200, Los Angeles, CA 90024 ( [email protected] ).

Author Contributions: Drs Torres and Rodriguez had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Torres, Taira, Rodriguez.

Acquisition, analysis, or interpretation of data: Torres, Taira, Bi, Gomez, Delgado, Vera, Rodriguez.

Drafting of the manuscript: Torres, Rodriguez.

Critical review of the manuscript for important intellectual content: Torres, Taira, Bi, Gomez, Delgado, Vera, Rodriguez.

Statistical analysis: Torres.

Administrative, technical, or material support: All authors.

Supervision: Torres, Taira, Rodriguez.

Conflict of Interest Disclosures: None reported.

Data Sharing Statement: See Supplement 2 .

Additional Contributions: The authors thank Jennifer M. Diaz, BA; Aura M. Elias, BS; and Rose Diaz, MD, MPH, from the UCLA David Geffen School of Medicine for their contributions to data collection. They did not receive compensation.

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