Travel Vaccines, Malaria Prophylaxis and Helminth Infection

The key reference site for travel vaccination and malaria prophylaxis is the CDC. CDC Traveller Destination Recommendations.

Travel Vaccines

Here is a table summarizing travel vaccines, grouped by condition, product, dose schedule, and the route of administration, based on Australian brand names:

ConditionProductDose Schedule (Regular)Dose Schedule (Accelerated)Route
Hepatitis AHavrix 14402 doses: 0, 6-12 monthsNot applicableIM
Vaqta Adult 50U2 doses: 0, 6-12 monthsNot applicableIM
Twinrix (A+B)3 doses: 0, 1, 6 monthsNot applicable for Hepatitis A aloneIM
Hepatitis BEngerix-B3 doses: 0, 1, 6 months4 doses: 0, 7, 21 days + booster at 12 monthsIM
Twinrix (A+B)3 doses: 0, 1, 6 months4 doses: 0, 7, 21 days + booster at 12 monthsIM
TyphoidTyphim ViSingle dose, booster every 2-3 yearsNot applicableIM
Vivotif4 capsules: one every 2 days, finish 1 week before travelNot applicableOral
Yellow FeverStamarilSingle dose, lifelong protectionNot applicableS/C or IM
Japanese EncephalitisIxiaro2 doses: 0, 28 days2 doses: 0, 7 days (for adults 18-65 years)IM
RabiesRabipur3 doses: 0, 7, 21 or 28 daysSame as regular dosingIM
Verorab3 doses: 0, 7, 21 or 28 daysSame as regular dosingIM
Cholera (and ETEC)Dukoral2 doses, 1-6 weeks apart2 doses, 1 week apartOral
Meningococcal (A, C, W, Y)MenveoSingle dose, booster every 5 yearsNot applicableIM
NimenrixSingle dose, booster every 5 yearsNot applicableIM
Tick-Borne EncephalitisFSME-Immun3 doses: 0, 1-3 months, 5-12 months3 doses: 0, 14 days, 5-12 monthsIM
Polio (IPV)IPOLSingle booster if previously vaccinated, booster every 10 yearsNot applicableIM
Measles, Mumps, Rubella (MMR)MMR II or Priorix2 doses, at least 28 days apartSame as regularS/C
Tetanus, Diphtheria, Pertussis (Tdap)BoostrixSingle booster every 10 yearsNot applicableIM

Malaria Prophylaxis

Here is the updated table for Malaria prophylaxis options, including the product, dose schedule, and geographical areas where the regimen should not be used due to resistance:

ProductDose Schedule (Regular)Geographical Areas Where Not Recommended (Due to Resistance)Route
Atovaquone/Proguanil (Malarone)1 tablet daily, start 1-2 days before travel, continue during travel, and for 7 days after leaving the areaGenerally effective worldwide, but use caution in areas with high parasite resistance like parts of Southeast AsiaOral
Doxycycline1 tablet (100 mg) daily, start 1-2 days before travel, continue during travel, and for 4 weeks after leaving the areaResistance is not a concern, but avoid in certain populations (e.g., pregnant women and children under 8 years)Oral
Mefloquine (Lariam)1 tablet (250 mg) weekly, start 2-3 weeks before travel, continue during travel, and for 4 weeks after leaving the areaWidespread resistance in Southeast Asia, especially along the borders of Thailand, Myanmar, Laos, and CambodiaOral
Chloroquine1 tablet (300 mg) weekly, start 1-2 weeks before travel, continue during travel, and for 4 weeks after leaving the areaWidespread resistance in Sub-Saharan Africa, South Asia, and parts of Southeast Asia and South AmericaOral
Primaquine2 tablets (15 mg each) daily, start 1-2 days before travel, continue during travel, and for 7 days after leaving the areaNot applicable for P. falciparum-endemic areas; requires G6PD testing before use in any areaOral

Key Notes on Resistance:

  • Atovaquone/Proguanil (Malarone) is broadly effective but may face increasing resistance in areas with high malaria transmission, particularly in parts of Southeast Asia.
  • Doxycycline does not have widespread resistance, making it a reliable option across most malaria-endemic regions.
  • Mefloquine (Lariam) should not be used in certain areas of Southeast Asia due to high levels of resistance.
  • Chloroquine has been rendered ineffective in much of the world due to resistance, especially in Africa, India, and Southeast Asia.
  • Primaquine is not used for P. falciparum prevention but is useful for P. vivax; it requires pre-screening for G6PD deficiency and is not typically affected by drug resistance.

Helminth Infection

Here is a table summarizing helminth infection prophylaxis or treatment recommendations, including the product, dose schedule, and geographical areas where the regimen should not be used due to resistance or other concerns:

ProductDose Schedule (Regular)Geographical Areas Where Not Recommended (Due to Resistance or Concerns)Route
AlbendazoleSingle dose (400 mg) for most helminth infections (repeat in 2 weeks for some infections)Resistance can occur in areas with heavy use, but still widely effective in most regionsOral
MebendazoleSingle dose (100-500 mg) for most helminth infections (repeat in 2-3 weeks if necessary)Resistance reported in parts of West Africa for some parasites; still widely effective elsewhereOral
IvermectinSingle dose (150-200 mcg/kg) for Strongyloides, Onchocerciasis, and other helminth infectionsMay have reduced efficacy in regions with high Onchocerciasis prevalence due to partial resistance, such as parts of West AfricaOral
Praziquantel20 mg/kg for Schistosomiasis and tapeworm infections (single dose or divided dose over a day)Resistance is rare but reported in areas with high endemic Schistosomiasis, such as parts of AfricaOral
Diethylcarbamazine (DEC)6 mg/kg daily for 12 days for Lymphatic FilariasisNot recommended in areas where Onchocerciasis is co-endemic (such as parts of Africa) due to severe side effects from co-infectionOral
Pyrantel PamoateSingle dose (10 mg/kg) for hookworm, roundworm, and pinworm infections; may require repeat dosingNo significant resistance concerns globally, still effective in most areasOral

Key Notes on Resistance and Use:

  • Albendazole and Mebendazole are the first-line treatments for most intestinal helminths. While some resistance has been reported, these medications are still effective in most regions.
  • Ivermectin is highly effective for Strongyloides and Onchocerciasis, but resistance is emerging in certain West African regions, especially where Onchocerciasis is common.
  • Praziquantel remains the main treatment for Schistosomiasis, though partial resistance has been observed in heavily endemic areas of Africa.
  • Diethylcarbamazine (DEC) is a standard treatment for Lymphatic Filariasis, but it should be avoided in regions co-endemic with Onchocerciasis, where it can cause severe adverse reactions.
  • Pyrantel Pamoate is effective against common intestinal worms and has no significant global resistance patterns, making it a reliable choice.

These recommendations are region-dependent and should be adapted based on specific travel destinations and the prevalence of resistant helminths.