World Health Organization · 2025 · 72 pages
Comprehensive guidance on vaccination for international travellers, covering routine, recommended and required vaccines for clinicians and public-health professionals worldwide.
- Issuer
- World Health Organization
- Edition
- 2025
- Audience
- Travel health practitioners, travel health professionals, health authorities, travellers, travel industry
- Evidence
- WHO vaccine position papers and expert consensus
- Reviewed
- 14 Oct 2026 · GMJ
What this guideline says
GMJ summary
This module provides detailed guidance on vaccine-preventable diseases relevant to international travel. It covers vaccination strategies across three categories: routine vaccines that should be reviewed before travelling, vaccines recommended for specific destinations or high-risk populations, and vaccines required by certain countries for entry. The document addresses 31 vaccine-preventable diseases including yellow fever, cholera, COVID-19, dengue, hepatitis A and B, Japanese encephalitis, malaria, meningococcal disease, mpox, polio, rabies, typhoid, and others.
The guideline emphasizes that no single vaccination schedule suits all travellers; each must be personalized according to previous vaccinations, health status, risk factors, countries to be visited, type and duration of travel, and time available before departure. Pre-travel consultation should ideally occur at least 6 months before departure to allow completion of optimal immunization schedules, though vaccines can be given up to the day of departure for some diseases. The document stresses that vaccination does not eliminate all risk and must be combined with other preventive measures such as avoiding mosquito bites, hand hygiene, and food/water safety.
Special attention is given to vulnerable groups including infants and young children, pregnant and lactating women, older adults, immunocompromised individuals, and frequent travellers. The module provides specific contraindications, dosing schedules, pre-departure timing, and adverse reactions for each vaccine. It also details requirements for the International Certificate of Vaccination or Prophylaxis (yellow card) and country-specific entry requirements, including those for Hajj and Umrah pilgrims.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Yellow fever vaccination becomes valid 10 days after administration; a single dose provides lifelong immunity and no booster is required since July 2016
- Pre-exposure rabies vaccination: two doses (days 0 and 7) intramuscularly or intradermally; post-exposure requires wound washing plus two booster doses (days 0 and 3) for previously vaccinated individuals, or rabies immunoglobulin (20 IU/kg for human, 40 IU/kg for equine) plus four-dose vaccine schedule for naive individuals
- Japanese encephalitis vaccine: two doses 4 weeks apart for inactivated vaccine; single dose for live attenuated or recombinant vaccine; recommended for travellers with extensive outdoor exposure in endemic areas during transmission season
- Hepatitis A vaccine: protection achieved 2–4 weeks after first dose; can be given up to day of departure; one dose may be sufficient for healthy individuals though two-dose schedule is standard
- Typhoid conjugate vaccine (TCV) recommended as single intramuscular dose for travellers aged ≥6 months to endemic areas, especially for stays >1 month or where antibiotic-resistant strains prevalent
- Meningococcal vaccination required for Hajj/Umrah pilgrims: quadrivalent (ACWY) or pentavalent (ACWYX) conjugate vaccine, given 10–14 days before travel
- Dengue vaccine (TAK-003): two doses 3 months apart; recommended only for children 6–16 years in high-transmission settings; not recommended for travellers including travelling children who should use vector control
- Cholera vaccine: two doses ≥7 days apart for WC-rBS vaccine (three doses for children 2–5 years); protection after 1 week; recommended only for high-risk travellers (emergency/relief workers) as risk for most travellers is very low
Routine and travel-related vaccination categories
Table extracted from the guideline
| Category | Rationale for vaccination | Vaccine |
|---|---|---|
| 1. Routine vaccines for review before travelling | Vaccines may be part of national immunization programmes; pre-travel consultation is opportunity to review vaccination status | BCG, COVID-19, DTP, HepB, Hib, Herpes zoster, HPV, Influenza (seasonal), Measles, Meningococcal, Mumps, Pneumococcal, Polio, Rotavirus, RSV, Rubella, Varicella |
| 2. Vaccines recommended for travel to certain destinations and/or for certain high-risk populations | Based on destination and risk profile (e.g. underlying health conditions, length of stay, humanitarian worker); protect travellers and prevent disease spread between countries | Chikungunya, Cholera, Dengue, Ebola, Hepatitis A, Hepatitis E, Japanese encephalitis, Malaria, Meningococcal, Mpox, Polio (adult booster), Rabies, Tick-borne encephalitis, Typhoid, Yellow fever |
| 3. Vaccines demanded by certain countries | Some countries require proof of vaccination for entry (e.g. for Hajj and Umrah pilgrims) | COVID-19, Haemophilus influenzae, Influenza vaccines, Meningococcal, Polio, Yellow fever |
Source: World Health Organization, International travel and health: Module 4: Vaccine-preventable diseases and vaccines. Reproduced in summary form.
From the guideline
Verbatim
“A single dose of yellow fever vaccine provides lifelong immunity to the disease, making boosters unnecessary.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As someone who has advised WHO on health and migration issues, I recognize this module as essential reference material for Georgia's growing travel medicine sector. The detailed rabies guidance is particularly relevant given our country's enzootic status and the need for both pre-exposure prophylaxis for rural travellers and reliable post-exposure treatment protocols in regional centres. I would stress to Georgian clinicians the importance of the updated yellow fever position—the lifetime validity of a single dose simplifies documentation for our citizens travelling to endemic regions and transiting through countries with yellow fever entry requirements. The practical challenge for Georgia will be ensuring consistent availability of specialized travel vaccines beyond our routine programme: while we have successfully integrated rotavirus, pneumococcal conjugate, and expanded our hepatitis B coverage, access to Japanese encephalitis, TBE, and pre-exposure rabies vaccines remains limited outside Tbilisi. Our national programme should prioritize establishing regional travel medicine clinics with proper cold chain for these vaccines and training primary care physicians in risk assessment, particularly for the growing number of Georgian labour migrants and tourists visiting endemic areas in Asia, Africa, and the Middle East.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 14 Oct 2026
Applicability
Georgia and the South Caucasus
For Georgia and the South Caucasus, this guidance is directly applicable given increasing international travel from the region. Georgia’s national immunization programme covers many routine vaccines listed (DTP, hepatitis B, Hib, measles-mumps-rubella, polio introduced since 1990s; rotavirus since 2013; pneumococcal conjugate vaccine since 2014), but travel medicine clinics must ensure travellers are up to date and provide destination-specific vaccines. Tick-borne encephalitis is endemic in forested areas of Georgia and neighbouring countries, making TBE vaccination relevant for both incoming and outgoing travellers to rural mountainous regions. Rabies remains enzootic in Georgia (WHO risk level 3–4), requiring pre-exposure prophylaxis for travellers to rural areas and post-exposure treatment capacity. Yellow fever vaccination is not required for entry to Georgia but is required for Georgian travellers visiting endemic areas in Africa and South America. National travel medicine programmes should establish pre-travel consultation services with access to specialized vaccines (Japanese encephalitis, yellow fever, rabies, TBE) that may not be part of routine stocks, ensure proper cold chain, and train providers in intradermal rabies vaccination techniques to conserve vaccine doses.
Questions this guideline answers
Quick answers
How far in advance should travellers complete their vaccinations before departure?
Ideally, travellers should consult a physician or travel medicine practitioner at least 6 months before departure to allow sufficient time for optimal immunization schedules to be completed. All vaccines should ideally be given at least 2 weeks before travelling. However, even when departure is imminent, travellers should still consult a health care provider, as some vaccines (like hepatitis A) can be administered up to the day of departure due to the long incubation period of the disease.
Is a booster dose of yellow fever vaccine required for international travel?
No. Since July 2016, a single dose of yellow fever vaccine provides lifelong immunity and the International Certificate of Vaccination or Prophylaxis is valid for the lifetime of the vaccinated person. A booster dose is not necessary. The certificate becomes valid 10 days after vaccination.
What post-exposure treatment is needed after a potential rabies exposure for someone who has been previously vaccinated?
Individuals who have previously received a complete series of pre-exposure rabies vaccination or at least two sessions of post-exposure vaccine should receive two booster doses of vaccine (on days 0 and 3) combined with thorough wound washing. Rabies immunoglobulin is not required for previously vaccinated individuals. The first dose should be administered on the day of exposure or as soon as possible afterwards.
Which vaccines are specifically required for Hajj and Umrah pilgrims to Saudi Arabia?
The Kingdom of Saudi Arabia requires proof of recent vaccination against meningococcal meningitis (with a polysaccharide or conjugate quadrivalent vaccine), poliomyelitis, and seasonal influenza for pilgrims visiting Mecca and Medina for Hajj or Umrah as well as for guest workers. Yellow fever vaccination is also required for pilgrims coming from yellow fever-endemic areas. The most recently available seasonal influenza vaccine should be administered at least 10 days before arrival.
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- Issuer
- World Health Organization
- Type
- Guideline
- Edition
- 2025
- Replaces
- International travel and health (2012)
- Status
- Current
- Published
- 2025-09-19
- Languages
- English
- Scope
- Global
- Audience
- Travel health practitioners, travel health professionals, health authorities, travellers, travel industry
- Pages
- 72
- Licence
- CC BY-NC-SA 3.0 IGO
- ISBN
- 978-92-4-011335-0
- Evidence
- WHO vaccine position papers and expert consensus
- Record history
- Created 14 Oct 2026 · updated 14 Oct 2026 · next check Apr 2027
World Health Organization. International travel and health. Module 4. Vaccine-preventable diseases and vaccines. Geneva: World Health Organization; 2025. (International travel and health). Licence: CC BY-NC-SA 3.0 IGO.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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