Vaccinations necessary before travelling?

Question

Any vaccinations necessary for my 3mths old baby before travelling to Indonesia?

Answer 1

it's not necessary, here's a good site, there's some frequently asked questions about travelling and vaccinations-scroll down a bit

http://www.thinktwice.com/faq.htm#10

Answer 2

Aye sir. you'll favor to convey your vaccination certificate mainly in case you shuttle to three international places like Brazil or some tropical international places. different maximum straightforward are: Hepatitis A hepatitis B Mosquitoes transmitted deceases examine your shuttle agent and embassy earlier vacationing.

Answer 3

I hope this helps. Good Luck and enjoy your trip.



http://www2.ncid.cdc.gov/travel/yb/utils/ybGet.asp?section=children&obj=child-vax.htm&cssNav=browseoyb



Chapter 8 – International Travel with Infants and Young Children
Vaccine Recommendations for Infants and Children
Note: Updated immunization schedule (January 12, 2006)

For all children, decisions regarding vaccinations should be made in cooperation with a health-care provider who will review the traveler's medical history and itinerary. Each traveler should be up to date with their routine childhood vaccinations because many of the diseases prevented by these vaccines are rare or nonexistent in the United States but are still common in other parts of the world. The recommended childhood and adolescent immunization schedule is depicted in Table 8-2. Table 8-3 depicts the catch-up schedule for children and adolescents who start their vaccination schedule late or who are >1 month behind. This table also describes the recommended minimal intervals between doses for children who need to be vaccinated on an accelerated schedule, which is sometimes required for international travel. Proof of yellow fever vaccination is required for entry into certain countries (see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country). Recommendations for other vaccines and immunobiologics depend on the traveler's medical history and itinerary and do not alter the schedule for recommended childhood immunizations.

Modifying the Immunization Schedule for Inadequately Immunized Infants and Younger Children before International Travel
Factors influencing recommendations for the age at which a vaccine is administered include the age-specific risks of the disease and its complications, the ability of people of a given age to respond to the vaccine, and the potential interference with the immune response by passively transferred maternal antibody. Vaccines are recommended for the youngest age group at risk for developing the disease whose members are known to develop an adequate antibody response to vaccination.

The routine immunization recommendations and schedules for infants and children in the United States do not provide specific guidelines for infants and young children who will travel internationally before the age when specific vaccines and toxoids are routinely recommended. When deciding when to travel with a young infant or child, parents should be advised that the earliest opportunity to receive routine immunizations recommended in the United States (except for the dose of hepatitis B vaccine administered at birth) is at 6 weeks if an accelerated schedule is followed. Parents should also be aware of the youngest age at which vaccinations can be administered for diseases endemic at their destination. The following section provides additional guidance for active and passive immunization of such infants and children. Additional information about all the diseases and vaccines mentioned below can be found in Chapter 4 (Prevention of Specific Infectious Diseases).

Routine Infant and Childhood Vaccinations
Hepatitis B Vaccine
Hepatitis B virus is a cause of acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma. There are 200 to 300 million chronic carriers worldwide. Infants and children who have not previously been vaccinated and who are traveling to areas with intermediate and high hepatitis B virus (HBV) endemicity are at risk if they are directly exposed to blood from the local population. Circumstances in which HBV transmission could occur in children include receipt of blood transfusions not screened for HBV surface antigen (HBsAg), exposure to unsterilized medical or dental equipment, or continuous close contact with local residents who have open skin lesions (impetigo, scabies, or scratched insect bites).

Hepatitis B vaccine is recommended for all infants, with the first dose administered soon after birth and before hospital discharge. Infants and children who will travel should receive the three doses of HBV vaccine before traveling. The interval between doses one and two should be 1-2 months. Between doses two and three, the interval should be a minimum of 2 months; the interval between doses one and three should be at least 4 months. The third dose should not be given before the infant is 6 months of age. Adolescents not previously vaccinated with hepatitis B vaccine should be vaccinated at 11-12 years of age. For adolescents, the usual schedule is two doses separated by at least 4 weeks, followed by a third dose 4-6 months after the second dose.

Diphtheria and Tetanus Toxoid and Pertussis Vaccine
Diphtheria, tetanus, and pertussis each occur worldwide and are endemic in countries with low immunization levels. Infants and children leaving the United States should be immunized before traveling. Optimum protection against diphtheria, tetanus, and pertussis in the first year of life is achieved with at least three but preferably four doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP), the first administered when the infant is 6-8 weeks of age and the next two at 4- to 8-week intervals. A fourth dose of DTaP should be administered 6-12 months after the third dose when the infant is 15-18 months of age. A fifth (booster) dose is recommended when the child is 4-6 years of age. The fifth dose is not necessary if the fourth dose in the primary series was given after the child's fourth birthday.

Two doses of DTaP received at intervals at least 4 weeks apart can provide some protection; however, a single dose offers little protective benefit. Parents should be informed that infants and children who have not received at least three doses of DTaP might not be fully protected against pertussis. For infants and children <7 years of age, if an accelerated schedule is required to complete the series before travel, the schedule may be started as soon as the infant is 6 weeks of age, with the second and third doses given 4 weeks after each preceding dose. The fourth dose should not be given before the infant is 12 months of age and should be separated from the third dose by at least 6 months. The fifth (booster) dose should not be given before the child is 4 years of age.

Haemophilus influenzae Type b Conjugate Vaccine
Haemophilus influenzae type b (Hib) is an endemic disease worldwide that can cause fatal cases of meningitis, epiglottitis, and other invasive diseases. Infants and children should have optimal protection before traveling. Routine Hib vaccination beginning at 2 months of age is recommended for all U.S. children. The first dose may be given when an infant is as young as 6 weeks of age. Hib vaccine should never be given to an infant <6 weeks of age. A primary series consists of two or three doses (depending on the type of vaccine used) separated by 4-8 weeks. A booster dose is recommended when the infant is 12-15 months of age.

If Hib vaccination is started when the infant or child is 7 months of age, fewer doses may be required. If different brands of vaccine are administered, a total of three doses of Hib conjugate vaccine completes the primary series. After completion of the primary infant vaccination series, any of the licensed Hib conjugate vaccines may be used for the booster dose when the infant is 12-15 months of age.

If previously unvaccinated, infants <15 months of age should receive at least two vaccine doses before travel. An interval as short as 4 weeks between these two doses is acceptable. Unvaccinated infants and children 15-59 months of age should receive a single dose of Hib vaccine. Children >59 months of age do not need to be vaccinated unless a specific condition exists such as functional or anatomic asplenia, immunodeficiency, immunosuppression, or HIV infection.

Polio Vaccine
While polio has been eradicated in the United States, poliovirus continues to circulate in parts of Africa and Asia. In the United States, all infants and children should receive four doses of inactivated poliovirus vaccine (IPV) at 2, 4, and 6-18 months and 4-6 years of age. If accelerated protection is needed, the minimum interval between doses is 4 weeks, although the preferred interval between the second and third doses is 2 months. Infants and children who had initiated the poliovirus vaccination series with one or more doses of oral poliovirus vaccine (OPV) should receive IPV to complete the series.

Measles, Mumps, and Rubella Vaccine
Measles is an endemic disease in countries where measles immunization levels are low, and the risk for contracting measles in many countries is greater than in the United States. Infants and children should be as well protected as possible against measles and should complete the immunization series before traveling. While the risk for serious disease in infants from either mumps or rubella is low, these diseases do circulate in many parts of the world and vaccination is recommended.

In addition to the measles, mumps, and rubella vaccine (MMR), monovalent measles, monovalent mumps, monovalent rubella, and combinations of the components are available. However, the Advisory Committee on Immunization Practices (ACIP) recommends that MMR be administered when any of the individual components is indicated.

According to the recommended childhood immunization schedule (Table 8-2), a child should receive MMR at age 12 months and again at age 4-6 years. For children who are 12 months of age, the second dose of MMR may be given 28 days after the first dose.

Infants 6-11 months of age should receive a dose of MMR before departure. However, MMR given before age 12 months should not be counted as part of the series. Children who receive MMR before age 12 months will need two more doses of MMR, the first of which should be administered at age 12 months.

If MMR is unavailable, monovalent vaccines may be used. However, a child receiving monovalent vaccines will still need two doses of MMR beginning at age 12 months.

Varicella Vaccine
Varicella (chickenpox) is an endemic disease throughout the world. The varicella vaccine is recommended for all children 12 months of age.

A single dose of varicella vaccine is also recommended for all susceptible children by their 13th birthday. Efforts should be made to ensure varicella immunity by this age, because varicella disease can be more severe among older children and adults. Children >13 years of age need to receive two doses of varicella vaccine at least 4 weeks apart to optimize protection.

Vaccination is not necessary for children with a reliable history of chickenpox. When a prior history of chickenpox is unclear, the vaccine may be given.

Pneumococcal Vaccine
Streptococcus pneumoniae causes substantial morbidity and mortality throughout the world each year. The vaccine is available in two forms: the pneumococcal conjugate vaccine (PCV7) and the pneumococcal polysaccharide vaccine (PPV23).

All infants should be vaccinated with PCV7. Infant vaccination provides the earliest protection and infants <23 months of age have the highest incidence of pneumococcal disease. The primary series for PCV7 includes three doses given at 2, 4, and 6 months of age with a fourth (booster) dose at 12-15 months of age (see Table 4-13). Children 24 months of age at high risk for the development of pneumococcal disease (with sickle cell disease, asplenia, HIV, chronic illness, or immunocompromising conditions) should receive a dose of PPV23 at least 2 months following their last dose of PCV7. If the child is 10 years of age, one revaccination with PPV23 should be considered 3-5 years after the first dose of PPV 23.

Unvaccinated children 7-11 months of age should receive two doses at least 4 weeks apart and a booster dose at age 12-15 months. Unvaccinated children 12-23 months of age should receive two doses at least 8 weeks apart. Previously unvaccinated healthy children 24-59 months of age should receive a single dose of PCV7. However, previously unvaccinated children 24-59 months of age at high risk for pneumococcal disease should receive two doses separated by at least 8 weeks. Children 24-59 months of age who are at increased risk for pneumococcal disease (as previously described) and who were previously vaccinated with PPV23 should receive two doses of PCV7 separated by at least 8 weeks. The PCV7 vaccine is not routinely recommended for children >59 months (5 years) of age.

Influenza Vaccine
Influenza vaccine can be used to reduce risk of influenza infection in transmission season (November-February in the Northern Hemisphere, April-September in the Southern Hemisphere, and throughout the year in the tropics). The vaccine is prepared in two forms: an intramuscular trivalent inactivated vaccine (TIV) and a live, attenuated, intranasal vaccine (LAIV).

All children 6-23 months of age should receive TIV annually. In addition, all children with risk factors for influenza (including but not limited to asthma, cardiac disease, sickle cell disease, HIV, and diabetes) should also receive TIV annually. In addition, all children who have close contact with healthy children <24 months of age or with persons at high risk should be vaccinated annually. For healthy children 5 years of age, LAIV is an acceptable alternative to TIV. (LAIV can be given to healthy persons 5-49 years of age).

Children receiving TIV should be administered an age-appropriate dose (0.25 mL for those 6-35 months of age and 0.5 mL for those 36 months of age). Children 8 years of age who are receiving influenza vaccine for the first time should receive two doses (separated by at least 4 weeks for TIV and at least 6 weeks for LAIV). Children 9 years of age should receive one injection of the 0.5-mL dose.

Hepatitis A Vaccine or Immune Globulin for Hepatitis A
Hepatitis A virus (HAV) is endemic in most parts of the world, and infants and children traveling to these areas are at increased risk for acquiring HAV infection. Although HAV is often not severe in infants and children <5 years of age, those infected efficiently transmit infection to other infants and children and to adults.

Children 2 years of age who will be traveling to areas where there is a high risk of HAV infection should be immunized. The HAV vaccine series consists of two doses at least 6 months apart. The first dose should be administered 4 weeks before travel to allow time for an adequate immune response to develop. The second dose is necessary for long-term protection.

The vaccine is not approved for children <2 years of age. Children <2 years of age and children who will be traveling less than 4 weeks after receipt of the first dose should be administered immune globulin (IG) (See Chapter 4, Hepatitis A section). The vaccine and IG can be administered at the same time at different anatomic sites.

IG interferes with the response to live injected vaccines (e.g., measles, mumps, rubella, and varicella vaccines). Administration of live vaccines should be delayed for at least 3 months after administration of IG. Moreover, IG should not be administered for 2 weeks after measles-, mumps-, and rubella-containing vaccines and for 3 weeks after vaccination with varicella vaccine. If IG is given during this time, the child should be revaccinated with the live vaccine at least 3 months after administration of IG. When travel plans do not allow adequate time for administration of live vaccines and IG before travel, the severity of the diseases and epidemiology of the diseases at destination points will help determine the most appropriate course of preparation.

Other Vaccines and Immune Globulin
Yellow Fever Vaccine
Yellow fever, a disease transmitted by mosquitoes, is endemic in certain areas of Africa and South America (Maps 4-12 and 4-13). Proof of yellow fever vaccination is required for entry into some countries (see Yellow Fever Vaccine Requirements and Information on Malaria Risk and Prophylaxis, by Country).

Infants are at high risk for developing encephalitis from yellow fever vaccine, a live virus vaccine. Vaccination of infants should be considered on an individual basis. Although the incidence of these adverse events has not been clearly defined, 14 of 18 reported cases of post-vaccination encephalitis were in infants <4 months old. One fatal case confirmed by viral isolation was in a 3-year-old child.

Travelers with infants <9 months of age should be strongly advised against traveling to areas within the yellow fever-endemic zone. The ACIP recommends that yellow fever vaccine never be given to infants <6 months of age. Infants 6-8 months of age should be vaccinated only if they must travel to areas of ongoing epidemic yellow fever and a high level of protection against mosquito bites is not possible. Infants and children >9 months of age can be vaccinated if they travel to countries within the yellow fever-endemic zone. Physicians considering vaccinating infants <9 months of age should contact the Division of Vector-Borne Infectious Diseases (970-221-6400) or the Division of Global Migration and Quarantine (404-498-1600) at CDC for advice.

Typhoid Vaccine
Typhoid fever is an acute, life-threatening febrile illness caused by the bacterium Salmonella enterica Typhi.

Two typhoid vaccines are available: a Vi capsular polysaccharide vaccine (ViCPS) administered intramuscularly and an oral, live, attenuated vaccine (Ty21a). Both vaccines induce a protective response in 50%-80% of recipients. The ViCPS vaccine can be administered to children 2 years of age, with a booster dose 2 years later if continued protection is needed. The Ty21a vaccine, which consists of a series of four capsules ingested every other day, can be administered to children 6 years of age. All the capsules should be taken at least 1 week before potential exposure. A booster series for Ty21a can be taken every 5 years.

Because neither vaccine is fully protective, preventing contamination of food and beverages remains extremely important.

Meningococcal Vaccine
Meningitis primarily affects children and adolescents, with high morbidity and mortality rates. Epidemics are recurrent in sub-Saharan Africa during the dry season (December through June), and CDC recommends travelers be vaccinated before traveling to this region during the dry season. Meningococcal vaccination is a requirement to enter Saudi Arabia when traveling to Mecca during the annual Hajj.

One meningococcal vaccine is licensed for use in the United States: the quadrivalent A, C, Y, and W-135 vaccine. The serogroup A polysaccharide in this vaccine induces an antibody response in some children as young as 3 months. Thus, vaccinating infants traveling to high-risk areas can provide some degree of protection. For children vaccinated at <4 years of age, revaccination in 2-3 years should be considered if they remain at high risk for infection. For children vaccinated at 4 years of age, revaccination should be considered in 3-5 years if they remain at high risk.

Japanese Encephalitis Vaccine
Primarily night-biting mosquitoes in rural areas of Asia and the Pacific Rim transmit Japanese encephalitis (JE). In temperate climates, their numbers are greatest from June through September; they are inactive during the winter. Most reported cases occur in children. Although most infections are asymptomatic, the mortality rate can be as high as 30%, and neurologic sequelae are reported in 50% of survivors. Serious neurologic sequelae occur more frequently in the very young. The risk to short-term travelers and those who confine their travel to urban centers is very low. Expatriates and travelers living for prolonged periods in rural areas where JE is endemic or epidemic are at greatest risk. Travelers with extensive unprotected outdoor, evening, and nighttime exposure in rural areas, such as might be experienced while bicycling, camping, or engaging in certain occupational activities, might be at high risk even if their trip is brief. The decision to vaccinate a child should take into consideration the itinerary, expected activities, and level of JE activity in the country.

JE vaccine is administered as a series of three injections on days 0, 7, and 30. A booster dose is administered at least 24 months later. Children 1-2 years of age receive 0.5 mL of vaccine per dose; those 3 years of age receive 1.0 mL of vaccine per dose. No data are available on vaccine efficacy for infants <1 year of age.

JE vaccine is associated with local reactions and mild systemic side effects (fever, headache, myalgias, and malaise). Serious allergic reactions, including anaphylaxis, have occurred up to 1 week after immunization. Children receiving the vaccine series should be observed for 30 minutes after immunization. Moreover, the series should be completed at least 10 days before departure, and during that time, vaccine recipients should be remain in areas with access to medical care.

Rabies Vaccine
Rabies is an acute, fatal encephalomyelitis usually transmitted by the bite of an infected mammal. Rabies occurs throughout the world and is endemic in most countries. As with other vaccines, the decision to vaccinate will depend on the itinerary and expected activities during international travel. Children should always be instructed to avoid contact with unfamiliar animals because those animals could be infected with rabies.

Three rabies vaccines are licensed for use in the United States. Each may be administered to infants and children. All the rabies vaccines, when used in a preexposure regimen, are given as a series of injections on days 0, 7, and 21 or 28 days. Even if a child has completed the pre-exposure prophylaxis, any mammal bite warrants immediate medical evaluation to determine the need for postexposure immunization.