Pre-Travel Medical Preparation of Business and Occupational Travelers: An Analysis of the Global TravEpiNet Consortium, 2009 to 2012

Khan, Nomana M.; Jentes, Emily S.; Brown, Clive; Han, Pauline; Rao, Sowmya R.; Kozarsky, Phyllis; Hagmann, Stefan H.F.; LaRocque, Regina C.; Ryan, Edward T.

We evaluated the proportion of GTEN travelers vaccinated for the following diseases: measles, mumps, rubella (MMR); hepatitis B; influenza; varicella; tetanus; hepatitis A; yellow fever (YF); typhoid; rabies; meningococcal; polio; and Japanese encephalitis (JE). For this analysis, MMR, influenza, varicella and tetanus vaccines were defined as generally recommended for all travelers before departure if they were not already immune. The proportion of travelers vaccinated for hepatitis A, hepatitis B ,and typhoid was assessed for specific groups going to endemic countries (high-and intermediate-risk countries for hepatitis A and B; highrisk countries for typhoid) based on the most current CDC recommendations available at the time of the consultation. 9,10 The proportion of travelers vaccinated for polio, rabies, meningococcal disease, JE, and YF was assessed for specific groups of at-risk travelers who met criteria (eg, destination country with risk, season with risk, duration of stay, or indicated for the itinerary) for recommended vaccination; a more extensive description of travelers who were considered at risk is available elsewhere. 11 For all vaccines, if the clinician indicated existing immunity or if the traveler received at least the first dose of a vaccine series at the pre-travel consultation, the traveler was considered, for this analysis, vaccinated for that disease. To analyze reasons for nonvaccination, we excluded those who were previously immune, were vaccinated at the clinic visit, or for whom information was not known.