Travel vaccination decisions depend on destination, age, timing, and the type of exposure expected. The figures below summarize CDC Yellow Book guidance and selected World Health Organization country-list requirements, with measurement periods and geographies identified wherever the source provides them.
Contents
- Yellow fever timing, protection, and safety
- Hepatitis A schedules and last-minute protection
- Typhoid vaccination coverage and schedules
- Other travel vaccine schedules
- Japanese encephalitis and cholera protection
- Rabies pre-exposure vaccination
- Yellow fever documentation by destination
Yellow fever timing, protection, and safety
The CDC Yellow Book states that yellow fever vaccine is given as one dose for travelers aged 9 months and older. The standard dose is 0.5 mL administered subcutaneously. For most people, booster doses are not recommended, and a single lifetime dose provides long-lasting protection for most travelers.
A completed International Certificate of Vaccination or Prophylaxis (ICVP) becomes valid 10 days after primary vaccination. Under the International Health Regulations, a completed yellow fever ICVP is considered valid for life. This timing matters for travelers whose destination or transit route requires proof: many travelers to countries with yellow fever risk need documentation that is valid 10 days after vaccination.
Age changes the risk assessment. Yellow fever vaccination is contraindicated for infants younger than 6 months. Ages 6–8 months are a precaution group, as are people aged 60 years and older. For higher-risk travel settings, consideration of a booster starts 10 years after the last dose.
Most reactions are mild. The CDC Yellow Book reports generally mild reactions in 10%–30% of vaccinees, with mild systemic symptoms typically lasting 5–10 days. Among U.S. travelers, anaphylaxis occurs at a rate of 1.3 cases per 100,000 doses.
The same source reports vaccine-associated neurologic disease incidence of 0.8 per 100,000 doses with YF-VAX. In people aged 60 years and older, YEL-AND incidence rises to 2.2 per 100,000 doses. Enhanced safety monitoring for Stamaril found YEL-AND incidence of 1.0 per 100,000 doses overall and 6.2 per 100,000 doses among people aged 60 years and older.
Yellow fever vaccine-associated viscerotropic disease has been reported more than 100 times worldwide since 2001. The median onset of YEL-AVD is 4 days after vaccination, with a reported range of 1–18 days. Its case-fatality ratio is approximately 43%, while incidence is 0.3 cases per 100,000 doses. These safety figures come from the CDC Yellow Book: Yellow Fever, which is the named source for the yellow fever figures in this article.
Hepatitis A schedules and last-minute protection
Hepatitis A vaccine is approved for people aged 12 months and older in a 2-dose series. The CDC Yellow Book lists Havrix as a 2-dose vaccine for ages 1–18 years and adults aged 19 years and older, with doses at 0 and 6–12 months. Vaqta also uses a 2-dose schedule for those age groups, with doses at 0 and 6–18 months.
For adults aged 18 years and older, Twinrix is approved as a 3-dose standard schedule at 0, 1 month, and 6 months. An accelerated Twinrix schedule uses doses at 0, 7, and 21–30 days, followed by a dose at 12 months. For imminent travel, the CDC Yellow Book: Last-Minute Travelers gives the same accelerated pattern: 0, 7, 21–30 days, plus a 12-month booster.
Infants aged 6–11 months traveling outside the United States should receive hepatitis A vaccine when protection is recommended. However, doses given before 12 months do not provide long-term protection. Adults older than 40 years should receive one hepatitis A vaccine dose as soon as travel is considered.
More than 90% of vaccinated people develop anti-HAV antibody levels correlated with protection 1 month after the first dose. For travelers departing in less than 2 weeks, immune globulin at 0.1 mL/kg can be given along with vaccine. For hepatitis A prophylaxis, immune globulin is 0.1 mL/kg for travel lasting up to 1 month and 0.2 mL/kg for travel longer than 1 month but no more than 2 months. A 0.2 mL/kg dose should be repeated every 2 months when the travel risk continues.
Hepatitis A post-exposure prophylaxis should be given within 2 weeks of exposure. For exposed people older than 40 years, hepatitis A vaccine plus immune globulin is recommended depending on the risk assessment. These schedule and response figures are from the CDC Yellow Book: Hepatitis A.
Typhoid vaccination coverage and schedules
U.S.-licensed typhoid vaccines protect 50%–80% of recipients, according to the CDC Yellow Book: Typhoid and Paratyphoid Fever. That range means vaccination reduces risk but does not protect every recipient, so vaccination does not replace food and water precautions.
The Vi capsular polysaccharide vaccine is approved for people aged 2 years and older. It is given as one 0.5 mL intramuscular dose, with boosters due every 2 years. Oral Ty21a is approved for people aged 6 years and older. Its primary course is a 4-capsule series taken every other day, with boosters due every 5 years.
| Vaccine | Minimum age | Primary schedule | Booster interval |
|---|---|---|---|
| Vi capsular polysaccharide | 2 years | One 0.5 mL intramuscular dose | 2 years |
| Oral Ty21a | 6 years | 4 capsules every other day | 5 years |
The oral Ty21a schedule also has administration details that affect how the course is taken. Capsules should be taken with cool liquid no warmer than 37°C (98.6°F), about 1 hour before a meal and at least 2 hours after a previous meal. The schedule, protection range, and administration instructions are from the CDC Yellow Book: Typhoid and Paratyphoid Fever.
Other travel vaccine schedules
The CDC Yellow Book: Vaccination and Immunoprophylaxis—General Principles lists a cholera vaccine for ages 2–64 years as a 1-dose vaccine. It lists Japanese encephalitis (JE) vaccine for ages 2 months to 65 years as a 2-dose series. Adult JE travelers aged 18–65 years can receive dose 2 as early as 7 days after dose 1.
Rabies pre-exposure vaccination is listed as a 2-dose series for all ages, with a 7-day interval. Tick-borne encephalitis (TBE) vaccine is a 3-dose series starting at age 1 year.
TBE timing varies by age. For ages 1–15 years, dose 1 to dose 2 is spaced 1–3 months apart. For people aged 16 years and older, the interval is 14 days to 3 months. Dose 2 to dose 3 is spaced 5–12 months apart for both age groups. If exposure continues, a TBE booster may be given at least 3 years after the primary schedule.
For adult travelers, Heplisav-B requires 2 doses separated by 1 month. The accelerated Twinrix schedule for imminent travel uses doses at 0, 7, and 21–30 days, followed by a 12-month booster. These schedules are from the CDC Yellow Book: Vaccination and Immunoprophylaxis—General Principles.
Japanese encephalitis and cholera protection
The CDC Yellow Book: Japanese Encephalitis reports that vaccination should be completed at least 1 week before travel. At approximately 6 years after a JE booster, 96% of persons were still protected.
Among adults, pain and tenderness were reported in about one-third after dose 1 or dose 2. Headache was reported in approximately 28% of adults, and myalgia in approximately 16%. In children aged 2 months to 2 years, fever rates after JE vaccination were higher than 20%.
The CDC Yellow Book: Cholera reports cholera vaccine efficacy of 90% at 10 days after vaccination in adults aged 18–45 years and 80% at 3 months after vaccination in that age group. Among recipients aged 2–17 years, more than 97% developed vibriocidal antibody seroconversion by day 11.
The cholera source also notes that 21 toxigenic V. cholerae O1 clinical isolates were submitted during 2017–2019. That is a surveillance count for that period, not a global estimate of all cholera infections.
Rabies pre-exposure vaccination
Rabies pre-exposure immunogenicity peaks 2–4 weeks after completing the primary 2-dose series. The CDC Yellow Book: Rabies separates follow-up by exposure category.
Travelers with category 2 risk should check titers every 2 years. Travelers with category 3 risk should receive one-time titer checks during years 1–3 after the primary 2-dose series. People with sustained risk may need an exposure duration of more than 3 years after the primary series, which affects how follow-up protection is managed.
The primary schedule itself is a 2-dose series with a 7-day interval for all ages in the CDC Yellow Book’s general travel vaccination table. The category-specific titer timing and the immunogenicity timing are from the CDC Yellow Book: Rabies.
Yellow fever documentation by destination
WHO International Travel and Health country-list entries show that yellow fever documentation rules differ by destination, traveler age, origin, and transit duration. The WHO country list for France was published in 2022 and requires proof for travelers aged 1 year or older after long transits. French Polynesia requires proof for travelers aged 1 year or older arriving from risk countries or transiting more than 12 hours through a risk-country airport.
| Destination | Stated proof requirement |
|---|---|
| Gabon | All travelers aged 9 months or older |
| Gambia | Travelers aged 9 months or older arriving from risk countries or transiting more than 12 hours through a risk-country airport |
| Ghana | All travelers aged 9 months or older |
| Guinea-Bissau | All travelers aged 1 year or older |
| Guyana | Travelers aged 1 year or older arriving from risk countries or transiting more than 4 hours through a risk-country airport |
| Sierra Leone | All travelers |
The same WHO International Travel and Health country list says Georgia requires proof of polio vaccination for travelers arriving from countries with poliovirus transmission. Travelers who cannot present a certificate may be offered oral polio vaccine at the border. These destination rules are country-list requirements, not estimates of vaccination coverage, and should be read with the stated publication context and traveler route.