child

Vaccinations For Children
Measles: Infant younger than 6 months is protected, if 6-11 months he\she should have MMR or separate measles. If a child is 12 months and traveling to an area of high risk, a first does should be administered and a second at 28 days.

Mumps and Rubella: Not needed for infants less than 12 months.

Varicella (Chicken pox): recommended if 12 months or older.

Haemophilis Influenza Type B (Hib): Never given less than 6 weeks old. Begin series at 2 months. If previously not vaccinated children under 15 months should have 2 doses of Hib before travel (there should be 4 weeks between doses). Unvaccinated children 15-59 months should have single dose.

Hepatitis B: Vaccination may begin at birth or by 2 months. Second dose should be given after 1-2 months. Third dose should be given at least 2 months later and not before 6 months of age.

Typhoid: Breastfeeding children are likely to protect infants. Vaccine is recommended for children 2 years or older.

Yellow Fever: Never given below 4 months, rarely given to children 4-6 years of age , unless a special situation. 6-9 years of age are vaccinated only if traveling to areas of ongoing yellow fever epidemic.

Hepatitis A: Recommended for children over 1 year old.

Vaccines for Children Traveling
Children going traveling with their parents may need their vaccinations adjusted - either because of the decreased availability of pediatric follow-up where they are going or because of the increased visit of the new area.

Changes in Schedule for Routine Immunization due to Travel

Vaccine
Age Routinely Given
Accelerated Schedule
DTaP - Diphtheria, Tetanus, Pertussis
2,4,and 6 months
6wks, 10wks, and 14wks
Hepatitis B (note: Hep B is given much earlier in U.S than in Canada)
Birth, 1, 6-12 months
0,1 month, 2 months, booster-12 months (Hep B is given much earlier in U.S than Canada.
MMR - Measles, Mumps, Rubella
12-15 months
6 months
Polio
2, 4, and 6 months
6wks, 9wks,and 12 wks

Note: When vaccines are given younger than routinely recommended or intervals are shortened, vaccinations may need to be repeated at a later date.

Special Notes on Vaccines in Children

Cholera Vaccine - Is no longer available in North America. Risk of Cholera to travelers is very low. Breast-feeding protects children. In older children, close attention to food and water will protect.

Hepatitis A - Is given to children over 1 yrs old. Breast-feeding protects small infants with passive immunoglobins from mother's milk.

Japanese Encephalitis Virus - Is given to children over 1yrs old traveling to rural areas endemic in this infection during the peak transmission season. Japanese Encephalitis is recommended only if staying in areas around rice paddies or pig farms, where the risk of JEV mosquitoes is high.

Rabies - Children may be more susceptible to rabid animal attacks than adults. Parents may consider this vaccine if their child is staying in a high-risk area for rabies.

Typhoid - Breast fed infants are protected from this. For older children careful boiling or chlorinating water prevents this disease. The new injectable vaccine is given to children between ages 2-6. An oral typhoid vaccine is available for older children.

Yellow Fever - This mosquito borne infection is required for travel to some countries. It is never recommended to children under 4 months, and only in exceptional circumstances for children 6-9 months. Infants 7-9 months may be vaccinated if they require it.

Children and Bugs
Preventing insect bites is very important in preventing many diseases. The following are recommended:
1. Placing nets over baby carriages and cribs
2. Eliminating standing water around living quarters
3. Stay inside between dusk and after dark
4. Dressing children carefully in long sleeved clothing over neck, wrists, and ankles
5. Not allowing children to go barefoot
6. Covering skin with DEET 20-35% - This is higher than what many other recommend. DEET is safe to use on children when used correctly. Apply on exposed skin, but not on irritated skin and wash it off after use.
7. Use a flying insect spray in living and sleeping quarters
8. Sleep in air-conditioned area when possible

Malaria Medication and Children
Chloroquine is self and well tolerated but has a bitter taste. Eating adult strength doses can harm children. Chloroquine should be kept in safe place away from children.

Mefloquine (Larium)
Is very safe in children. Neurological agitation from mefloquine is not seen in children as with adults.

Malarone
Is a new medication and is more expensive. It is taken daily according to weight.

WEIGHT
DOSE
10-20 kg
1 Pediatric strength tablet
21-30 kg
2 Pediatric strength tablet
31-40 kg
3 Pediatric strength tablet
40+ kg
1 Adult strength tablet


Doxycycline
Safe for ages 9+. Also safe in lactating mothers, but not in pregnant woman..