Vaccinations for foreign travel

My four-year-old son and I are going to Africa in two weeks. Which vaccinations does he need?


Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

What a wonderful thing to be able to travel to a foreign land with your child! Obviously, this obligates special attention to health issues. Children who travel to foreign countries require special consideration when it comes to immunizations. There are certain diseases in foreign countries that are so prevalent that getting vaccinated against them is important before visiting. However, even for those diseases for which we currently vaccinate, the schedule of shots may need to be modified prior to going to certain country.

This is not just a personal health issue. There are countries which require their visitors to have received certain vaccinations. And there are countries which have high prevalence of diseases for which there is no vaccination but have recommendations of medications that should be taken to lower the risk of getting those diseases. And finally, there are recommendations based upon how long you plan to be in the country. For example, a particular vaccination may not be needed if the length of stay is less than two weeks.


Normal Vaccines

Of course, it is recommended that all children stay up-to-date on their shots. In general, it is preferable that children receive all their immunizations prior to going abroad. Usually, the DTP, Polio, and HiB vaccinations are given at two-month intervals. There are recommended schedules that allow for these shots to be given in more-frequent intervals to ensure the child has received all shots before leaving. In addition, the measles vaccine, usually given after the first birthday, may be given earlier, but will then require an additional booster shot later. There is also an accelerated hepatitis B vaccine schedule. The rules for how frequent these vaccines may be given are somewhat complicated, but they're available to all physicians, so inquiring about the accelerated vaccine schedule is important to do as early as you know when you plan to leave.

Yellow Fever Vaccine

The yellow fever virus causes fever and liver problems. It is generally transmitted through mosquito bites. This vaccine is required to enter some countries. However, it is not recommended in babies under six months of age.

Cholera Vaccine

This organism causes massive diarrhea and subsequent dehydration. Unfortunately, the vaccine does not work particularly well.

Typhoid Vaccine

This vaccinates against a particular bacterium that causes high fever and sometimes diarrhea. It is generally recommended for those who plan to eat and drink water of questionable purity.

Meningococcal Vaccine

This vaccinates against a bacterium that can cause severe, life-threatening illness and meningitis. While this bacterium is relatively uncommon here in the US, there are certain parts of the world where it is quite common, and vaccination is warranted.

Rabies Vaccine

This is probably not necessary unless the child is going to be living for an extended time in an area where there is a high prevalence of rabies in the animals.

Japanese Encephalitis Vaccine

This infection is caused by a virus and is spread by mosquitoes. It causes an infection of the brain. 


Unfortunately, there is not yet a vaccine for this common disease spread by mosquitoes. There are currently a lot of tests being done with possible vaccines. Until one becomes available, current recommendations are to take certain antibiotics the entire time spent in the country.

Africa is a big place, and there are different recommendations for vaccination and medications against malaria, depending upon the countries you and your son plan to visit. Fortunately, there are two outstanding resources you and your son's doctor can use to help figure out what is needed. The Centers for Disease Control in Atlanta has a hotline and web site addressing the health concerns of travelers. Although the call is not free, the information is.

CDC Traveler's Hotline -- (404) 332-4559
But I think their web site [] is even better. It has information about vaccinations needed, the diseases that are prevalent and other health recommendations geared toward whichever countries you plan to visit. I suggest you check it out, print it up and make an appointment with your son's doctor. Then, have a fun and safe trip to Africa!

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