4 Tips to Raise Travel Vaccine Rates

Many Americans fail to receive recommended vaccines for infectious disease such asmeaslesand hepatitis A before traveling abroad, a pair of recent studies revealed.

The first study analyzed data on 40,810 adults who received pre-travel consultations between 2009 and 2014. The researchers found that only 47% of the 6612 vaccine-eligible patients were immunized against measles, mumps, and rubella (MMR) before traveling internationally.

A separate study examined a 2015 outbreak of hepatitis A infection in Tulum, Mexico, in which 29 Americans developed hepatitis A within a 3-month period. Of the patients, 17 stayed at 1 of 9 resorts within several miles of each other, 23 reported eating seafood, and 16 reported eating ceviche, a dish consisting of raw fish.

Additionally, none of the travelers had received a hepatitis A vaccination prior to their trip. The study authors emphasized that this outbreak could have been avoided if the travelers had been properly vaccinated.

“Hepatitis A vaccination prior to travel is the most effective way to avoid infection, regardless of length of stay or quality of lodging," said lead author Monique Foster, MD, MPH, in a press release.

In exclusive interviews withPharmacy Times, Dr. Foster and Emily Hyle, MD, lead author of the measles study, shared these 4 tips for retail clinicians to improve vaccination rates among travelers:

1. Recognize suboptimal vaccination.

Understanding why patients fail to properly vaccinate themselves before they travel is an important first step in preventing foreign-born diseases.

Drs. Foster and Hyle said the reason for this low vaccination is simple: travelers are unaware of the risk of disease or the protection afforded by vaccination.

“Studies have shown that the primary reason travelers fail to get vaccinations prior to travel, particularly when it comes to hepatitis A, is that they simply did not know the vaccination was needed,” Dr. Foster said, citing a previous study in which only 36% of more than 400 travelers reported seeking travel health advice.

Dr. Foster noted that travelers rarely reported not having enough time prior to departure to receive their vaccinations, and Dr. Hyle recommended that those planning international travel should visit a health care provider or travel clinic 4 to 6 weeks prior to their trip, so that they may learn more about the recommended vaccines.

2. Ask patients about their travel plans.

Retail clinicians should view each patient visit as an opportunity to ask about upcoming travel plans in order to ensure that the patient is referred to a travel clinic and properly prepared, Dr. Hyle said.

Clinicians should also confirm that patients have received the 2 MMR vaccinations recommended by the US Centers for Disease Control and Prevention (CDC) prior to travel, especially if they are traveling to destinations that don’t frequently require a travel clinic referral.

Dr. Foster noted that that CDC recommends that anyone traveling to countries with high or intermediate endemicity of hepatitis A infection should get vaccinated against the disease. Therefore, clinicians should know where the patient is planning to travel and understand the vaccinations required of travelers entering that country, particularly if it requires malaria prophylaxis or if there is any reported resistance to common antimalarial medication in the area.

3. Educate patients on disease risk and prevention.

Retail clinicians have an essential role to play in educating patients about the importance of travel health.

Dr. Foster advised clinicians to examine patients’ medical, social, vaccination, and travel history in order to determine their risk of infection during their trip, and then consult or refer them appropriately.

Clinicians should also communicate common precautions for avoiding disease during their travels; for example, those traveling to areas where hepatitis A is common should avoid consuming non-bottled water, uncooked fruit and vegetables, and undercooked meats, as travelers are most often exposed to the hepatitis A virus through contaminated food and water.

4. Share travel health resources with patients.

There are a number of resources available to both patients who plan to travel and the retail clinicians treating them.

Dr. Foster pointed specifically to the CDC Health Information for International Travel Book, more commonly referred to as the “Yellow Book,” as a reference for clinicians to use when consulting travelers.

Additionally, both researchers advised that travelers and clinicians consult the CDC’s traveler’s health website for country-specific recommendations and information on travel advisories.

Finally, Dr. Foster encouraged retail clinicians to familiarize themselves with local travel clinics where they can refer patients who require specialized travel advice.