Health advice on immunisations for travel

What is the issue?

Victorians travelling overseas are at increased risk of a range of vaccine preventable diseases, including measles, respiratory infections (e.g. influenza and COVID-19), gastrointestinal illnesses (e.g. hepatitis A, typhoid), mpox and rabies. Vaccines are available to protect against these diseases.

Some of these diseases occur infrequently in Australia but are endemic (i.e. widespread) in other countries. They can be imported into Australia by returning travellers who are infected while overseas. Sometimes, infected travellers may not become unwell until they return to Australia. These illnesses may then be passed on to others in our community and cause disease outbreaks.

Rates of vaccination against many diseases have decreased worldwide, further increasing the risk of outbreaks, with measles a particular concern at present. Vaccine schedules have also changed over time. Therefore, Victorians may not be immune to infectious diseases which are not common in Victoria, but which are currently circulating worldwide.

Important vaccine-preventable diseases for travellers

Influenza and COVID-19 remain common vaccine-preventable diseases caught by travellers. Measles is present across the globe with several countries such as Indonesia and India currently experiencing large outbreaks, while cases in Europe and the United States have been increasing. Any traveller should check they are protected against measles. Two measles vaccinations are 99% effective at preventing infection by the virus.

Rabies virus is present in Asia, Africa, North and South America and parts of Europe. Timor-Leste had previously been considered rabies-free, however an outbreak of rabies in the neighbouring Indonesian province of West Timor has now spread to Timor-Leste.

Since May 2022, there has been a multi-country outbreak of mpox (formerly monkeypox) which has mostly impacted men who have sex with men. Mpox continues to spread in many countries and the risk of transmission linked to international travel remains. In Victoria, the mpox vaccine (JYNNEOS® vaccine) is available free-of-charge for eligible people. A course of two mpox vaccines is needed for optimal protection.

Many other vaccine-preventable illnesses occur more commonly in people returning to their country of birth or visiting friends and relatives (e.g. hepatitis A and typhoid).

Who is at risk?

Any person who is travelling overseas is at risk of getting a travel-related infectious disease. People who have close contact with travellers who have recently arrived from overseas may also be at risk of these diseases.

The risk of contracting a travel-related illness or becoming seriously unwell is higher in people who are not fully vaccinated against these infectious diseases, are older, have underlying health conditions or are visiting friends and relatives.

Travellers returning to their country of birth, or to visit friends or relatives may be at increased risk of vaccine-preventable diseases compared to tourists on holiday. This risk is influenced by the length of the visit, a loss of immunity (protection) to previous diseases, being more likely to eat local food and drink, and a tendency for closer or more frequent interactions with people in the local community.

Recommendations

For the public

• Travellers should see a health professional to discuss what vaccines are available to protect themselves and others. Anyone planning overseas travel should see their GP or a travel health professional at least 6 – 8 weeks before their trip to discuss recommended vaccinations and personalised health advice, depending on the destination and length of stay.
• Prior to travel it is also important to check whether routine vaccinations, including any boosters, are up to date. This includes measles-mumps-rubella (MMR), diphtheria-tetanus-whooping cough (pertussis), polio, and chickenpox (varicella) vaccines.
• People planning international travel should also ensure they have had a 2024 influenza vaccination (which is recommended for all Victorians over the age of 6 months), and that they are up to date with their COVID-19 vaccinations, including boosters if eligible.
• People who are travelling to areas where rabies is present, including Timor-Leste, should see a health professional to the discuss the need for vaccination against rabies.
• In October 2023, the Department of Health began a 12-month pilot to expand the role of community pharmacists, which included the authorisation to administer select travel and other vaccines. Participating pharmacists and more information can be found on the Better Health Channel - Community Pharmacist Pilot
• Vaccination records can be checked online on MyGov through Medicare. The Australian Government Smart traveller website also provides advice on travel health.

For health professionals

• GPs and health professionals should discuss vaccinations with any patients planning to travel overseas. Specific vaccination advice should be provided relevant to the destination.
• For all travellers, it is important that vaccinations against COVID-19 and influenza are up to date.
• Given the current global increase in measles, it is strongly recommended that all overseas travellers are immune to measles, either by having completed a full course of measles vaccine or having demonstrated serological immunity.
• Free measles-mumps-rubella (MMR) vaccines can be offered to people born during or after 1966 who do not have documentation of having received two doses of measles-containing vaccine. All individuals who are unsure of their vaccination history should be offered vaccination, regardless of Medicare status.
  For those known to have received only one dose previously, a second dose is recommended. People who are not Medicare eligible can also receive the free MMR vaccine.
• Infants from 6-11 months of age can receive a free dose of MMR vaccine prior to overseas travel. If an infant receives MMR vaccine at <11 months of age, they still need to also receive the two recommended vaccine doses at ≥12 months of age (at 12 and 18 months).
• Any traveller to a rabies-enzootic country, including Timor-Leste, should be assessed for a rabies vaccination.
• Anyone at-risk of mpox infection should be vaccinated 4-6 weeks before they depart to allow for maximum protection. Two doses are required for optimal protection, provided 28 days apart.

More information

Clinical information

• Assessment of returned travellers with fever - factsheet for clinicians:
• Disease information and advice
• Immunisation

Consumer information

• Australian Government Smart traveller website

Better Health Channel website:

• Travel and holidays
• Travel Immunisation
• Influenza (flu) – immunisation
• Measles
• Mpox
• Rabies
• Hepatitis A
• Typhoid

Contacts

For more information, please contact the Communicable Disease Prevention and Control section at the Department of Health on 1300 651 160 (24 hours).

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