Vaccine	Indication	Administration
Routine, domestic immunizations recommended by the Advisory Committee on Immunization Practices
Haemophilus influenzae type B	All infants; older children and adults with asplenia or sickle cell disease; sometimes administered to those older than 5 years who have received a bone marrow transplant or to those 5 to 18 years of age with human immunodeficiency virus infection	2- or 3-dose primary series, and a booster dose (dose 3 or 4, depending on vaccine used in the primary series) at 12 to 15 months of age to complete the full series
Hepatitis A	All travelers older than one year	2 doses separated by at least 6 months
Hepatitis B	All travelers	3 doses at 0, 1, and 6 months of age
Herpes zoster virus	Adults older than 60 years	Single dose
Human papillomavirus	All children and young adults	3-dose series is advised for girls and boys starting at 11 or 12 years of age, but may be given as young as 9 years; it may be given up to 26 years of age in men and women
Influenza	Virtually all travelers older than 6 months, regardless of destination	IM (inactivated) or intranasal (live); annual boosters required
Measles, mumps, rubella	All travelers	2 doses separated by at least 28 days for those older than 1 year; may be given to infants 6 to 11 months of age, but 2 more doses at least 28 days apart are needed
		Those born in the United States before 1957 are assumed to be immune
Meningococcal	Those in crowded living conditions (e.g., a dormitory): routine immunization at 11 or 12 years of age with the conjugate vaccine, and a booster dose given at 16 years of age	A 1-dose primary series of Menactra is licensed for those 2 to 55 years of age
		Menveo is licensed for those 2 months to 55 years of age
		Menomune, the polysaccharide vaccine, is licensed for those older than 2 years
Pneumococcal	All infants, and adults older than 65 years	4 doses of the conjugate vaccine (Prevnar 13) are given to infants at 2, 4, 6, and 12 to 15 months of age; it is also advised for adults older than 65 years and for those 6 to 64 years of age with certain medical conditions
		The polysaccharide vaccine (Pneumovax 23) is advised for adults older than 65 years, and those 2 to 64 years of age with underlying medical conditions
Poliovirus	All infants and children	Primary series: 4 doses at 2, 4, and 6 to 18 months of age, and 4 to 6 years of age
Rotavirus	All infants	3 doses of Rotateq (monovalent) at 2, 4, and 6 months of age, or 2 doses of Rotarix (pentavalent) at 2 and 4 months of age
Tetanus, diphtheria, pertussis (Td, Tdap)	All travelers	Td is given every 10 years for adults
		Tdap should be given to adolescents at 11 to 18 years of age instead of Td; adults 19 years and older should receive a single dose of Tdap instead of Td if they did not receive Tdap as an adolescent
		Tdap is recommended in each pregnancy between 27 and 36 weeks of gestation
Varicella	All travelers	Children younger than 13 years should receive 2 doses: 1 at 12 to 15 months of age and another at 4 to 6 years of age; those 13 years and older should receive 2 doses at least 28 days apart
Travel-specific immunizations
Cholera	Adults 18 to 64 years of age traveling to cholera-affected areas, particularly persons at high risk of cholera (e.g., health care workers who will be caring for patients during cholera epidemics); not indicated for most travelers	Single oral dose of Vaxchora; booster schedule is not yet determined
Japanese encephalitis	Travelers to endemic areas in Asia and Western Pacific; higher priority for duration of travel more than 1 month and rural travel; risk is very low with urban, short-term travel	2 IM doses at days 0 and 28; booster administered at 1 year for those at ongoing risk; 96% of patients are protected after 6 years, and the average duration of protection after booster is 14 years
Meningococcal meningitis	Travelers to the meningitis belt of Africa ( http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/meningococcal-disease for a map), or if crowded living conditions (e.g., dormitory) are anticipated	1 dose of MenACWY is given to those 2 to 55 years of age; 1 dose of MPSV4 is given to those 56 years or older who have never received meningococcal vaccine; a booster dose is advised 5 years after the previous dose of vaccine for those who received their previous dose at ≥ 7 years of age
Poliovirus	Travelers to a country with ongoing transmission of polio ( http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6327a4.htm)	In addition to the 4-dose childhood series, adult travelers to polio-endemic destinations should receive a single dose of the inactivated poliovirus vaccine; subsequent boosters are not advised
	Long-term (more than 4 weeks) travelers to Afghanistan and Pakistan may be required to show proof of polio immunization before leaving those countries; vaccine should be received 4 weeks to 12 months before departure from polio-endemic countries
Rabies	Travelers visiting regions in which rabies is enzootic; higher priority for longer duration of stay, rural or remote travel	3 IM doses at days 0, 7, and 21 or 28; boosters not advised for those at low risk; for those at increased risk (e.g., cavers, wildlife workers in endemic areas), serology should be tested every 2 years and a booster administered if antibodies are below protective levels
		It should be noted that postexposure immunization for rabies (received preexposure series: 2 doses separated by 3 days; did not receive preexposure series: 4 doses at days 0, 3, 7, and 14, plus a single dose of rabies immune globulin) may not be available in low-resource settings
Typhoid fever	Consider for all travelers to low-income nations; higher priority for high-risk destinations, rural travel, or duration of travel more than 1 month	IM (inactivated): boosters required every 2 years
		Oral (live): 4 tablets, 1 taken every other day; provides protection for 5 years
Yellow fever	Travelers to endemic areas (tropical Africa and tropical South America); should not be used in those younger than 9 months	The previous recommendation was 1 dose every 10 years; however, in February 2015, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices approved a new recommendation, stating that a single dose has long-lasting protection and is adequate for most travelers
		Increased risk of significant adverse events in first-time vaccine recipients older than 60 years
		Contraindicated in those taking immunosuppressive medications, or who have primary immune deficiency (including thymus disorders) or myasthenia gravis; if the risk of getting the vaccine exceeds the risk of exposure to yellow fever, physicians should write a letter of exemption or complete the waiver section of the International Certificate of Vaccination or Prophylaxis (“yellow card”)
Immunizations not routinely given in the United States
Smallpox	Special populations, such as military personnel and smallpox researchers; not advised for most travelers	Administered with a bifurcated needle; special training required
Tick-borne encephalitis	Travelers to endemic areas in Europe, the former Soviet Union, and Asia	3 IM injections; schedules vary among preparations, but most series require a minimum of 6 months to complete
		Not available in the United States; at-risk travelers may receive this vaccine in Canada or Europe
Tuberculosis (bacillus Calmette-Guérin vaccine)	Given once at birth in most low-income nations; consider for health care workers traveling to destinations with high tuberculosis resistance to both isoniazid and rifampin	Single dose