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:: Travel health education article

  • Vaccines for traveling in Taiwan

Travel Vaccinations

Hepatitis A

  • Recommended for: travelers with adventurous dietary habits, prolonged stays, or itineraries outside of common tourist (or other prearranged fixed) packages, especially in rural areas.
  • Consider for: all risk-averse travelers desiring maximum pretravel preparation.

 

Hepatitis B

  • Recommended for: all health care workers; adventure travelers; travelers with high potential to seek medical or dental care in local facilities; those with prolonged stays; those with frequent short stays in this or other high- or intermediate-risk countries; those with possible contact with contaminated needles (e.g., from acupuncture, tattooing, or injection-drug use) or possible sexual contact with a new partner during the stay.
  • Consider for: risk-averse travelers with short stays desiring maximum pretravel preparation.
  • Travelers should observe safer-sex practices and blood/bodily fluid precautions.

 

Influenza

  • Risk exists throughout the year, with highest activity usually occurring from December through March.
  • Recommended for: all travelers due to demonstrated influenza risk in this group.
  • Travelers not already immunized with the currently available vaccine formulation should be vaccinated. Travelers immunized with the current formulation more than 6 months earlier should consider revaccination because immunity may have declined. Consider baloxavir or oseltamivir as standby therapy, especially for those who are at high risk for complications from influenza or inadequately vaccinated.

 

Measles, mumps, rubella

  • Indicated for those born in 1981 or later (1970 or later in Canada and UK; 1966 or later in Australia) without evidence of immunity or of 2 countable doses of live vaccine at any time during their lives.
  • Infants 6 to 11 months old traveling internationally should get 1 dose of measles-mumps-rubella (MMR) vaccine before travel. This dose does not count as part of the routine childhood vaccination series.

 

Rabies

  • Preexposure vaccination:
    • Risk from wildlife and domestic animals exists and is limited to areas south of the Da'an and Heping rivers. Gem-faced civets and ferret-badger have been known for carrying rabies in Taiwan. Canine rabies is not present.
    • Recommended for: animal workers (such as veterinarians and wildlife professionals) traveling to areas where risk exists; all travelers likely to have contact with bats.
  • Postexposure prophylaxis considerations:
    • Terrestrial mammal (including gem-faced civets and ferret- badger but excluding dog) and bat bites or scratches should be taken seriously, and postexposure prophylaxis should be sought even by those already vaccinated.

 

Japanese encephalitis

  • Risk exists in rural agricultural areas throughout the country, except in the central mountains. Transmission occurs from May through October, with peak activity from July through August. Japanese encephalitis is transmitted to humans through bites from infected mosquitoes of the Culex species, mainly Culex tritaeniorhynchus in Taiwan. Since the national vaccination program was implementing in 1968, there are now around 20 to 30 sporadic JE cases annually in Taiwan.
  • Recommended for prolonged stays: all travelers and expatriates (both urban and rural).
  • Recommended for short stays: travelers going to rural areas where risk exists, especially those with anticipated extensive outdoor exposure during the transmission season.
  • Not recommended for: short-stay travelers going to urban areas only; day trips to usual tourist sites in rural areas; or travel outside of the transmission season.
  • Travelers should observe insect precautions from dusk to dawn.

 

Routine Vaccinations

Tetanus, diphtheria, pertussis

  • Due to increasingly frequent pertussis outbreaks worldwide, all travelers should receive Tdap vaccine every 10 years, assuming they previously received an adequate primary series. Those who received Td or TT for their most recent booster should receive an immediate dose of Tdap, regardless of the interval since the last tetanus dose.

 

Pneumococcal

  • Recommended for adults aged ≥ 65 years and all adults with chronic disease or immunocompromising conditions.

 

Varicella

  • Indicated for all persons born outside the US or born in the US in or after 1980, except for persons with an adequate vaccination history (2 lifetime doses), reliable evidence of previous infection, or laboratory confirmation of immunity.

 

COVID-19

  • All eligible travelers should be up to date with their COVID-19 vaccines. There are 4 COVID-19 vaccines approved for use and available in Taiwan: Oxford/AstraZeneca, Moderna, Pfizer/BioNTech, and Medigen.

 

Edit by Tzu Jung Chou, MD,

Fellow of National Taiwan University Hospital, Department of Family Medicine.

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