Immunizations and travel.

Determining the appropriate immunizations for international travelers is a complex, multifaceted process. This article proposes a stepwise and systematic approach to the immunization needs of the traveler-patient. Vaccines for routine health maintenance as well as special issues of the elderly, pregnant, immunocompromised, and child are important in the initial evaluation. Specific travel immunizations (i.e., those for routine travel, those required by a country, those that are geographically indicated and immunizations for extended stays) comprise the remainder of the immunization interview. Health care providers should also be familiar with cost and risk statistics, both the risk of the traveler contracting an illness overseas and the risk of side effects from the vaccines themselves. With such cost-benefit analysis, the provider can offer the traveler immunizations as well as information.