Vaccine	Standard regimen	Booster	Age	Adverse effects	Cost per dose*	Notes
Hepatitis A
Havrix	1.0 mL IM	1.0 mL IM 6 to 12 months after first dose	≥ 19 years†	Injection site soreness, headaches	$64	Safety in pregnancy not determined
Vaqta	1.0 mL IM	1.0 mL IM 6 to 12 months after first dose	≥ 19 years†	Injection site soreness, headaches	$78
Hepatitis B
Recombivax-HB	1.0 mL IM at 0, 1, and 6 months	A booster is not routine	≥ 20 years†	Injection site soreness, headaches	$74	Safety in pregnancy not determined Contraindicated in yeast hypersensitivity
Engerix-B	1.0 mL IM at 0, 1, and 6 months (Accelerated schedule: 1.0 mL IM at 0, 1, 2, and 12 months)	1.0 mL IM 12 months after first dose	≥ 20 years†	Injection site soreness, headaches	$60
Combined hepatitis A and hepatitis B
Twinrix	1.0 mL IM at 0, 1, and 6 months	Not routine	≥ 18 years	Injection site soreness, headaches, nausea	$94	Safety in pregnancy not determined Contraindicated in yeast hypersensitivity
Immune globulin (human)
Baygam	0.02 to 0.06 mL per kg	0.02 to 0.06 mL per kg every 3 to 5 months	≥ 2 years	Injection site soreness, urticaria	$31 for 2 mL	Safety in pregnancy not determined Never shown to transmit hepatitis B, hepatitis C, or human immunodeficiency virus Avoid concurrent administration with MMR and varicella vaccines
Japanese encephalitis
Je-Vax	1.0 mL SQ on days 0, 7, 30	1.0 mL SQ every 2 to 3 years	≥ 3 years	Fever, headache, nausea, vomiting (urticaria and angioedema are rare)	$312 for 3 doses	Safety in pregnancy not determined Administer last dose 10 days before trip departure
Meningococcal
Menomune	0.5 mL SQ	0.5 mL SQ every 3 to 5 years	≥ 2 years	Injection site soreness	$80	Safe in pregnancy
Rabies
RabAvert	1.0 mL IM on days 0, 7, 21, or 28	Every 2 to 5 years (check serum for antibody presence)	All ages	Myalgias, lymphadenopathy	$155	Give only if risk of exposure to rabies is substantial; pregnancy is not a contraindication to preexposure therapy After animal bite, rabies vaccine on day of bite and on day 3 required if preexposure rabies vaccine administered (rabies immune globulin not necessary) Mefloquine or chloroquine may interfere with immune response to intradermal Imovax vaccine if administered concurrently
Imovax	1.0 mL IM on days 0, 7, 21, or 28	Every 2 to 5 years (check serum for antibody presence)	All ages	Myalgias, lymphadenopathy	$160.59
Typhoid fever
Vivotif Berna (oral Ty21a)	Four capsules: 1 capsule given every other day	Four-capsule regimen every 5 years	≥ 6 years	Nausea, vomiting, cramping, fever	$43 for 4 capsules	Oral Ty21a vaccine capsules must be kept refrigerated; each capsule should be taken whole (do not chew) with cool liquid one hour before a meal Oral Ty21a vaccine contraindicated in pregnancy andimmunocompromised patients Start mefloquine (Lariam) or chloroquine (Aralen) at least 3 days after completion of oral Ty21a vaccine Safety of Typhim VI vaccine in pregnancy not determined
Typhim VI	0.5 mL IM	0.5 mL IM every 2 years	≥ 2 years	Nausea, vomiting, cramping	$49
Yellow fever
YF-Vax	0.5 mL SQ	0.5 mL SQ every 10 years	≥ 9 months	Headaches, myalgias, fever, encephalitis (rarely in the elderly)	$62	Consider carefully in elderly patients Contraindicated in pregnancy, patients with egg allergy, and immunocompromised patients Avoid concurrent administration with other live virus vaccines (MMR, oral polio, varicella, oral Ty21a)