11 Jan 2024

Navigating Immunization Requirements for Expatriates: Insights from AP Companies'

When it comes to working internationally, balancing professional goals and health becomes crucial. Dr. Diskin, Medical Strategy Director at AP Companies and Dr. Rapoport, Medical Operations Director at AP Companies, join forces to offer a shared perspective on the complex world of immunizations for expatriates heading to new work locations.

Dr. Diskin has kindly provided the following advice:

Regardless of the destination, it is critical to ensure that routine immunizations are up-to-date and this is where you want to start. While some individuals have become opposed to vaccines as of late, you may not be afforded the privilege of herd immunity in other locations. It is much easier to refuse vaccination when everyone else around you is immune.           Alternatively, there will be many places you will not be permitted to go without proof of immunity or immunization.           This typically includes vaccinations against diseases such as measles, mumps, and rubella (MMR), diphtheria, tetanus, pertussis (Tdap - childhood series and very 10 years as an adult), varicella, smallpox and polio.

Seasonal influenza vaccine is recommended annually for everyone as it is unpredictable who will be the one to contract serious illness and require hospitalization in a foreign land – and who can afford two weeks of down time when on a special assignment with deadline after deadline. If you are on an assignment in the Southern Hemisphere, check what vaccine you should be getting. Ask for the quadrivalent vaccine if you are older or have pre-existing respiratory problems. If you are over 65, get the new RSV vaccine and make sure you have had your pneumonia vaccine(s) – also if you have respiratory issues. COVID vaccine to minimize risk and severity of illness and decrease chances of LONG COVID is an individual choice but those over 65 or with risk factors for serious illness should highly consider the vaccine.           There is currently a new COVID-19 variant emerging and rapidly spreading that appears to be sensitive to the 2023-24 vaccine, but only 16% of the US population has received the booster at this time. Shingles vaccine for those over 50 is another opportunity to avoid downtime and a painful condition.

Destination-specific vaccines to meet country specific vaccine requirements that must be fulfilled before travel or are highly recommended due to current risk levels are the bread and butter of travel medicine clinics. These should be checked as soon as you know you need to travel and checked again 2-3 weeks before you are scheduled to leave. The requirements may be different for short-term and long-term assignments.           Long-term travelers should be aware of any vaccine requirements for entry, employment, or schooling.

Examples include Yellow Fever. Many countries, especially in Africa and Latin America, require proof of yellow fever vaccination for entry. This is usually required if you are arriving from a country where yellow fever exists, even if it was just a transit stop. The vaccine needs to be given 10 days before entry and only a single lifetime dose is required (previously every 10 years). You will receive a “yellow card” as proof of vaccination and must keep it with you.

Other examples include Meningococcal vaccine, cholera, hepatitis, typhoid, rabies, and Japanese encephalitis. Certain vaccines – such as hepatitis B and rabies – may be occupation dependent.

Is this going to be a family adventure? Extra consideration should be given to children traveling abroad, as they may require different or additional immunizations compared to adults.           Nothing is scarier than having a sick child far away from home.

It is also much more common for potentially immunocompromised patients such as those with HIV, on immunomodulating medications, or on immunosuppressive medications for conditions such as rheumatoid arthritis, psoriasis or inflammatory bowel disease to accept long-term assignments.           These individuals should seek specific advice on vaccination and other medical needs prior to travel.

Dr. Rapoport's sheds light on the intricate process involved in providing insured individuals with necessary vaccinations. Facing geopolitical challenges and considering local situations, AP Companies navigates through regulations and the availability of vaccines. Dr. Rapoport details the challenges of obtaining accurate vaccination records, especially when vaccinations were administered during childhood.

The need for adaptability surfaces when insured individuals require multiple vaccinations within a short timeframe or face imminent relocations. In such cases, AP Companies seeks solutions aligning with legislative requirements while accommodating practicalities and insured individuals' preferences.

Both Dr. Diskin and Dr. Rapoport reiterate the complexity of identifying necessary immunizations for relocation. Their advice reinforces the recommendation for expatriates to consult with travel medicine specialists, ensuring up-to-date vaccinations and considering specific risk factors. By doing so, individuals contribute not only to their personal health but also to the global effort in controlling the spread of infectious diseases.

Please contact AP Companies for tailored medical support and comprehensive services in navigating these complexities. Here, expertise meets dedication in safeguarding the health of expatriates worldwide, ensuring a seamless blend of medical strategy operational and cost efficiency.

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8 Dec 2023

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