Category: Vaccinations

Travel Health

You’ve purchased your airline tickets, reserved a hotel, and planned the itinerary for your trip.   Whether traveling for business or pleasure, you prepare in advance for your journey.   What clothes do I need to bring?  Should I stop delivery of the mail and newspaper?  Do I need my passport?  Have I packed my cables, chargers, and batteries?  Do I have all my toiletries?  Who will water my plants and feed the fish?

Here’s another important question to consider:  do I need any vaccines or medications before my journey?

Nowadays, travel to destinations both near and far is commonplace.  As a primary care physician, I want to make sure you are well prepared for a fun, safe, and healthy trip.

What vaccines or medications do I need?

Luckily for you (and for me), the Centers for Disease Control (CDC) and its team of infectious disease specialists, epidemiologists, and public health experts monitor disease trends around the world.  The CDC’s Travelers’ Health page ( provides excellent, up to date information on the vaccinations and medications you may need to protect yourself.

Here’s a brief run-down of the vaccinations you should receive regardless of travel plans, assuming your childhood immunizations were up to date.

  • Tdap (tetanus, diphtheria, pertussis) or Td (tetanus, diphtheria) booster: one dose of Tdap is recommended for all adults, followed by a Td booster every ten years.
  • Influenza (flu shot) vaccine: one dose annually.
  • Shingrix (shingles) vaccine: two doses for all adults who are 50 years of age or older, given two to six months apart.
  • Pneumovax 23 vaccine: one dose is recommended for all adults aged 65 years or older. Both Pneumovax 23 and Prevnar 13 are advised for those who are 19 to 64 years old with an underlying medical condition that may increase one’s susceptibility to pneumonia.
  • Human papilloma virus (HPV-9) vaccine: recommended for all women and men through age 26.
  • Meningococcal vaccine: advised for those at increased risk for exposure to meningitis.  This includes college students living in dormitories, military recruits, and those with functional or anatomic asplenia (without a spleen).

Now, let’s take a closer look at some of the vaccines and prophylactic medications often recommended for travelers.  Depending upon your specific destination, your physician may recommend one or several of the following:

  • Hepatitis A vaccine: consists of two shots given six months apart. Recommended for those visiting parts of Africa, Asia, Central and South America, and Eastern Europe.  Hepatitis A is present in the United States and Western Europe, but is less common.
  • Hepatitis B vaccine: administered as three injections over six months. The hepatitis B vaccine has been included as part of routine childhood immunizations since the early 1990’s, but is also advised for travelers who have not been previously vaccinated.
  • Typhoid vaccine: available either as a single injection or four pills that are taken over eight days. This vaccine provides protection for up to five years.
  • Malaria prophylaxis: antimalarial medication is indicated for travelers visiting an area that is endemic for malaria. Several antimalarial medications are available;  medication choice depends upon local susceptibility and resistance patterns.
  • Yellow fever vaccine:  delivered via injection, this vaccine is advised for those visiting a country where yellow fever is endemic (parts of Africa, Central America, and South America).  Only specially authorized providers may administer this vaccine.  Those who receive the vaccine are provided with an International Certificate of Vaccination or Prophylaxis (ICVP).  Be sure to bring this with you as some countries require this for proof of vaccination.
  • Japanese encephalitis vaccine: transmitted via an infected mosquito, Japanese encephalitis is mostly found in rural agricultural areas in Asia.  This vaccine is recommended for those who plan to spend extensive time (multiple weeks) outdoors in an endemic, rural or agricultural community during Japanese encephalitis virus transmission season.

How soon before my trip should I meet with my doctor?

It is always wise to plan ahead.  I recommend that you start preparing at least four weeks before your trip, but even earlier would be preferable.  Antimalarial pills are started two days to two weeks before travel, depending upon the specific medication chosen. The oral typhoid vaccine should be completed at least one week before travel, while the injectable typhoid vaccine should be administered at least two weeks before potential exposure.  Similarly, the yellow fever vaccine must be given at least ten days before your trip.  The hepatitis A and B vaccine series are administered over six months.   If you’re reading this and suddenly realize that your trip is two weeks away, don’t fret.   I recommend that you start the hepatitis vaccines as the initial doses may provide some protection;  you may then schedule the remaining doses following your return home.

 Where may I find more information?

I recommend the following resources:


Wishing you safe travels,

Brad Weiner, MD


This blog is for informational purposes only. It does not replace medical care from a licensed physician.  Please contact your doctor if you have any questions or concerns.

The Flu Vaccine

Our New England weather has turned cooler over the past few days, reminding us that summer is coming to a close and winter is only a few months away. Soon the leaves will change into brilliant hues of yellow, orange, and red, followed by our first frost, our first snowfall, and then the start of influenza (flu) season.

Flu season usually reaches peak activity during January, February and March, but sometimes arrives as early as December.  Some important reminders about influenza:

What is the flu?

Influenza, or the flu, is a contagious viral infection. Typical symptoms of the flu include a fever (100-103F) for three to five days, shaking chills, diffuse muscle aches, and fatigue. A sore throat, cough, and runny nose may develop. Nausea, vomiting, and diarrhea may also sometimes occur.

How long does the flu last?

Typically, symptoms last for one to two weeks, but recovery may be slow. It is not uncommon to feel unwell for up to three to four weeks.

Why all the fuss over the flu?

While most people have a self-resolving illness, potential complications include pneumonia, dehydration, or an exacerbation of an underlying medical condition such as asthma, diabetes, congestive heart failure, or kidney disease, and in rare instances, death.

Who should get the flu shot?

Everyone older than 6 months. Young children, pregnant women, the elderly, and those with chronic illness are most vulnerable. Please check with your physician first if you have a fever or a severe egg allergy.

Why should I get a flu shot?

When you receive the flu vaccine, you are not only protecting yourself, but you are also protecting your family members, friends, colleagues, and other members of your community.

Does the flu shot work?

The quadrivalent flu vaccine offers protection against two strains of influenza A and two strains of influenza B. When the vaccine’s strains match those circulating in the community, the vaccine provides protection. Last year’s flu shot did not match all of the circulating strains, so people were still susceptible to the flu. Despite the lack of a perfect match, the flu shot still offered some protection and is therefore worthwhile.

Will the flu shot give me the flu?

No.  You cannot get the flu from the flu shot.  This type of vaccine contains an inactivated virus which is dead and cannot cause the flu.  Frequently, the “flu” that people develop after receiving the vaccine is another viral upper respiratory infection, but it is not influenza.  Remember, the flu shot is administered during the fall and winter months.  This coincides with the peak season of the common cold.  For those of you who develop an actual case of influenza shortly after the flu shot, you were going to get the flu anyways.  The flu vaccine takes approximately 10 to 14 days to “kick in” before it starts to provide you with protection.

How do I get the vaccine?

You may contact your physician’s office to inquire about receiving the vaccine. Many local pharmacies and some community centers offer the flu vaccine as well.

Wishing you a happy, healthy, and flu-free winter!

Brad Weiner, MD


This blog is for informational purposes only. It does not replace medical care from a licensed physician. Please contact your doctor if you have any questions or concerns.