Prioritising immunisations for travel: international and Japanese perspectives

Immunisation has traditionally played an important role in travel medicine practice and unlike routine immunisations, vaccines for travel are sought by and often paid for by the traveller. A convenient way of looking at vaccines for travel is by grouping them into those that are: Required, Routine, or Recommended, although this classification is not always consistent. Prioritising the use of vaccines classed as "Recommended" has proved the most controversial. There are a number of factors that influence both the traveller and health professional in this decision making process. The incidence rate and impact of a disease are thought by many to be the two most important factors to consider when prioritising vaccines. For travellers, the efficacy and adverse events associated with vaccines may also be important. This article reviews the role of immunisation in travel health with the aim of assisting travel health professionals prioritise their use of vaccines. It also highlights the need for travel medicine advisors worldwide to be aware of the differences between Japan and other nations with regard to national immunisation programmes, vaccine availability and vaccine uptake.