International travel and health



All travellers should be up to date with vaccination according to national recommendations. Both whole-cell (wP) and acellular (aP) pertussis vaccines provide excellent protection and are safe apart from minor adverse events. For several decades, wP vaccines have been widely used in national childhood vaccination programmes; aP vaccines, which cause fewer adverse events but are more expensive, are now licensed in many countries. Both wP and aP are usually administered in combination with diphtheria and tetanus toxoids (DTwP or DTaP).

WHO recommends a 3-dose primary series, with the first dose administered at age 6 weeks; subsequent doses should be given 4–8 weeks apart, at age 10–14 weeks and 14–18 weeks. The last dose of the recommended primary series should be completed by the age of 6 months.

Protection declines with time and probably lasts only a few years. A booster dose should be administered 1–6 years after the primary series, preferably during the second year of life. Some countries now offer an adolescent/adult booster, in particular to health care workers and young parents. Previously unvaccinated adolescents/adults should receive 3 doses of wP or aP vaccine with an interval of 2 months between the first and second, and 6–12 months between the second and third doses.