
Travel and Vaccine
Travel and Vaccination Clinic
Mandatory Vaccines
Your Travel Medical Kit
Adult Vaccine Schedules
Child’s Vaccine Schedules
Vaccinations for Children
National Childhood Immunisation Schedule (wef Jan 2008)
Find Out More About Yellow Fever
ANNEX 1
Countries1 with risk of yellow fever transmission2 and countries requiring yellow fever vaccination
ANNEX 2
International Health Regulations
Travel and Vaccination Clinic
‘International travel can pose various risks to health, depending on the characteristics of both the traveller and the travel.’ WHO International travel and health report – 2008 Edition
Vaccination is a very safe and effective way of preventing certain infectious diseases.
Plan before you travel. Discuss your itinerary with our doctors and let us advice you on your vaccine requirements. See us at least 4 weeks before your travel date to allow sufficient time for optimal immunization schedules to be completed.
Mandatory Vaccines
Yellow Fever Vaccine
Mandatory for travelers going to or coming from certain countries in Sub-Saharan Africa and South America.
Yellow Fever Vaccination Certificate
Source: Singapore Immigration and Checkpoints Authority Website.
For entry into Singapore, a valid yellow fever vaccination certificate is required from travellers (over one year of age) who, within the preceding six days have been in or have passed through any country endemic for yellow fever.
The International Certificate of Vaccination for yellow fever is considered valid 10 days after vaccination. The certificate is for a period of 10 years.
Countries endemic for yellow fever are as follows:
Angola |
Argentina |
Benin |
Bolivia |
Brazil |
Burkina Faso |
Burundi |
Cameroon |
Central African Republic |
Chad |
Colombia |
Congo |
Cote d’lvoire |
Democratic Republic of Congo |
Ecuador |
Equatorial Guinea |
Ethiopia |
French Guyana |
Gabon |
Gambia |
Ghana |
Guinea |
Guinea-Bissau |
Guyana |
Kenya |
Liberia |
Mali |
Mauritania |
Niger |
Nigeria |
Panama |
Paraguay |
Peru |
Rwanda |
Senegal |
Sierra Leone |
Sudan |
Suriname |
Togo |
Trinidad & Tobago |
Uganda |
Venezuela |
Meningococcus Vaccine & Polio Vaccine
Mandatory for pilgrims to Saudi Arabia.
Your Travel Medical Kit
A medical kit is an absolute necessity for international travelers. The contents of the kit may vary depending on your specific needs, destination, quality of accommodation and assess to quality medical care.
Please remember that self-medication is not a substitute for proper medical care. Please seek medical attention as soon as possible especially if your symptoms do not improve.
These are some medicines that you might find useful to have in your travel medical kit. Recommended doses are for healthy adults. Please consult us for dosing in children, elderly and persons with chronic illnesses. Please do not take any drug that you have a known allergy to.
- For fever and pain.
- Take 2 tablets 4 times a day.
- Do not exceed 8 tablets a day.
- For gastritis.
- Take 2 tablets 4 times a day.
- Do not exceed 12 tablets a day.
- May cause constipation or diarrhea.
- For diarrhea.
- Take 1 tablet 3 times a day.
- For replacing essential salts and fluids in the event of severe vomiting or diarrhea.
- Dissolve 1 sachet in clean water and consume hourly.
- For blocked, stuffy or runny nose.
- Take 1 tablet every morning.
- For vomiting and motion sickness.
- Take 1 tablet 3 times a day.
- To prevent motion sickness, take 1 tablet at least 30 minutes before travel.
- This is a broad spectrum anti-biotic that is useful for traveler’s diarrhea, dysentery, cholera, urine tract infection and skin and soft tissue infections.
- Take 2 tablets 2 times a day for 5 days.
- Stop if you develop a rash.
- Take 1 tablet one day before departure.
- Take 1 tablet once every day while you are traveling.
- Take 1 tablet everyday for a week after you have returned.
- Attach the patch onto your skin or on clothes.
- Each patch lasts up to 12 hours.
- Apply to sun exposed areas concentrating on the face and neck.
- Avoid contact with eyes.
- Re-apply regularly especially if you are sweating profusely or are going swimming.
- Dissolve 1 sachet in clean water and consume 3 times a day.
- Wash wounds under clean running water.
- Apply Antiseptic Ointment and then cover with a clean gauze.
- Wrap the area with a clean bandage and tape the bandage securely.
- See a doctor as soon as possible.
Adult Vaccine Schedules
Please refer to the Child’s Vaccine schedule for ages below the age stated under each vaccine
Vaccine | Against | Sequence | Duration of Protection |
Twinrix 16 years old and above |
Hepatitis A+B | Rapid1st shot 2nd shot – day 7 3rd shot – day 21 4th shot- 1 yearStandard1st shot 2nd shot – month 1 3rd shot – month 6 |
10 years10 years |
Engerix-B Adult 20 years old and above |
Hepatitis B | Rapid1st shot 2nd shot – day 7 3rd shot – day 21 4th shot- 1 yearStandard1st shot 2nd shot – month 1 3rd shot – month 6 |
10 years10 years |
Havrix Adult 19 years old and above |
Hepatitis A | 1st shot 2nd shot – month 6 |
10 years |
Dukoral 7 years old and above |
Cholera and E. Coli (Traveller’s Diarrhea) | 1st drink 2nd drink – day 7 |
2 years |
Typherix 2 years old and above |
Salmonella (Typhoid Fever) | 1 shot only | 3 years |
Fluarix 9 years old and above |
Influenza | 1 shot only | 1 year |
Boostrix 4 years old and above |
Tetanus, Diphtheria and Pertussis | 1 shot only | 10 years |
Mencevax 2 years old and above |
Meningococcus NB. For travelers to Middle East or community living (eg dormitory) |
1 shot only | 10 years |
Varilrix 13 years old and above |
Varicella (Chickenpox) | 1st shot 2nd shot – week 6 |
Life |
Japanese Encephalitis 3 years old and above |
Japanese Encephalitis NB. For travelers to rural/jungle Southeast Asia |
1st shot 2nd shot – day 7 3rd shot – day 28 |
4 years |
Stamaril 6 months old and above |
Yellow Fever NB. For travelers to South America or Sub-Saharan Africa |
1 shot only | 10 years |
Malarone 40 kg and above of body weight |
Malaria | Pills to be taken everyday starting 1 day before entering and stopping 7 days after leaving the endemic area | As long as taking the pills |
Cervarix | HPV Virus (Cervical Cancer) |
1st shot 2nd shot – month 1 3rd shot – month 6 |
At least 5.5 years Need for booster is being studied |
Child’s Vaccine Schedules
Please refer to the Adult’s Vaccine schedule for ages above the age stated under each vaccine
Vaccine | Against | Sequence | Duration of Protection |
Twinrix 1 to 15 years old |
Hepatitis A+B | 1st shot 2nd shot – month 6 |
10 years |
Engerix-B Ped 0 to 19 years old |
Hepatitis B | 1st shot 2nd shot – month 1 3rd shot – month 6 |
10 years |
Havrix Junior 1 to 18 years old |
Hepatitis A | 1st shot 2nd shot – month 6 |
10 years |
Dukoral 2 to 6 years old |
Cholera and E. Coli (Traveller’s Diarrhea) | 1st drink 2nd drink – day 7 3rd drink – day 14 |
2 years |
Typherix 2 years old and above |
Salmonella (Typhoid Fever) | 1 shot only | 3 years |
Fluarix 6 months to 8 years old |
Influenza | 1st shot 2nd shot – week 4 |
1 year |
Boostrix 4 years old and above |
Tetanus, Diphtheria and Pertussis | 1 shot only | 10 years |
Mencevax 2 years old and above |
Meningococcus NB. For travelers to Middle East or community living (eg dormitory) |
1 shot only | 10 years |
Varilrix 1 to 12 years old |
Varicella (Chickenpox) | 1 shot only | Life |
Japanese Encephalitis (reduced dose) 0 to 3 years old |
Japanese Encephalitis NB. For travelers to rural/jungle Southeast Asia |
1st shot 2nd shot – day 7 3rd shot – day 28 |
4 years |
Stamaril 6 months old and above |
Yellow Fever NB. For travelers to South America or Sub-Saharan Africa |
1 shot only | 10 years |
Malarone 11 to 20kg – ¼ pill 21 to 30kg – ½ pill 31 to 40 kg – ¾ pill |
Malaria | Pills to be taken everyday starting 1 day before entering and stopping 7 days after leaving the endemic area | As long as taking the pills |
Vaccinations for Children
Vaccinations serve to prevent illness and disease by stimulating the production of antibodies in us. This is especially useful for illnesses with no good cure, or for those which tend to spread very rapidly amongst our community.
Successful mass vaccination programmes can benefit even those in the community who fail to get vaccinated by reducing the incidence of the illness within the community.
In Singapore, measles and diphtheria vaccinations are required BY LAW. While the other vaccines on the National Immunization Programme ( NIP ) are not compulsory, parents and caretakers are strongly encouraged to adhere to the recommended vaccinations for your child’s own protection. Singapore’s National Childhood Immunization schedule can be found here.
While not officially incorporated into the NIP, we would like to encourage parents to consider providing the following vaccines for their children:
- Rotavirus vaccine ( oral ) at 2 months and 4 months of age.
- Seasonal Influenza every year from 6 months of age to 2 years of age.
- Chicken Pox ( Varicella ) vaccine, given after 12 months of age. To reduce the number of injections given to your child, this can be combined with the MMR vaccine at 13 months
- Human Papillomavirus ( HPV ) vaccine which reduces the risk of Cervical Cancer, for girls at 9 to 10 years of age.
Although mild coughs and colds should not stop you from bringing your child for scheduled vaccinations, do inform the clinic and the doctor if your child is feeling unwell.
In addition, please highlight to the doctor if your child has/had:
- Fever, with or without other symptoms
- Allergic reactions to any previous vaccines or medications, or egg allergy.
- A history of other medical problems, such as cancer, leukemia, SLE or uncontrolled epilepsy.
- Missed any previous doses of vaccines, which may require ‘catch-up’ vaccinations.
After the vaccinations, some of the common reactions include:
- Redness, soreness or induration ( hardening ) around the injection site
- Fever
- Irritability
- Mild rashes
If you child experiences these symptoms, using a topical cream to sooth the injection site or some Paracetemol syrup to control the fever may be useful. In very rare circumstances, if your child throws a fit ( seizure ) or becomes extremely lethargic or if the fever does not settle within 1 to 2 days, please bring your child to the nearest clinic or hospital for review.
Some of the National Immunization schedules for other parts of the world can be found at:
- Australia: http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips2
- Japan: http://idsc.nih.go.jp/vaccine/dschedule/ImmEN-05rev.pdf
- UK: http://www.nhs.uk/Planners/vaccinations/Pages/Vaccinationchecklist.aspx
- USA: http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm
National Childhood Immunisation Schedule (wef Jan 2008)
Age | Standard Schedule | Common Schedule | Alternative Schedule |
At Birth | BCG Hepatitis B | BCG Hepatitis B | BCG Hepatitis B |
1 mth | Hepatitis B | Hepatitis B | |
2 mth | 6 in 1 (DPT, HiB, Polio, HepB) | ||
3 mth | DPT Polio | 5 in 1 (DPT, HiB, Polio) | |
4 mth | DPT Polio | 5 in 1 (DPT, HiB, Polio) | 6 in 1 (DPT, HiB, Polio, HepB) |
5 mth | DPT Polio | 5 in 1 (DPT, HiB, Polio) | |
6 mth | Hepatitis B | Hepatitis B | 6 in 1 (DPT, HiB, Polio, HepB) |
1-2 yrs | MMR | 15 mth – MMR | 15 mth – MMR |
18 mth | DPT Polio | 5 in 1 DPT, HiB, Polio | 5 in 1 DPT, HiB, Polio |
6-7 yrs | MMR Polio | MMR Polio | MMR Polio |
10-11 yrs | DT Polio | DT Polio | DT Polio |
Optional Vaccines
1. Pneumococcus
2. Haemophilus Influenza
3. Rotavirus 4. Menigococcal
5. Varicella
6. Hepatitis A
NB
1. All above schedules are approved and accepted by the Ministry of Health (MOH).
2. Standard Schedule is the schedule as set out by MOH.
3. Common Schedule is the schedule that the majority of children are on.
4. Alternative Schedule is gaining popularity due to the fewer number of injections.
Find Out More About Yellow Fever
Yellow fever is a serious and frequently fatal viral disease transmitted by mosquitoes.
Vaccination against yellow fever is required from any person who is going to or coming from or has passed through any country which is wholly or partly endemic for yellow fever. (Please see below for the list of countries)
Yellow fever vaccination can only be given at designated Yellow Fever Vaccination Centers and travelers will be issued with a WHO International Certificate of Vaccination. Robertson Medical Practice is an approved Vaccination Center for Yellow Fever.
Certain people are not fit to receive the Yellow Fever Vaccine. These include pregnant mothers, children under 6 months of age, travelers who are allergic to egg and travelers with a compromised immune system. Such travelers need to obtain a medical waiver prior to travel.
Yellow fever vaccine generally has few side effects; fewer than 5% of vaccinees develop mild headache, muscle pain, or other minor symptoms 5 to 10 days after vaccination. A single dose confers immunity for 10 years.
Africa |
Central and South America |
||
Angola Benin Burkina Faso Burundi Cameroon Cape Verde Central African Republic Chad Congo Côte d’Ivoire Democratic Republic of Congo Equatorial Guinea |
Ethiopia Gabon The Gambia Ghana Guinea Guinea-Bissau Kenya Liberia Mali Mauritania Niger Nigeria |
Rwanda São Tomé and Principe Senegal Sierra Leone Somalia Sudan Tanzania Togo Uganda |
Argentina Bolivia Brazil1 Colombia Ecuador French Guiana Guyana Panama Paraguay Peru Suriname Trinidad and Tobago Venezuela |
ANNEX 1
Countries1 with risk of yellow fever transmission2 and countries requiring yellow fever vaccination
Country | Countries with risk of yellow fever transmission | Countries requiring yellow fever vaccination for travellers coming from countries with risk of yellow fever transmission |
Countries requiring yellow fever vaccination for travellers from all countries |
Afghanistan | Yes | ||
Albania | Yes | ||
Algeria | Yes | ||
Angola | Yes | Yes | |
Anguilla | Yes | ||
Antigua and Barbuda | Yes | ||
Argentina | Yes | ||
Australia | Yes | ||
Bahamas | Yes | ||
Bahrain | Yes | ||
Bangladesh | Yes | ||
Barbados | Yes | ||
Belize | Yes | ||
Benin | Yes | Yes | |
Bhutan | Yes | ||
Bolivia | Yes | Yes | |
Botswana | Yes | ||
Brazil | Yes | Yes | |
Brunei Darussalam | Yes | ||
Burkina Faso | Yes | Yes | |
Burundi | Yes | Yes | |
Cambodia | Yes | ||
Cameroon | Yes | Yes | |
Cape Verde | Yes | ||
Central African | |||
Republic | Yes | Yes | |
Chad | Yes | Yes | |
China | Yes | ||
Christmas Island | Yes | ||
Colombia | Yes | ||
Congo | Yes | Yes | |
Congo, Democratic | |||
Republic of | Yes | Yes | |
Costa Rica | Yes | ||
Côte d’Ivoire | Yes | Yes | |
Djibouti | Yes | ||
Dominica | Yes | ||
Ecuador | Yes | Yes | |
Egypt | Yes | ||
El Salvador | Yes | ||
Equatorial Guinea | Yes | Yes | |
Eritrea | Yes | ||
Ethiopia | Yes | Yes | |
Fiji | Yes | ||
French Guyana | Yes | Yes | |
French Polynesia | Yes | ||
Gabon | Yes | Yes | |
Gambia | Yes | Yes | |
Ghana | Yes | Yes | |
Grenada | Yes | ||
Guadeloupe | Yes | ||
Guatemala | Yes | ||
Guinea | Yes | Yes | |
Guinea-Bissau | Yes | Yes | |
Guyana | Yes | Yes | |
Haiti | Yes | ||
Honduras | Yes | ||
India | Yes | ||
Indonesia | Yes | ||
Iran (Islamic Republic | |||
of) | Yes | ||
Iraq | Yes | ||
Jamaica | Yes | ||
Jordan | Yes | ||
Kazakhstan | Yes | ||
Kenya | Yes | Yes | |
Kiribati | Yes | ||
Korea, Democratic | |||
People’s Republic of | Yes | ||
Lao People’s | |||
Democratic Republic | Yes | ||
Lebanon | Yes | ||
Lesotho | Yes | ||
Liberia | Yes | Yes | |
Libyan Arab | |||
Jamahiriya | Yes | ||
Madagascar | Yes | ||
Malawi | Yes | ||
Malaysia | Yes | ||
Maldives | Yes | ||
Mali | Yes | Yes | |
Malta | Yes | ||
Mauritania | Yes | Yes | |
Mauritius | Yes | ||
Montserrat | Yes | ||
Mozambique | Yes | ||
Myanmar | Yes | ||
Namibia | Yes | ||
Nauru | Yes | ||
Nepal | Yes | ||
Netherlands Antilles | Yes | ||
New Caledonia | Yes | ||
Nicaragua | Yes | ||
Niger | Yes | Yes | |
Nigeria | Yes | Yes | |
Niue | Yes | ||
Oman | Yes | ||
Pakistan | Yes | ||
Palau | Yes | ||
Panama | Yes | Yes | |
Papua New Guinea | Yes | ||
Paraguay | Yes | Yes | |
Peru | Yes | ||
Philippines | Yes | ||
Pitcairn Islands | Yes | ||
Portugal | Yes | ||
Reunion | Yes | ||
Rwanda | Yes | Yes | |
Saint Helena | Yes | ||
Saint Kitts and Nevis | Yes | ||
Saint Lucia | Yes | ||
Saint Vincent and | |||
the Grenadines | Yes | ||
Samoa | Yes | ||
Sao Tome and | |||
Principe | Yes | Yes | |
Saudi Arabia | Yes | ||
Senegal | Yes | Yes | |
Seychelles | Yes | ||
Sierra Leone | Yes | Yes | |
Singapore | Yes | ||
Solomon Islands | Yes | ||
Somalia | Yes | Yes | |
South Africa | Yes | ||
Sri Lanka | Yes | ||
Sudan | Yes | Yes | |
Suriname | Yes | Yes | |
Swaziland | Yes | ||
Syrian Arab Republic | Yes | ||
Thailand | Yes | ||
Timor Leste | Yes | ||
Togo | Yes | Yes | |
Tonga | Yes | ||
Trinidad and Tobago | Yes | Yes | |
Tunisia | Yes | ||
Uganda | Yes | Yes | |
United Republic | |||
of Tanzania | Yes | Yes | |
Uruguay | Yes | ||
Venezuela | Yes | ||
Viet Nam | Yes | ||
Yemen | Yes | ||
Zimbabwe | Yes |
1 For the purpose of this publication, the term “country” covers countries, territories and areas.
2 Risk of yellow fever transmission is defined as either yellow fever has been reported currently or in the past plus presence of vectors and animal reservoirs that create a potential risk of infection and transmission.
* Either yellow fever has been reported or disease previously reported plus the presence of vectors and animal reservoirs create a potential risk of infection and transmission.
ANNEX 2
International Health Regulations
The spread of infectious diseases from one part of the world to another is not a new phenomenon, but in recent decades a number of factors have underscored the fact that infectious disease events in one country may be of potential concern for the entire world. These factors include: increased population movements, whether through tourism or migration or as a result of disasters; growth in international trade in food; biological, social and environmental changes linked with urbanization; deforestation; alterations in climate; and changes in methods of food processing, distribution and consumer habits. Consequently, the need for international cooperation in order to safeguard global health has become increasingly important.
The International Health Regulations (IHR), adopted in 1969, amended in 1973 and 19811 and completely revised in 20052 provide the legal framework for such international cooperation. The stated purpose of the Regulations is to prevent, protect against, control, and provide public health responses to, the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.
Their main objectives are to ensure: (1) the appropriate application of routine, preventive measures (e.g. at ports and airports) and the use by all countries of internationally approved documents (e.g. vaccination certifi cates); (2) the notifi cation to WHO of all events that may constitute a public health emergency of international concern; and (3) the implementation of any temporary recommendations should the WHO Director-General have determined that such an emergency is occurring. In addition to its new notifi cation and reporting requirements, the IHR (2005) focus on the provision of support for affected states and the avoidance of stigma and unnecessary negative impact on international travel and trade.
1 International Health Regulations (1969): third annotated edition. Geneva, World Health Organization, 1983.
2 International Health Regulations (2005): http://www.who.int/ihr
The IHR (2005) entered into force on 15 June 2007. They take account of the present volume of international traffi c and trade and of current trends in the epidemiology of infectious diseases, as well as other emerging and re-emerging health risks.
The two specifi c applications of the IHR (2005) most likely to be encountered by travellers are the yellow fever vaccination requirements imposed by certain countries (see Chapter 6; country list) and the disinsection of aircraft to prevent importation of disease vectors (see Chapter 2).3
The vaccination requirements and the disinsection measures are intended to help prevent the international spread of diseases and, in the context of international travel, to do so with the minimum inconvenience to the traveller. This requires international collaboration in the detection and reduction or elimination of the sources of infection.
Ultimately, the risk of an infectious agent becoming established in a country is determined by the quality of the national epidemiological and public health capacities and, in particular, by day-to-day national health and disease surveillance activities and the ability to detect and implement prompt and effective control measures. The requirements for states to establish certain minimum capacities in this regard will, when implemented, provide increased security for visitors as well as for the resident population of the country.
3 Hardiman M., Wilder-Smith A. The revised international health regulations and their relevance to the travel medicine practitioner. Journal of Travel Medicine, 2007,
14(3):141—144.
Need more advice?
Come down to Our Clinics for a discussion with Our Doctors, or call our clinics for more information:
Email: hello@dtapclinic.com.sg
I would like to know what are the possible allergic reactions to a Yellow Fever injection as my wife, daughter & I are visiting Brazil & Argentina in March 2012.
Thank you
Hi sudesh,
For Yellow Fever vaccinations we use Stamaril by Sanofi Pasteur. 16% of patients will get pain, redness, bruising and swelling at the injection site. Les than 10% of patients will get headaches, muscle aches, nausea, diarrhea or fever.
rgds
Dr Tan