Infants and children up to two years of age should have received
3 doses of diphtheria, tetanus, and pertussis vaccine (DTP Vaccine). One dose of DTP
affords little protection, two doses provide some protection and 3 doses 70-80%
protection. Parents must note that less than the 3 recommended doses of DTP puts a child
at greater risk of infection. Travelers may wish to receive the remaining doses of the
vaccine at the recommended intervals while abroad.
The measles, mumps, and rubella vaccine (MMR vaccine), should be
administered to all children 15 months of age or older. For younger children going to
areas of high risk, measles vaccine may be given earlier. Infants less than 6 months of
age are protected by maternally derived antibodies.
Three doses of trivalent oral polio vaccine (OPV) is normally
recommended for all infants and children by two years of age. Enhanced inactivated
poliovirus vaccine (eIPV) is also available.
Hepatitis B vaccine is a routine vaccination for infants and
children under 2 years of age. All infants and children should be vaccinated.
Hib vaccine: By age 2 years, four doses of vaccine are normally
recommended for infants and children.
Immune globulin for protection against Hepatitis A is recommended
for infants and children under 2 years of age traveling to areas of the world with
intermediate or high rates of Hepatitis A. The new hepatitis A vaccines are not licensed
for use by children < 2 years of age.
For typhoid fever, breast feeding is likely to protect infants.
Careful preparation of formula and food from boiled or chlorinated water can help protect
nonbreastfed infants and children up to two years of age. The old, injectable killed
typhoid fever vaccine is licensed for use in children as young as 6 months of age. The new
injectable ViCPS typhoid vaccine is recommended for children between 2 and 6 years of age
traveling to areas where there is questionable sanitation.
For Meningococcal vaccine, effectiveness of the vaccine in
children is dependent upon the child's age when the vaccine is administered. Protection
may not be completely effective in children vaccinated between 3 months and 2 years,
especially for vaccination before 3 months of age. The vaccine may be safely given to
infants, but it may be less effective than in adults.
Yellow Fever vaccine should not be administered to any infant
under 4 months of age and children 4-6 months old should be considered only under very
unusual circumstances. Infants 6-9 month old can receive the vaccine if they cannot avoid
traveling to areas of risk and when a high level of protection against mosquito bites is
not possible. Infants 9 months or older should be vaccinated as required or recommended
for travel to South America or Africa.
One cholera vaccine, administered parenterally with a 2-dose
primary series, is currently licensed in the United States. The risk of cholera to U.S.
travelers of any age is so low that it is questionable whether vaccination is of benefit.
No data are available concerning the efficacy or side effects of cholera vaccine in
children less than 6 months of age. Cholera vaccine is not recommended for children less
than 6 months of age. Breast-feeding is protective against cholera; careful preparation of
formula and food from safe water and foodstuffs should protect nonbreast-fed infants. If a
child less than 6 months of age is to travel to areas requiring cholera immunization, a
medical waiver should be obtained before travel. For older infants and children traveling
to areas that require vaccination, a single dose of vaccine is sufficient to satisfy local
requirements.
