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Traveling Abroad? You May Need These Vaccines Before You Go
Depending on where you’re headed, you may need more than your passport. Here’s what adults 50-plus should know about travel vaccines, timing and destination-specific requirements
Covid-19 Pandemic Vaccine, Globe showing the Americas with a vaccine to illustrate the world being vaccinated against a pandemic like Covid-19 and flu.
AARP (Getty Images)
If you’ve (finally!) booked that bucket-list vacation abroad, no one has to tell you that planning an international trip involves checking a lot of boxes — flights, hotels, passport renewal. One of the most commonly overlooked is also arguably the most time sensitive: getting the right vaccines.
The Centers for Disease Control and Prevention (CDC) and World Health Organization recommend scheduling a pretravel health visit with your doctor between four and eight weeks before your departure to get up to speed on immunizations, health risks associated with your specific destination and the implications of traveling with certain underlying conditions. And yet up to 16 percent of travelers wait until two weeks or less before their trip to have that conversation.
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“New vaccinations can take time to generate immunity, and some of them require multiple doses, spaced out over time,” says Dr. Michael Ben-Aderet, medical director of hospital epidemiology at Huntington Hospital, a Cedars-Sinai affiliate.
For travelers 50 and older, the stakes are even higher.
“While most travel-specific recommendations don’t change based on age, adults over 50 tend to be more susceptible to infections and potentially have more severe symptoms,” says Ben-Aderet. “We also know that our patients over 50 tend to take more daily medications, and it’s critical to make sure that any travel prescriptions don’t interfere with important daily meds.”
Where to find destination-specific guidance
- CDC Travel Health: Recommended and required vaccines, plus current health and safety alerts, searchable by country.
- CDC’s Find a Clinic: Locates travel vaccine providers near you, including yellow fever–authorized centers.
- CDC Yellow Book: Along with the U.S. government’s current health guidance for specific international destinations, this online guide offers recommendations for pretravel vaccinations and preventative care.
- U.S. Department of State: Offers destination-specific travel and risk information.
Many vaccine-preventable diseases that are rare in the U.S. are still an issue in other parts of the world. For instance, in the U.S., tetanus itself is rare, but 85 percent of tetanus deaths occur in adults 65 and older — a reminder that even routine boosters, not just exotic travel-specific shots, deserve your attention before a big trip. Polio and diphtheria, no longer common in the U.S., are two others that still circulate in some countries. Chronic conditions add another layer, since having an underlying illness can make an infection, even a routine one, more severe and harder to treat.
“If you are immunocompromised or have other significant comorbidities, check with your primary care doctor when booking travel if you have concerns about your destination,” says Dr. Shauna Gunaratne, assistant professor of medicine in the division of infectious diseases at Columbia University Irving Medical Center.
“If you are significantly immunocompromised — for example, receiving chemotherapy, or a transplant recipient — it would be a good idea to check with your oncologist or transplant doctor before booking travel,” she adds. “Otherwise, make the travel consultation once you have defined plans so the travel medicine specialist can go over your specific destination and itinerary and discuss risks with you based on your travel plans.”
Which vaccines are commonly recommended?
No matter the destination — Mumbai, Mexico, Mauritius, Milan — make sure you’re current with routine vaccinations. Those include:
- Flu
- Tdap (tetanus, diphtheria and whooping cough)
- Pneumococcal
- Shingles
Depending on your age and overall health, the following vaccines may also make sense (check with your doctor):
- COVID-19
- RSV
- MMR (measles, mumps, rubella)
- Hepatitis A and B
- Meningococcal
“Depending on your medical history, vaccination record and travel destination, the recommendations may be highly variable,” Ben-Aderet says. “That’s why it is so important to see a travel clinic and speak with a physician. They can help review the CDC recommendations for your destination, review your medical records and discuss your specific health needs.”
From there, the vaccines you need depend heavily on where you’re going. Hepatitis A and B are common recommendations. Hepatitis B is advised for trips to high-risk regions across Asia, Africa, parts of the Middle East, South and Western Pacific islands and some Caribbean countries; while hepatitis A is recommended for regions with elevated risk — much of Asia, Africa, Central and South America and parts of Eastern Europe — even for travelers staying in cities and upscale hotels.
Typhoid fever is another frequent recommendation, and the numbers explain why: The disease sickens an estimated 9.2 million people worldwide every year, with about 85 percent of U.S. cases occurring in international travelers — the majority of them returning from South Asia, primarily India, Pakistan and Bangladesh.
Depending on the itinerary, your doctor might also recommend vaccines for Japanese encephalitis, rabies, cholera or yellow fever.
Yellow fever works a little differently than the others. For one thing, you can’t get the vaccine at just any pharmacy or primary care office; you must go to a specially authorized vaccine center. What’s more, it’s not only a health recommendation; in some countries, it’s required for entry.
Countries like Angola require proof of yellow fever vaccination from every arriving traveler, regardless of where the trip originated. Other countries require it only if you’re arriving from — or have recently passed through — a country with yellow fever risk. To complicate matters, a country’s entry rule and its actual health risk aren’t always the same: Brazil, for instance, has no vaccination entry requirement at all, yet the CDC still recommends the vaccine for travelers heading to many of its states due to disease exposure.
To avoid trip-ending surprises, be sure to check the CDC’s country-specific vaccine pages for both your destination and any layover countries, ideally within 30 days of departure.
Planning ahead
The four-to-six-week window is the general rule, but some itineraries call for even more time; for instance, multi-destination trips or vaccines that require more than one dose. Japanese encephalitis, for instance, requires two doses at least 28 days apart; hepatitis B requires three doses over six months.
Miss that four-to-six-week window? “It’s still important that you see a travel medicine specialist,” Gunaratne says. “You can still get some vaccines that may have some benefit for you during your travel — for example, one dose of hepatitis A offers a lot of protection even right before travel — and you can get necessary medications such as malaria prophylaxis if needed. Moreover, you will still receive helpful travel advice for your trip to make sure you stay healthy and safe.”
If you’re managing a chronic condition or taking regular medications, that pretravel visit is also the time to review potential interactions and confirm that live vaccines, like yellow fever, are appropriate given any immune-related conditions or treatments.
Also important to include on your pretravel checklist: a separate travel medical policy since most Medicare and most Medicare Advantage plans don’t cover medical care received outside the U.S.
“Medical care abroad can be variable, depending on where you are visiting,” Ben-Aderet says. “It’s important to think about what the options at a destination are before traveling, especially if you have high-risk medical conditions. Contact your health insurance company to ask about the details of coverage in the area of travel in case of emergency.”
“You can also consult the CDC and U.S. Department of State if you are looking to get health care abroad,” adds Gunaratne.
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