Travel vaccines - priorities determined by incidence and impact

Steffen, Robert, Chen, Lin H., and Leggat, Peter A. (2023) Travel vaccines - priorities determined by incidence and impact. Journal of Travel Medicine. (In Press)

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Background: Infectious disease epidemiology is continuously shifting. While travel has been disrupted by the COVID-19 pandemic and travel-related epidemiological research experienced a pause, further shifts in vaccine-preventable diseases (VPD) relevant for travellers have occurred.

Methods: We conducted a literature search on the epidemiology of travel-related VPD and synthesized data for each disease with a focus on symptomatic cases and on the impact of the respective infection among travellers, considering the hospitalization rate, disease sequela and case fatality rate (CFR). We present new data and revised best estimates on the burden of VPD relevant for decisions on priorities in travel vaccines.

Results: COVID-19 has emerged to be a top travel-related risk and influenza remains high in the ranking with an estimated incidence at 1% per month of travel. Dengue is another commonly encountered infection among international travellers with estimated monthly incidence of 0.5–0.8% among non-immune exposed travellers; the hospitalized proportion was 10 and 22%, respectively according to two recent publications. With recent yellow fever outbreaks particularly in Brazil, its estimated monthly incidence has risen to > 0.1%. Meanwhile, improvements in hygiene and sanitation have led to some decrease in foodborne illnesses; however, hepatitis A monthly incidence remains substantial in most developing regions (0.001–0.01%) and typhoid remains particularly high in South Asia (>0.01%). Mpox, a newly emerged disease that demonstrated worldwide spread through mass gathering and travel, cannot be quantified regarding its travel-related risk.

Conclusion: The data summarized may provide a tool for travel health professionals to prioritize preventive strategies for their clients against VPD. Updated assessments on incidence and impact are ever more important since new vaccines with travel indications (e.g. dengue) have been licensed or are undergoing regulatory review.

Item ID: 79131
Item Type: Article (Research - C1)
ISSN: 1708-8305
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Copyright Information: © The Author(s) 2023. Published by Oxford University Press on behalf of International Society of Travel Medicine. All rights reserved. For permissions, please e-mail: This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (
Date Deposited: 12 Jul 2023 00:34
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420299 Epidemiology not elsewhere classified @ 50%
42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 50%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200499 Public health (excl. specific population health) not elsewhere classified @ 50%
20 HEALTH > 2001 Clinical health > 200104 Prevention of human diseases and conditions @ 50%
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