TG 300 ATTACHMENT A

IMMUNIZATIONS
Immunizations for Peace Corps Volunteers
Indications and Administration

Vaccine Indications Primary Series Booster Precautions † / comments

Encephalitis, All Volunteers serving 1.0ml SC day 0, 7, 30 1.0ml SC every 3 years Delayed hypersensitivity
Japanese (JE) in endemic areas may be seen up to 10 days
later
Local or mild systemic
reactions in 20%
Encephalitis, High risk of exposure to 0.5ml IM months 0, 1, 0.5ml IM every 3 years Egg anaphylaxis,
Tick-Borne ticks in an endemic area and 10-12 thimerosol anaphylaxis
(TBE) (see text)
Immuno (Austrian) vaccine
IMMUNO
is effective and well
tolerated

All Volunteers
Hepatitis A
Hepatitis A vaccine 1.0ml IM months 0, 6 none after 2nd dose Prior allergy to hepatitis A
GLAXO-SMITH-KLINE (HAVRIX) vaccine, alum, 2-
plus
MERCK (VAQTA)
phenoxyethanol
IG 2.0ml IM for rapid
protection (see text) Occasional local or mild
systemic reactions

Immune globulin (IG)
IG use in Peace Corps is limited to
rapid protection for 1 month after
Hepatitis A vaccination or for
persons allergic to Hepatitis A
vaccine.
5ml (0.06ml/kg) IM repeat every 4 months Prior allergy to immune
globulin; give more than 3
months before, or 14 days
after, MMR
Mild local reaction
common

All Volunteers except: 1.0ml IM (deltoid): none Prior allergy to hepatitis B

Hepatitis B months 0, 1, 6 vaccine
Serologic evidence of
GLAXO- immunity (see text) Occasional local or mild
SMITHKLINE
Also: if occupational systemic reactions
MERCK
risk of blood exposure,
PASTEUR
measure antibody level
1-6 months after series

Age ≥ 50 0.5 ml IM annually repeat annually Egg anaphylaxis, prior

Influenza Asthma, diabetes, (Sept/Oct for Northern vaccine-induced Guillain-
chronic conditions1 Hemisphere) Barre.
1
Health care workers
Local reactions common,
occasional mild systemic

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Vaccine Indications Primary Series Booster Precautions † / comments

Measles- All Volunteers except: If never immunized and Give 0.5ml SC to all Pregnancy,
Mumps-Rubella Age ≥ 50 born in or after 1957: Volunteers except those immunosuppression,
(MMR) Documented 2 doses of 0.5ml SC months 0,1 meeting criteria listed. neomycin anaphylaxis,
MMR no further boosters gelatin anaphylaxis, egg
Serologic evidence of anaphylaxis.
necessary
immunity (see text). Fever 5-12 days later in
15%. rash in 5%;
arthralgias or arthritis some
women 2
delay PPD testing for 4-6
wks, interacts with IG

Meningococcal All Volunteers in 0.5ml SC (1 dose) every 3 years Pregnancy (consider

Meningitis endemic or epidemic risk/benefit)
A, C, Y, areas.
Local mild reactions seen
W-135

Pneumococcal Age ≥ 65 0.5ml IM or SC (1 dose) repeat after 5 years if Pregnancy (consider

Pneumonia Surgical or functional asplenic, or for several risk/benefit)
23-valent asplenia. other conditions 4
Local reactions common,
At risk for infection or
occasional mild systemic
complication. 3

All Volunteers: one dose

Polio of IPV booster if serving
in an endemic area.

Inactivated Polio Vaccine (IPV) 0.5ml SC months 0, 1, 0.5ml SC once as an Anaphylaxis to neomycin,
and 2 if prior adult streptomycin, polymyxin
vaccination in doubt
well tolerated

Rabies REQUIRED: 1.0ml IM only: Reassess every 2 years. Egg anaphylaxis for PCEC,
(preexposure) highly endemic areas days 0, 7, 21 Check antibody titer if anaphylaxis or type II
and/or inadequate access risk will be frequent. reaction to prior vaccine
(or days 0, 7, 28 5 )
HDCV to post-exposure series 1.0 ml IM only if
Steroids and immuno-
PCEC
OPTIONAL: antibody titer <1:5
RVA
supressives interfere with
developed countries response
with adequate access to
post-exposure series and
rabies immune globulin

Rabies See text for post- COMPLETED N/A As for pre-exposure vaccine
(postexposure) exposure PREEXPOSURE:
recommendations 2 doses 1.0ml IM:
HDCV days 0, 3
PCEC Clean wound with soap
RVA and water INCOMPLETE OR NO
PREEXPOSURE:
HRIG 6 plus 5 doses IM:
days 0, 3, 7, 14, 28

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Vaccine Indications Primary Series Booster Precautions † / comments

Tetanus- All Volunteers must Doses given at 0, 1, and Dose given if > 2 yrs Prior severe hypersensitivity
diphtheria (Td) have received Td or 7-12 if prior vaccination since last dose or neurologic reaction
Tdap within 2 years of in doubt. Tdap can be
(assures maximum Local reactions common.
Tetanus- start of Peace Corps substituted for any one
protection for at least 3 Use Td in adults (not DT or
diphtheria- service of the three Td doses in
more years) 7 tetanus toxoid alone)
pertussis (Tdap) the series.

Typhoid All Volunteers except in

low risk countries

ViCPS (Typhim Vi)
Ty21a (oral typhoid vaccine)
0.5ml IM (one dose) 0.5ml IM every 2 years Hypersensitivity to ViCPS
Mild local reactions seen
1 capsule with cool repeat every 5 years Delay if experiencing GI
liquid on days 0, 2, 4, 6 illness or if on antibiotics;
give 24 hrs before or after
mefloquine or Diamox
Infrequent nausea, abd.
cramps
ENSURE COLD CHAIN;
DO NOT FREEZE

Heat/phenol killed vaccine 0.5ml SC days 0, 30 0.5ml SC every 3 years Prior severe reaction to
heat/phenol killed vaccine

Yellow Fever All Volunteers in 0.5ml SC (one dose) every 10 years Pregnancy, immuno-
endemic areas or those supression, egg anaphylaxis,
requiring vaccination age <6 mo; do not use within
entry into country of 3 wks of cholera vaccine
service
<5% mild systemic reactions

STORE FROZEN- USE

WITHIN 1 HOUR

† Precautions: Do not administer this vaccine if any of the listed conditions are present. Consult OMS to review the
risks and benefits, which may include vaccination after informing the Volunteer of the risks and benefits or transfer
or medical separation to avoid exposure to this disease.

NOTES ON SPECIFIC VACCINES:

1
Chronic cardiovascular, pulmonary disease, renal, immunologic, or metabolic disorders.
2
Up to 40% of non-immune women may develop arthralgias, sometimes with persistent joint pains, due to rubella
vaccine. Does not occur in those already immune to rubella.
3
Chronic cardiovascular, pulmonary disease (but not asthma), renal, immunologic, or metabolic disorders.
4
Chronic renal failure, nephrotic syndrome, or organ transplant.
5
Third dose can be given anytime on or after day 21. 21 day schedule recommended for areas where Trainees may
be exposed soon after arrival.
6
Human Rabies Immune Globulin 20IU/kg body weight; as much infiltrated at bite site as possible, remainder IM
7
Generally, Td booster is given every 10 years, however booster indicated every 5 years if a dirty wound occurs.

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