International travelers are frequently at risk of exposure to infectious pathogens and should seek advice about immunizations and other necessary prophylaxis prior to departure [1,2]. In preparation for a trip, individuals should arrange a pre-travel consultation with either a specialized travel clinic or a primary care practice with expertise in travel medicine . The traveler should come to the visits with a record of prior immunizations and an itinerary.
Immunization needs are based on the traveler's prior immunizations, health conditions, and likely exposures while traveling (table 1). Those exposures depend upon the countries and regions to be visited and on the nature of potential exposures to infectious agents. For example, travelers with short-term tourism itineraries may have different requirements from those with longer-term occupational exposures. A pre-travel consultation enables updating of routine immunizations to protect against illness due to infections for which there is an increased risk of exposure during travel (such as diphtheria, measles, and varicella) [4,5].
Information on the indications, dosing, side effects, timing, and contraindications for immunizations in travelers are provided by the Centers for Disease Control and Prevention (CDC) in an annual publication, Health Information for International Travel  and online . The World Health Organization (WHO) also has online information . Information may be found at these sites: http://wwwnc.cdc.gov/travel/content/diseases.aspx and www.who.int/ith.
Issues related to immunizations for travelers are reviewed here. Other travel-related medical issues and measures to prevent malaria are discussed separately. (See "Travel advice" and "Prevention of malaria infection in travelers".)
A standard immunization form should be part of the patient's medical record. Details to be recorded include vaccine type, dose, date of administration, manufacturer, lot number and site of administration . It is also important to document if a patient declines to receive any recommended vaccine.