Vaccination of the traveller

Selection criteria

For all and whatever the destination

– for the adults: update of vaccinations against the diphteria (preferably with a reduced amount of anatoxine), tetanus and the poliomyelitis;
– for the children: update of the vaccinations included in the French vaccine calendar in particular more precociously for

• measles, as from 9 months, followed by a revaccination with a vaccine triples measles-mump-rubella in 12 months, 

·         BCG as of the first month in the event of long stay in endemic area, 

·         hepatitis B as of the birth if the risk is high.

According to the epidemiologic situation

- Voyage in an intertropical zone of Africa or South America 
Yellow fever: 1 injection at least 10 days before the departure
validity: 10 years.
Exigible starting from the age from 1 year, possible as of the 6 months age.
Reserved in the centers approved by the Directorate-General of health.

- Stay prolonged in rural zone at the East or rain season in South Asia 
Japanese Encéphalite:  3 injections with J0, J7, J 21 or 28, the last at least 10 days before the departure (in the event of imminent departure, an accelerated diagram: J0, J7, J 14 are allowed).
Possible in the child from 1 year (up to 3 years: half proportions).
Vaccine under personal ATU reserved in the centers of international vaccinations.

- spring or estival Stay in rural zone in Central or Eastern Europe 
Encéphalite with ticks: 3 injections, two first 1 month from interval, third 9 to 12 months later; recalls every 3 years.
Possible in the child as from 3 years (first injection: half-amount up to 16 years).

- Stay prolonged in situation of strong promiscuity and epidemic period, in particular in Africa sahélienne in dry season 
Meningitis with méningocoques A and C:  1 injection at least 10 days before the departure
Not very effective in the child below 24 months, possible nevertheless in the event of epidemic, as of the 6 months age, with the proviso of renewing the injection later a few months.

* Pilgrimage In Mecque: a vaccination going back to less than 3 years and more than 10 days by tetravalent vaccine ACYW135 (Ménomune®) is required by the authorities saoudiennes. This vaccine is reserved for the hospital use and the centers of vaccinations entitled to carry out antiamaril vaccination.

According to the conditions and duration of the stay  (country on low medical level)

- all types of stays 
Hepatitis a: 1 injection 10 to 15 days before the departure, recall 6 to 12 months later;
duration of protection: 10 years.
Possible in the child starting from the age of 1 year.

- stay prolonged or under precarious conditions of hygiene
Typhoid: 1 injection 2 weeks before the departure; duration of protection: 3 years.
Possible in the child starting from the 2 years age.

- prolonged or frequent stays, activities or behaviors at the risks 
Hepatitis b: 2 injections separated by one month, single recall 6 months later.
* in the event of imminent departure: 3 injections separated by one month, recall 1 year later;
an accelerated protocol (J0, J7, J21) is also possible. In both cases the recall at the end of one year is imperative.

- stay prolonged or "adventurous" and in situation of insulation (in Asia and in particular in India)
Rage on a purely preventive basis: 3 injections with J0, J7, J21 or 28, recall 1 year later; duration of protection: 5 years.
Recommended in the young children as of the age of walk.
The protective inoculation does not exempt treatment after exposure, which must be implemented as soon as possible.

Conclusion

A voyage is an occasion to update the basic vaccine calendar. Indeed, the vaccinations recommended in France are even more necessary in the tropical countries. One should not stick to the administrative obligations because they are often established to avoid the importation of an infectious disease in a country where it does not exist, and not to protect the traveller. It is significant to have a sufficient time to establish the whole of the vaccine program. The optimum time advised is one month before the departure what makes it possible to construct the whole of vaccinations necessary. Lastly, the point most significant to underline is that the establishment of the vaccine calendar of the traveller must take account of the traveller, the type of voyage (conditions, lasted…) and of the epidemiologic conditions of the country of destination.

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