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NOTICE: Yellow Fever Vaccine Single Dose Vials Now Available
March 2008 - In March 2008, the Centers for Disease Control and Prevention (CDC) was informed by sanofi pasteur, the only manufacturer of U.S. yellow fever vaccine, that the single-dose vials of yellow fever vaccine, YF-VAX,® are now available. Limitations on orders will be in place as sanofi pasteur works to build inventory of the single-dose vials. In the interim, the 5-dose vials of YF-VAX® continue to be available in sufficient supply. To accommodate all travelers who need this vaccine, clinics administering vaccine are advised to attempt to schedule vaccinations to efficiently use the 5-dose vials.Travelers to yellow fever endemic countries are encouraged to contact their travel vaccine providers for information about yellow fever vaccine supplies. For more information on this temporary shortage, click here.

Vaccine needs vary considerably from country to country but the best place to start is with the recommended vaccine schedules for children and adults. In Utah, some vaccinations are required for school entry. However, most of the vaccines that are routinely administered in childhood require periodic booster doses throughout life to maintain an effective level of immunity. Adults often neglect to keep up the recommended schedule of booster vaccinations, particularly if the risk of infection is low. Additionally, some adults have never been vaccinated at all. It is important to realize that diseases such as diphtheria and poliomyelitis, which no longer occur in most industrialized countries, many be present in those visited by travelers. Pretravel precautions should include booster doses of routine vaccines if the regular schedule has not been followed, or a full course of primary immunization for people who have never been vaccinated.

Additional vaccines are advised on the basis of a travel risk assessment for the individual traveler. In deciding which vaccines are appropriate, the following factors should be considered for each vaccine:

risk of exposure to the disease
age, health status, vaccination history
special risk factors
reactions to previous vaccine doses, allergies
risk of infecting others
cost

Mandatory vaccination, as authorized by the International Health Regulations, now concerns only yellow fever. Yellow fever vaccination is carried out for two different reasons:

(1) to protect the individual in areas where there is a risk of yellow fever infection, and
(2) to protect vulnerable countries from importation of the yellow fever virus.

Travelers should therefore be vaccinated if they visit a country where there is a risk of exposure to yellow fever. They must be vaccinated if they visit a country that requires yellow fever vaccination as a condition of entry: this condition applies to all travelers who arrive from (including airport transit) a yellow fever endemic country.

Travelers should be provided with a written record of all vaccines administered (patient-retained record), preferably using the international vaccination certificate (which is required in the case of yellow fever vaccination).

Category	Vaccine
1. Routine vaccination	Diphtheria/tetanus/pertussis (DTaP) or tetanus/diphtheria for age 7+ (Td) Hepatitis B (HBV) Haemophilus influenzae type b (HIB) Measles, Mumps, Rubella (MMR) Poliomyelitis (IPV)
2. Selective vaccination determined by destination and risk factors	Cholera Influenza Hepatitis A (HAV) Japanese encephalitis Malaria (pills) Meningococcal meningitis Pneumococcal disease Rabies Tick-borne encephalitis Tuberculosis (BCG) Typhoid fever Yellow fever (for individual protection)
3. Mandatory vaccination	Yellow fever (for protection of vulnerable countries) Meningococcal meningitis (for Hajj, Umra)

To find out which immunizations are needed for the region you will be visiting, you may go to the Centers for Disease Control and Prevention Travelers' Health website. You will find a wealth of travel information at this site: food and water recommendations, disease outbreak areas, recommended precautions and much more. It's a great place to start, when planning a trip.

Routine adult and childhood vaccine recommendations, required shots for LDS missionaries, a list of travel clinics throughout the state and other valuable travel information can be accessed through the Utah Immunization Program website:

Childhood Schedule
Adult Schedule
Missionary Requirements
Travel Clinics

You may also call the Utah Immunization Program Hotline at 1-800-275-0659 for additional questions or information.

If you are planning on traveling out of the country, make sure your immunization needs are assessed and your vaccinations completed in plenty of time to assure immunity. Most vaccines build immunity in approximately one week to ten days. However, immunizing against some diseases requires multiple vaccinations and may take six months or more to complete. Be sure to find out which vaccines you will need as soon as you know your travel plans. Remember that vaccine immunity may be the most important thing you bring with you!