Travellers who are immunocompromised
People who are immunocompromised are recommended to be up to date with their routinely recommended vaccinations before travelling overseas.
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This page was added on 03 February 2025.
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Overview
People who are immunocompromised are recommended to be up to date with their routinely recommended vaccinations before travelling overseas. This is because of their potentially higher risk of serious illness or death from infections. People who are immunocompromised may need additional vaccinations before travelling overseas depending on the:
- immunocompromising condition
- medications they are currently receiving
- travel destination
- duration of travel
- disease exposure risk
- access (or otherwise) to adequate and safe medical care while overseas
For more details about the immunosuppressive potential of various medications and medical conditions, see:
- Table. Types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise
- Table. Immunosuppressive potential of cancer and organ rejection therapies
- Table. Immunosuppressive potential of conventional (non-biological) immunosuppressive therapies
- Table. Immunosuppressive potential of small molecule targeted therapies
- Table. Immunosuppressive potential of biological therapies
- Table. Immunosuppressive potential of corticosteroids
- Table. Immunosuppressive potential of certain medical conditions
Live vaccines
Most live vaccines, including BCG vaccine, are contraindicated in travellers who are moderately or severely immunocompromised. The exceptions are:
- MMR (measles-mumps-rubella) and monovalent varicella vaccines can be safely administered to some people with certain inborn errors of immunity (see Table. Vaccination for people with inborn errors of immunity), people with asplenia or hyposplenia, and people with HIV who have an adequate CD4+ count (see Table. Levels of immunocompromise in children and adults with HIV). Combination MMRV (measles-mumps-rubella-varicella) vaccine is not recommended in people who are immunocompromised, due to a lack of published data on its use in this population.
- Yellow fever vaccine can be safely administered to some travellers who are not severely immunocompromised.1,2 Booster doses may be recommended (see Yellow fever). Yellow fever vaccine is contraindicated for most people who are severely immunocompromised.
See Table. Types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise for more details.
Non-live vaccines
People who are immunocompromised should receive seasonal influenza vaccine before travelling if they have not received it in the past 12 months.
Additional non-live vaccines may be recommended before travel for some people who are immunocompromised. These may include:
- cholera vaccine (inactivated)
- hepatitis A vaccine
- hepatitis B vaccine
- polio vaccine
- Japanese encephalitis vaccine (inactivated)
- typhoid vaccine (inactivated)
- meningococcal vaccine(s)
- rabies vaccine
See the relevant disease-specific chapters for more details.
Other precautions
Providers should also discuss additional health precautions that people who are immunocompromised may need to consider while they are travelling overseas. These include:
- considering the need for antimalaria prophylaxis and protection against mosquito bites
- ensuring safe food and water consumption
- understanding the signs of infection to be aware of during travel
- ensuring they have a plan for access to antibiotics and health care if they become unwell overseas
References
- Huber F, Ehrensperger B, Hatz C, et al. Safety of live vaccines on immunosuppressive or immunomodulatory therapy – a retrospective study in three Swiss travel clinics. Journal of Travel Medicine 2018;25(1):tax082.
- de Jong W, de Man RA, Dalm VA, et al. Yellow fever vaccination for immunocompromised travellers: unjustified vaccination hesitancy? Journal of Travel Medicine 2019;26(6):taz015.