Before the school year started, I received a notice in the mail that I would have to update my son’s vaccination records before he could enter Grade 2. Yes, that adorably chubby baby who took his first trip at a mere 10 weeks (Quebec City, if you’re curious) is now 7-years-old! Fortunately, I knew he was up-to-date on his vaccinations, and so it was a matter of phoning the Public Health office and updating their records. Easy peasy.
But that reminder brought me back to when we were planning our first family vacation with our daughter before she was a year old (Varadero, Cuba, if you’re curious). Because we would be traveling to the Caribbean, I had questions about any possible travel vaccinations for babies that I should be aware of. I consulted with our family doctor, and she advised that the main health concerns for the Caribbean and Mexico, outside of mosquito-borne diseases, are Hepatitis A and Hepatitis B. Because Hepatitis A is not a serious illness for babies, and an infant is very low risk for Hepatitis B (transmitted via infected blood) she felt that the vaccines for Hepatitis weren’t necessary. Our recommended immunization schedule that we were following was enough to protect her.
I had already been vaccinated against Hep A and Hep B via the Twinrix vaccine a few years back for a (sadly, cancelled) trip to Ethiopia and South Africa, so we were free to enjoy our vacation, just taking the usual precautions for staying healthy while traveling like scrupulous hand washing, avoiding food you can’t peel or heat, and trying our best to avoid insect bites. To date (and I’m totally knocking wood here) we have been very lucky to not have taken ill during any trips to the Caribbean or Mexico.
Travel Vaccinations for Babies and Children: Routine Vaccinations
For most vacation destinations in Canada, the U.S., Mexico, the Caribbean, South America, Europe, and Australia, your routine immunizations are enough to protect your child against diseases and illnesses that have been mostly eradicated in North America, but are still very much present in some parts of the world.
By the age of six, a child should be fully immunized against many diseases that can cause serious illness and even death, including :
- Haemophilus influenzae type b (Hib)
- Meningococcal disease
- Whooping cough (Pertussis)
- Chickenpox (Varicella)
- Pneumococcal conjugate
- Hepatitis B
But if you plan on visiting countries outside of North America, you may consider or even require additional travel vaccinations for babies , toddlers, or children.
Here is a look at a few that may be necessary:
Travel Vaccinations for Babies and Children: Cholera & Traveler’s Diarrhea
Cholera is an intestinal infection that is caused by a bacteria called Vibrio cholerae which is found in contaminated water in places with contaminated water and poor sanitation. It is more commonly found in destinations in Asia, India, and Africa, but Haiti is currently experiencing an outbreak and thus, its connected neighbour–Dominican Republic–is also affected. See the WHO’s cholera map, here. The diarrhea can cause severe dehydration and even kidney failure or death, but if caught early most have a full recovery through the use of anti-biotics.
But the lion’s share of people who experience traveler’s diarrhea can thank a strain of E. coli bacteria called Enterotoxigenic E. coli (ETEC) that is the most common cause of diarrhea in travelers to the Caribbean and Latin America, including Mexico, and is typically found in food that is not adequately cooked as well as contaminated water and ice. Most large resorts have their own in-house water purification systems, but a quick consult with your doctor or pharmacist prior to your trip is advised to discuss travel vaccination options. The same vaccine for cholera is also effective against ETEC, and certain vaccines are available for children as young as two.
Travel Vaccinations for Babies and Children: Hepatitis A Vaccine
Since my children were babies, they have added Hepatitis B to our routine vaccination schedule. And since Hepatitis A does not present a serious risk to babies and small children, I didn’t bother immunizing my kids against it because I was already vaccinated. However, if you or someone in your family are immunocompromised or have been diagnosed with a chronic illness, you may consider administering the Hepatitis A vaccine to your child to prevent them from spreading it.
Hepatitis A occurs worldwide but is more common in regions with poor sanitation and lack of safe food and water. The Hepatitis vaccine can be given to children after their first birthday, and two doses must be given at least six months apart. The protection from the Hepatitis A vaccine is expected to last for at least 20 years, if not longer.
Travel Vaccinations for Babies and Children: Japanese Encephalitis Vaccine
Japanese encephalitis (JE) virus is transmitted to humans primarily through the bite of an infected mosquito.
JE occurs mainly in south east Asia and in parts of the western Pacific, primarily in rural areas. JE is the leading cause of viral encephalitis in Asia. The risk of getting JE is low for most travelers, particularly for short-term visitors to major urban areas, and most infections present no symptoms. Only a small fraction of people infected with the JE virus actually develop the disease.
However, when encephalitis occurs, it is usually severe, and often fatal or permanently damaging.
JE vaccine is not authorized for use in children less than 18 years of age, but usage may be considered in high risk circumstances. Two separate doses are administered 28 days apart.
Babies and Children: Rabies Vaccine
So I am seriously regretting letting my kids pet and play with all those stray cats and dogs we often see at the beach, especially after taking a look at the WHO’s Rabies risk map (hello, Mexico and the Caribbean). Rabies is a rare viral infection that affects the central nervous system, and is most often spread to humans through the bite of an infected animal.
You should seriously consider the pre-travel rabies vaccine if you’re traveling to a destination that is particularly high risk. Toddlers and small children may not listen to you when you say to avoid animals and may also not report a bite. The pre-travel rabies vaccination for babies and toddlers should be given in the deltoid muscle for older children and adults and into the upper thigh muscle in infants. The pre-exposure vaccine is three needles, two are given a week apart, and the third is given between the 21st and 28th day after the first.
As a kid we heard that if you got rabies you needed 16 needles in the stomach, which sounds horrible until you consider that rabies is most often fatal. Post-exposure, however, there is hope and it’s less horrifying than before, and certainly less-horrifying than dying of rabies.
Post-exposure protocol includes local wound treatment, and a shot given on day 0 with as much as possible in and around the wound, and then and four doses of rabies vaccine given on days 0, 3, 7 and 14. If you were taking anti-malarials, are immunocompromised, or didn’t receive the pre-travel vaccine, a fifth needle should be given on day 28.
Travel Vaccinations for Babies and Children: Typhoid Vaccine
Typhoid fever is transmitted through ingestion of food and water contaminated with the feces of people with the disease or who are chronic carriers.
Symptoms range from mild illness with low-grade fever to severe systemic disease with abdominal perforation and extra-intestinal infection that, if untreated, may be fatal.
There are 3 types of typhoid vaccines that provide approximately 50% protection against the disease. Protection with the Typh-I vaccines lasts for three years, and protection is offered for seven years following the Typh-O vaccine.
Typhoid immunization is recommended for most people two years of age and older that are traveling to South Asia, including Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka and is not routinely recommended for travel outside of South Asia.
Travel Vaccinations for Babies and Children: Yellow Fever Vaccine
Yellow Fever is a mosquito-borne virus transmitted to humans through the bite of an infected mosquito. It is endemic and intermittently epidemic in sub-Saharan Africa and tropical South America, and present in certain parts of the Caribbean.
Risk for acquiring YF is low, especially if staying in highly developed urban areas.
However, Yellow Fever is unique among these diseases in that proof of vaccination must be presented when traveling to the at-risk countries. In Canada, the Yellow Fever vaccine is only available at specialized travel clinics.
The Yellow Fever vaccine is one of the recommended travel vaccinations for babies over nine-months-old if visiting high-risk destinations, and may be considered for infants from 6 to 8 months of age if traveling to areas where risk of Yellow Fever is the highest.
Have Baby Will Travel is not a medical site, and any questions regarding travel vaccinations for babies, toddlers, and young children should be directed to your pediatrician, family doctor, or an accredited travel clinic.
This post was written with support from Valneva Canada. As always, all opinions remain my own.
Image courtesy Biggishben/Wikimedia Commons