Persons planning to travel outside the US should be up to date on routine vaccines and, depending on their destination, duration of travel, and planned activities, may also receive certain travel-specific vaccines. Tickborne encephalitis and dengue vaccines, which are not available in the US, are reviewed in a separate article available online. Detailed advice for travel to specific destinations is available from the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/travel/destinations/list. Recommendations for administration of vaccines as part of routine adult immunization are discussed in a separate issue.

The US Advisory Committee on Immunization Practices (ACIP) has recommended the addition of a routine second dose of varicella vaccine for children <13 years old. Varicella vaccine has been used in the US since 1995, but varicella outbreaks have continued to occur among school children vaccinated with a single dose. In one such outbreak, the attack rate was 100% in unvaccinated children and 18% in those previously vaccinated.1 In vaccinated children, the typical maculopapular-vesicular rash of varicella may be only maculopapular with few or no vesicles, but these children could still transmit virus to susceptible contacts.