Essential Travel Vaccinations

Who’s at risk and which shots to get when.

A number of vaccines are strongly recommended by the CDC or the State Department; others are required by certain countries to cross their borders. In most cases, advance planning is required so that enough time is given for the vaccination to take effect. So, what to take when? Here, a breakdown of the basics every world traveler should know.


Who Should Get It & When: Anybody over the age of 18 needs a polio booster—even those who remember sucking on vaccine-saturated sugar cubes in grade school. It can be administered anytime before travel.

Destinations & Dangers: “Polio was mostly eradicated, but there are still pockets remaining in Nigeria, India, Pakistan, and Afghanistan,” says Stuart Rose, M.D., of Travel Medicine.

Hepatitis A

Who Should Get It & When: Antibodies develop within two weeks of injection, so getting the shot a month before travel is playing it safe. A second dose six to 12 months later dramatically boosts antibody levels, providing virtually 100 percent immunity.

Destinations & Dangers: Hepatitis A, a viral infection of the liver, is picked up from water and food (especially shellfish) or is transmitted sexually. According to the CDC, Mexico and Central and South America are the highest-risk areas for Americans. But even travelers to low-risk regions should consider a vaccination.

Hepatitis B

Who Should Get It & When: Three doses provide lifelong protection: The first should be given at least one month before travel, the second one month later, and the third six months after the second. Alternately, Twinrix, a combination Hepatitis A and B vaccine, can be administered over three weeks.

Destinations & Dangers: Hepatitis B is passed on through bodily fluids or syringes. The vaccine probably isn’t necessary for most travelers, but anybody can end up exposed to blood or an unsterilized needle, so it’s not a bad idea. (In fact, it’s now a routine childhood vaccination.) High-risk regions for Hepatitis B are Africa, Southeast Asia, and the Middle East.


Who Should Get It & When: A series of three injections is given over three to four weeks, to be completed before travel. More doses are required in the case of an actual bite. If contracted, rabies must be treated with a shot of rabies immune globulin, says Bradley Connor, M.D., of Travel Health Services, “which probably isn’t available in Nepal.”

Destinations & Dangers: Rabies is a viral infection of the central nervous system, transmitted by an animal bite, usually that from a dog or a monkey in the developing world, or a bat, a skunk, a fox, or a raccoon in North America. Southeast Asia, sub-Saharan Africa, the Indian subcontinent, and Central and South America are all hosts to rabies. A vaccine is recommended for travelers who may come in contact with these animals, particularly children, who tend to find such beasts cute.

Yellow Fever

Who Should Get It & When: This vaccine should be given a minimum of ten days before travel and is considered effective for at least ten years. Pregnant women or anyone sensitive to eggs are advised against getting it.

Destinations & Dangers: Carried by a day-biting mosquito, yellow fever, a viral infection of the liver, is found mostly in sub-Saharan Africa, South America, and Panama. An international certificate of vaccination confirming inoculation (or, alternately, a waiver) is required for entry into certain countries, listed on

Typhoid Fever

Who Should Get It & When: Available as a single injection or as four capsules, this vaccine kicks in one week after the last dose—but it’s only ever about 65 percent effective. It is not recommended for young children.

Destinations & Dangers: Typhoid is spread through contaminated food or water. It occurs mainly in South and Southeast Asia, but there is also risk in Africa, the Caribbean, and Central and South America.


Who Should Get It & When: Everyone, travelers and homebodies alike, should get a tetanus shot every five to ten years. (It now protects against diphtheria and whooping cough as well.)

Destinations & Dangers: Rusty nails are everywhere, so no place is without risk. Tetanus, otherwise known as lockjaw, gets serious when the severe spasms caused by the disease start to affect the respiratory muscles and interfere with breathing.