Immunization Issues

Immunizations When Moving or Traveling Abroad

Updated: October 16, 2006

Sometimes it may be hard for parents to keep up with immunization requirements and recommendations. This is especially true when families move to a different state—or country—where there may be different immunization recommendations.

The childhood and adolescent immunization schedule, approved by the Advisory Committee on Immunization Practices of the CDC, the American Academy of Pediatrics, and the American Academy of Family Physicians, covers all children in the United States regardless of state or local day care regulations. Children in compliance with this schedule should be in compliance with any school or day care regulations.

However, hepatitis A vaccine is recommended for children residing in certain states or counties. Check with your healthcare provider or the health department in the community to which you will be moving to find out local immunization recommendations.

Immunization requirements for day care and school attendance may vary between States, territories and the District of Columbia. This is because it is the responsibility of the individual states to determine which vaccines should be required for school and day care entry based on the public health needs of the state.

Parents should recognize that the state’s immunization requirements should be considered the minimum standard because not all of the vaccines that are recommended to protect children are mandated. For example, there are a number of vaccines recommended to specifically protect against diseases that occur primarily in young infants.

Exemptions from the requirements for school entry also differ from state to state.

Whether you are moving to a different state or moving to the US from abroad, there are a number of things that you can do to be sure that you or your child have all the necessary immunizations:

  1. Assemble your child’s immunization records. If your current state has an immunization registry, obtain a printout from your health care provider. If all of your or your child’s immunizations are not in a registry have your health care provider give you a summary of the immunizations and when they were each given.
  2. Check the immunization recommendations for the new State.
    » Search for Immunization Recommendations for the new State
  3. Learn about the specific vaccines and the diseases that they prevent.
  4. Be certain that your child is fully immunized according to CDC recommendations for your new home. If you and your child have been fully immunized, having this documentation will satisfy every state’s day care and school entry requirements, because the CDC recommended schedule is more inclusive than any school mandate.
    » Search for State Vaccine Requirements for School Entry
  5. Be sure to begin preparing well in advance because some immunization schedules such as hepatitis A and hepatitis B require a number of months between doses to assure protection.
  6. You may also want to consult a health care provider in the new State or contact an official at the state or local health department for detailed information or to answer specific questions about your child’s immunization needs and to find out how to obtain the immunizations in that state.
    » Search for State Health Departments

Immunization received in other countries

If you are moving to the US from a different country be sure to bring all your immunization records with you. To assure that you and your child are protected against the vaccine preventable diseases and that your immunizations will comply with the state immunization requirements for day care and school attendance requires a review of the immunization records.

State immunization laws for day care and school attendance usually require vaccination against specific diseases rather than immunization with specific vaccines. Generally speaking, therefore, vaccines administered according to the schedules used in most developed countries will likely meet immunization requirements for those diseases in the US. However, it is important to understand that most states have specific rules about the number of doses of vaccine that have been given and when the last booster dose was administered.

There may be diseases for which vaccines are recommended (or mandated) in the US that are not recommended in your country for universal use. As outlined in the previous section it is important to learn about what vaccines are recommended for different regions in the US and also about the requirements for day care and school attendance well in advance of matriculation.

Although immunization schedules and recommendations from around the world may have many similarities, they may differ from US recommendations in a number of ways:

  • Same diseases but different vaccines. Vaccine licensure varies from country to country. Therefore the vaccines used in one country may be different than the ones used in the US for the same disease. For instance, DTaP used in the US may differ from DTaP licensed in other countries—and many other countries continue to utilize the whole cell DTP. Generally, vaccines used in other countries will be equally effective to those used in the US. However, not all countries have a fully effective regulatory authority for vaccines or have immunization programs that can assure the quality, potency and safety of vaccines. Vaccines received through UNICEF and other United Nations agencies do conform to World Health Organization regulatory standards, however. If there are questions about the quality of the immunization, it would be better to re-immunize to assure protection. Specific information is available from state health departments
  • Different diseases. Recommendations for immunizations differ according to the public health needs of the country. Therefore different vaccines may be recommended for different countries. For example, while yellow fever vaccine is routinely administered in Brazil, in the US it is only recommended for travelers to countries where yellow fever is endemic. 
  • Same vaccines but different brand names. Identical vaccines licensed in different countries may be marketed under different brand names. 
  • Different schedule. Different countries use different immunization schedules. For example, the US immunization schedule recommends DTaP and Hib vaccination at 2, 4, and 6 months of age; the UK immunization schedule recommends them at 2, 3, and 4 months of age.

Immunizations for moving from the US to another country

Reliable and frequently up-dated information for US travelers (or for moving for extended periods of time) to other countries can be found on a country by country basis at the Web site of the National Center for Infectious Diseases Traveler’s Health. There you can also search for the location of a Yellow Fever Vaccination Clinic.

A directory of national and international private travel clinics can be found at the Web site of the International Society for Travel Medicine.

Below are links to information about vaccine recommendations in a number of countries:

The following link tabulates the various vaccines licensed in a number of countries: