Immunizations

Before you go abroad, be sure that you and your child have received all necessary immunizations. Check with your primary care physician or refer to the Center for Disease Control (CDC) for guidelines. Check with your primary care physician or your local health department for vaccinations:

• United States Health Departments
• Canadian Health Ministries

Additional vaccinations may be needed prior to travel to Mexico (see below).

Hepatitis A

Hepatitis A is widespread throughout Mexico, so everyone except for children under two years and pregnant women should be vaccinated at least four weeks before departure. You may be vaccinated up to two weeks before departure, but this yields only a 45 percent protection rate. You should receive a second vaccination six months later for long-term protection.

Children under two and pregnant women should receive the Hepatitis A immunoglobulin injection (this is not the vaccine), as should travelers who will be leaving for Mexico in less than two weeks. A new vaccine, Twinrix, combines both Hepatitis A and Hepatitis B vaccines into one vaccine, with certain advantages. For information, contact your physician. For an overview of Hepatitis A disease, see Hepatitis.

Hepatitis B

Hepatitis B is transmitted from person-to-person through the exchange of bodily fluids such as semen, vaginal secretions, or blood. If there is any chance that you might have been exposed to it, we suggest vaccination against Hepatitis B. As in the United States, all health-care workers and anyone whose occupation puts them in contact with blood and blood products should be vaccinated. This disease can also be transmitted through the use of contaminated personal items that can break the skin, such as combs, razors, or manicuring tools. Anyone receiving manicures and pedicures at resorts should check that the instruments used are sterilized. To confer immunity against Hepatitis B, you should receive a series of three injectable vaccinations on Day 1, Day 30, and at 6 months. For more information on Hepatitis B, see Hepatitis.

Rabies

We do not routinely advise vaccination against rabies unless you foresee heavy exposure to undomesticated animals. This would include traveling to rural or remote regions where access to medical care might be limited. The vaccination series for rabies includes four injections over a 28-day period. Contact your state or local health department for information on where you can receive a rabies vaccination. (For a list, see U.S. Health Departments or Canadian Health Ministries)

Yellow Fever

In Mexico Yellow Fever is very rare among travelers. It is not a required vaccination, but we recommend it for people traveling to remote tropical regions. Do not give the vaccination to infants under four months old (it is best to defer vaccination until babies are 9 to 12 months old.) Pregnant women, or people with egg allergies or an immuno-suppressed condition such as HIV without the diagnosis of Autoimmune Deficiency Syndrome (AIDS), organ transplant recipients, or cancer may receive the vaccination if an infectious disease or travel medicine specialist deems the risk of infection significant. Call your local or state department of health, or visit ASTMH for a listing of doctors in your state who provide the Yellow Fever vaccination. A single vaccination lasts ten years. For additional information, see Yellow Fever.

Typhoid

Typhoid is not a required vaccination for those traveling to Mexico. However, we recommend the vaccine for people who will be traveling to remote tropical destinations. The injectable vaccine is no longer available in the U.S. market. The oral typhoid vaccine, Ty21a, produced by Vivotif Berna of the Swiss Serum and Vaccine Institute, consists of four doses given every 48 hours until completion. It is available for people six years of age and older. The vaccine has about a 50 to 80 percent efficacy rating, and you should get a booster every five years.

The vaccine has not been tested in pregnant women and thus cannot be recommended. The oral vaccination consists of a live virus and should not be given to immuno-compromised travelers, including those infected with HIV. The injectable vaccine is a safer choice for these people.

The anti-malarial drugs, Mefloquine and Proguanil, and many antibiotics inhibit the Ty21a virus in test-tube studies. There is a theoretical concern that the vaccine may not be as effective if given while you are taking these other medications. Chloroquine, another antimalarial, does not affect the Ty21a virus. Serious reactions to the vaccine are rare, but some people complain of mild abdominal pain and/or generalized itching, nausea, or rash.

To find out where you can receive a typhoid vaccination and for information on vaccinations for children under the age of two, consult with your local or state health department (For a list, see U.S. Health Departments or Canadian Health Ministries). Additional guidelines for the oral, Ty21a vaccine: keep the capsules refrigerated, but not frozen. Take each capsule with cool liquid on an empty stomach.

Tetanus Guidelines

After primary childhood immunization (a series of four shots, called Diptheria-Pertussis-Tetanus or DPT, during the first five years of life) a person should receive a tetanus booster (dT) every ten years. If you are up to date on your tetanus immunization, clean wounds require no further treatment.

If you were immunized as a child, but have not had a tetanus shot in the past five years, you’ll need a booster if you have a dirty, contaminated wound, a deep puncture, or a complicated wound or burn. Ask your doctor for a diptheria-tetanus (dT) booster.

If you were never immunized as a child and you have a dirty, contaminated wound, a deep puncture, or a complicated wound or burn, you should receive anti-tetanus immune globulin (TIG) as well as beginning an immunization series of dT.