A Clinician's Guide to the ACIP Travel Vaccination Recommendations

Since international travel exposes patients to diverse pathogens and healthcare environments, ensuring their pre-travel immunizations align with the latest Advisory Committee on Immunization Practices (ACIP) recommendations is paramount for minimizing infectious disease risk. With that in mind, here’s what you need to know to deliver optimal pre-travel health advice and optimize patient care.

Why Leverage the ACIP's Guidance

The ACIP's travel vaccination recommendations are a cornerstone of pre-travel consultations because these evidence-based guidelines are meticulously crafted by public health experts. Here’s a few key factors about the ACIP’s recommendations:

• Active monitoring of the global disease patterns and outbreaks
• Adapted to protect against the most relevant threats
• Based on rigorous scientific data on vaccine effectiveness and potential side effects
• Activity, itinerary, and destination-specific recommendations, such as rural travel or eco-tourism, to assess risk and reduce unnecessary vaccinations

How to Optimize Pre-Travel Consultations

To ensure the best recommendations for patients, there’s more to be done in daily practice:

• Review and update vaccination records and protocols regularly to ensure alignment with the latest ACIP recommendations. Review and update patient’s existing immunization electronic health records, and ensure patient education materials are up-to-date and at an appropriate level of health literacy.

• Offer vaccinations proactively. Don't wait for patients to ask about vaccinations. Ensure patients are current on routine vaccinations like measles, mumps, rubella (MMR), tetanus, diphtheria, and polio (Tdap) before considering travel-specific vaccines. Assess patients' vaccination status during routine visits, and offer the recommended vaccines based on their age, health history, and travel plans.

• Tailor communication and education to overcome vaccine hesitancy and address their concerns with clear, accurate, and science-based information. Highlight the benefits of vaccination in preventing serious illnesses and protecting both the individual and the community to empower informed decision-making.

• Utilize resources. The CDC and the ACIP's websites offer healthcare professionals the latest vaccine recommendations, patient education materials, and tools to support vaccination efforts. For example, vaccine information statements can be helpful to explain the benefits, risks, and potential side effects of recommended vaccines.

Commonly Recommended Travel Vaccinations

Here's an overview of some frequently encountered travel vaccines, emphasizing the importance of consulting the ACIP's latest recommendations for specific destinations:

• Hepatitis A and B vaccines protect against viral infections transmitted through contaminated food or water. Consideration for vaccination depends on endemicity in the destination and the patient's hygiene practices.
• Typhoid vaccine guards against a bacterial infection spread through contaminated food or water. The ACIP emphasizes the importance of assessing planned activities and access to clean water when determining vaccination necessity.
• Japanese Encephalitis (JE) is a mosquito-borne viral infection that can cause brain inflammation. The ACIP recommends JE vaccination for specific regions, particularly for travelers engaging in outdoor activities.
• Rabies, a potentially fatal viral infection transmitted through animal bites, necessitates pre-exposure vaccination for high-risk destinations with limited post-exposure prophylaxis availability.
• Meningococcal meningitis is prevalent in specific regions. The ACIP recommends vaccination based on the destination and the meningococcal serogroups circulating there.

Essential Resources for Clinicians

It’s important to stay informed of the latest information, vaccine recommendations, patient education materials, and tools to support vaccination efforts and maintain safe and healthy travel. Here’s a few key resources:

• ACIP website (https://www.cdc.gov/vaccines/acip/index.html)
• CDC’s the "Traveler's Health" section (https://wwwnc.cdc.gov/travel)