Family travels into Nigeria during yuletide seasons (Part 1)

The yuletide season is around the corner and many family and friends will be travelling into Nigeria for visits.  It is important that the children they are coming in with are well prepared ahead of the journey.

Meanwhile, the preparation goes beyond shopping, buying flight tickets, making hotel reservations and travelling down to Nigeria. It is critical that the family visits a Travel Clinic before coming preferably 4-6 weeks before the visit. This is to allow for proper evaluation and vaccinations that might be needed for vaccine-preventable diseases at destination.

Children should complete the routine immunizations of childhood on a normal schedule. However, travel at an earlier age may require accelerated schedules. The recommended childhood and adolescent immunization schedule is available at www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html.

The catch-up schedule for children and adolescents who start their vaccination schedule late or who are >1 month behind can be accessed at        www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html. Country-specific vaccination recommendations and requirements for departure and entry vary over time. A Yellow Fever vaccination certificate is required on arrival from all travellers 9 months of age and older coming into Nigeria (iamat.org/country/nigeria/risk/yellow-fever).

Travel-specific vaccine considerations include the following: Hepatitis B vaccine: Vaccine can be administered with an accelerated schedule of 4 doses of vaccine given at 0, 1, 2, and 12 months; the last dose may be given on return from travel.

Influenza vaccine: Influenza viruses circulate predominantly in the winter months in temperate regions (typically November– April in the Northern Hemisphere and April– September in the Southern Hemisphere) but can occur year-round in tropical climates. Since influenza viruses may be circulating at any time of the year, travellers aged ≥6 months who were not vaccinated during the influenza season of their country of residence should be vaccinated ≥2 weeks before departure if vaccine is available.

MMR or MMRV vaccine: Children travelling into Nigeria need to be vaccinated at an earlier age than is routinely recommended. Infants aged 6–11 months should receive 1 MMR dose. Infants vaccinated before age 12 months must be revaccinated on or after the first birthday with 2 doses of MMR or MMRV separated by ≥28 days. Children aged ≥12 months should be given 2 MMR or MMRV doses separated by ≥28 days.

Meningococcal vaccine: Children aged 2 months to 18 years who travel to or reside in areas of sub-Saharan Africa known as the “meningitis belt” during the dry season (December through June) should receive quadrivalent meningococcal conjugate (MenACWY) vaccine.

Polio vaccine: Polio vaccine is recommended for travellers to countries with evidence of wild poliovirus (WPV) or vaccine-derived poliovirus circulation (during the last 12 months) this include Nigeria. (wwwnc.cdc.gov/travel/destinations/list). If necessary, Infants and children should receive an accelerated schedule to complete the routine series. Young adults (≥18 years of age) who are travelling to areas where polio vaccine is recommended and who have received a routine series with either inactivated polio vaccine (IPV) or live oral polio vaccine in childhood should receive a single lifetime booster dose of IPV before departure.

Rabies: Rabies virus causes acute viral encephalitis that is virtually 100% fatal. Travelling children may be at increased risk of rabies exposure, mainly from dogs that roam the streets. Bat bites also carry a potential risk. There are 2 strategies to prevent rabies in humans: Avoiding animal bites or scratches. Use of preexposure and postexposure prophylaxis.

Typhoid: Vaccination is recommended for travellers to Nigeria. Two typhoid vaccines are available and both vaccines induce a protective response in 50%–80% of recipients. The vaccine can be administered to children who are aged ≥2 years, with a booster dose 2 years later if continued protection is needed.