Travel Vaccinations

There are many vaccines that you should have already received prior to your transplant in order to prevent infection and/or in your childhood following the recommended immunization schedule by the CDC, however, there still may be vaccinations that you need to receive depending on the location that you are traveling to. It is important that you check with your transplant team or infectious disease doctor to determine which vaccinations you should receive before traveling to any foreign country. Remember that as a post-transplant patient you cannot receive live vaccines.

Tips for making sure you are ready for travel with vaccines: (1)

When possible, get vaccinations at least 2-3 months in advance of the planned trip. Consult your transplant team or infectious disease doctor for the best course of immunization.
Receive vaccinations preferably from a dedicated travel clinic familiar with organ transplant patients.
General (routine) vaccinations should be up to date before you travel.
General vaccination information for travel can be found in the CDC’s Yellow Book.
Vaccination Guidelines for organ transplant patients can be accessed here.

Possible Vaccinations You May Need Prior to Travel

Diphtheria/pertussis/tetanus:

Recommended for adults 19-64 who have previously not been vaccinated receive a single shot.

Hepatitis A:

Hepatitis A is spread by contaminated food or water in areas with poor sanitation.
Symptoms: Nausea, vomiting, diarrhea, and can lead to liver damage.
Receive 2 shots, 6 months apart prior to travel.
Some transplant patients are given gamma globulin if travel is too soon for the vaccine to become effective or if the vaccine does not produce an effective response.

Hepatitis B

Hepatitis B virus is spread through blood and bodily fluids.
Causes liver damage and liver failure.
Series of 3 shots is recommended.

Rabies

Rabies is caught by the bite of an infected animal.
Almost always results in death if you are not vaccinated.
Rabies infected dogs are common in: Asia, Africa, South America, and Central America.
Vaccine is recommended to those traveling >30 days or if expecting frequent contact with animals.

Japanese Encephalitis (JE)

JE causes headaches, confusion, seizures, and paralysis.
Vaccine given as 2 shots, 28 days apart.
Recommended to those traveling >30 days to certain parts of the world, during peak seasons, and travelers going to rural areas likely to engage in outdoor activities.

Meningococcus

Symptoms include headache, fever, and a stiff neck; can be life-threatening.
Necessary if traveling to: sub-Saharan Africa during December to June and for those traveling to Saudi Arabia.

Typhoid

Most common disease acquired during travel that can be prevented by vaccination.
Typhoid is a bacterial infection that is transmitted through contaminated food.
Symptoms include fever, diarrhea, and abdominal pain.
Vaccine is a single dose, all travelers >2 years where typhoid is common.
Transplant patients should receive the injectable vaccine, not the live oral vaccine.

Yellow Fever

Yellow fever is caused by a virus transmitted by a mosquito.
Symptoms include fever, headache, body aches, and jaundice.
Common in South America and sub-Saharan Africa.
Organ transplant patients should avoid areas where yellow fever is common because there is no treatment and patients cannot receive the vaccine because it is a ‘live’ vaccine.

Influenza A/B

Common viral infection that can be deadly in some cases.
Symptoms include muscle aches, fever, chills, runny nose, headaches, congestion, and fatigue.
Transplant patients (and family members) should receive the injected influenza vaccine each year.
Do not receive the nasal mist vaccine as this is a live vaccine.

Pneumococcus

Bacterial infection caused by Streptococcus pneumoniae.
Spread through contact with people and can cause ear infections, sinus infections, pneumoniae, and infections in the brain.
Two types of vaccines exist: PCV13 and PPVS23, both transplant patients can receive.

Coronavirus (COVID-19)

This is a novel coronavirus that emerged in China in 2019.
Symptoms include shortness of breath, fever, cough, loss of sense of smell, abdominal pain, extreme fatigue.
There is no vaccine or treatment for this virus as of yet, so transplant patients are at high risk for morbidity and mortality with the virus.
Due to the high concentration of people infected with the virus, at this time it is recommended that transplant patient avoid all types of travel unless absolutely necessary.
Please speak with your transplant team if you do need to travel so they can advise you on the safest travel practices and the safest mode of travel for you and your family to avoid becoming infected.
Find more information on the American Transplant Society's page COVID-19 Information for Transplant Patients .

References:

1. Yadav P, Baddley J. Guide to Safe Travel after Transplant. Guide to Safe Travel after Transplant. 2018.

2. Kidney Health Australia, Harvey M. Transplant and Travel. Queensland