… Prepared by TMA Member Yeppoon, Qld: Dr Julie Burke
Travelling with children can be very rewarding. People of all ages and cultures are drawn especially towards children, often making the family travel experience especially fulfilling.
Travelling with children does, however, pose some extra challenges. Ensuring optimum preventative care with pre travel vaccinations can eliminate some of these extra stressors.
Routine Schedule of Vaccinations
All travelling children should be immunised in accordance with the Australian National Immunisation Programme. If you can not find documentation of your child’s vaccinations; this can easily be retrieved from the Australian Childhood Immunisation Register. Travel doctors will tend to adopt the policy of “no documentation means not immunised” and vaccination will be recommended; as evidence shows the risk of adverse events if a child is inadvertently revaccinated far outweighs the risk of the disease.
Routine schedules are designed to vaccinate children at the earliest age when they respond with optimal, long-term protection. Little ones are more susceptible to disease but usually have little chance of exposure in Australia. However, travelling to developing countries, the risk of exposure may greatly increase. Almost all of the routine vaccines can be given early and more frequently than the schedule suggests.
Measles, for example; is an exotic disease in Australia, but is regularly re-introduced by young travellers, especially from regions where there is no national programme to eliminate it. The Measles/Mumps/Rubella vaccination can be given as young as 9 months of age but with a booster 3 months later.
Since late 2008, an Australia-wide whooping cough epidemic has seen an increase in hospitalisations of infants with life-threatening whooping cough. It is highly infectious; making little travellers highly vulnerable in crowded airports/aeroplanes/countries.
Polio has been eradicated from most of the world but still circulates in many developing countries, particularly Africa and the Indian sub-continent and, to a lesser degree, Indonesia and the Arabian Peninsula.
The routine whooping cough/diphtheria/tetanus/hepatitis B/polio vaccination given at at 2, 4 and 6 months can be given at 6 weeks; 10 weeks; and 18 weeks without affecting the booster immunity. The 3rd dosage may even be given as early as 14 weeks if the child at high risk; but an extra booster to cover for the hepatitis B component of the vaccination would be necessary.
Rotavirus; the predominant cause of severe dehydrating gastroenteritis in infants and young children in both developed and developing countries; can also be prevented through an accelerated schedule; the first dose of this can be given as young as 6 weeks with interval between dose between 1st, 2nd, and 3rd dose at 4 weeks minimum.
Meningococcal disease is both sporadic and epidemic throughout the world. with meningococcal C associated with small clusters in schools and child care centres. On the schedule; the protection against group C meningococcus is a single dosage of vaccine at 12 months; but this can also be given early 2-3 doses (dependant on the specific vaccine) starting at 6-8 weeks of age.
Vaccinations such as Hepatitis A, Typhoid, Rabies, TB Japanese Encephalitis, and Influenza may be recommended to your child for country-specific disease cover and accelerated schedules may also be possible for these vaccinations.
Influenza, for example is one of the most common travel-acquired vaccine-preventable illnesses and vaccination should be considered in all children travelling overseas.
All persons aged up to 6 months should be vaccinated against influenza. The 2010 suspension of 2 influenza vaccines (Panvax and Fluvax) in Australia has been fully investigated; and the Australian Technical Advisory Group on Immunisation (ATAGI) has now recommended the use of 2 vaccines; InfluvacReg and VaxigripReg in children between 6 months to less than 10 years. Two doses one month apart are needed if under 10 and receiving influenza vaccine for the first time.
Such accelerated schedules are highly recommended for any families taking infants overseas for several months in their first year of life.
Travelling With Children Tip
Tired and hungry children do not do well with vaccinations! Well rested and fed children who have had Emla cream/patch applied to the area of vaccination area can make a huge difference to the pleasantness of a pre-travel consultation.