Vaccine Recommendation for travelers to Indonesia

Transmission Guidance
Recommendations
Hepatitis A Recommended for most travelers, including those with Fecal-oral route (contaminated Hepatitis A (Yellow Book)
"standard" itineraries and accommodations food and water)
Dosing info
Person-to-person contact

Hepatitis B Consider for most travelers; recommended for those Contact with blood and other Hepatitis B (Yellow Book)
who might be exposed to blood or other body fluids, body fluids:
Dosing info
have sexual contact with the local population, or be
exposed through medical treatment (e.g., for an  Unprotected sex
accident).  Injection drug use
 Contaminated transfusions
 Exposure to human blood
 Contaminated tattoo and
piercing equipment

Japanese Recommended for the following groups: Bite of infected mosquitoes Japanese
Encephalitis (primarily Culex) encephalitis(Yellow Book)
 Long-term travelers (i.e. trips lasting a month or
Japanese Encephalitis
more) to endemic areas during Japanese encephalitis
Vaccine for US Children
virus transmission season.

Consider for the following groups:

 Short-term (<1 month) travelers to endemic areas

during Japanese encephalitis virus transmission
season if their itinerary or activities will increase their
risk (e.g. spending substantial time outdoors in rural
or agricultural areas; staying in accommodations
without air conditioning, screens, or bed nets.)
Vaccine Recommendation for travelers to Indonesia

Transmission Guidance
Recommendations
 Travelers to an area with an ongoing outbreak of
Japanese encephalitis.
 Travelers to endemic areas who are uncertain of
specific activities or duration of travel.

Malaria Antimalarials recommended for travelers to malaria risk Bite of infected mosquito Malaria (Yellow Book)
areas in Indonesia (female Anopheles)
Considerations when
choosing a drug for
malaria
prophylaxis (Yellow Book)

Rabies Recommended for the following groups: Mammal bites (including dogs, Rabies (Yellow Book)
bats, other carnivores)
 Travelers involved in outdoor and other activities that
might bring them into direct contact with dogs, bats,
and other mammals (such as campers, hikers, bikers,
adventure travelers, and cavers).
 Those with occupational risks (such as veterinarians,
wildlife professionals, researchers).
 Long-term travelers and expatriates.
 Children, because they are considered at higher risk;
consider lower threshold for vaccination.

Typhoid Recommended for most travelers, especially those who Fecal-oral route (contaminated Typhoid (Yellow Book)
are staying with friends or relatives; visiting smaller food and water)
Dosing info (Yellow Book)
cities, villages, or rural areas where exposure might
occur through food or water; or prone to "adventurous
eating"
Vaccine Recommendation for travelers to Indonesia

Transmission Guidance
Recommendations
Yellow Fever Required if traveling from a country with risk of YFV Bite of infected mosquitoes Yellow Fever (Yellow
transmission and ≥9 months of age.1 Book)

Non-Vaccine-Preventable Diseases
The following diseases are possible risks your patients may face when traveling in Indonesia. This list is based on our best available
surveillance data and risk assessment information at the time of posting. It is not a complete list of diseases that may be present in a
destination. Risks may vary within different areas of a destination.

Guidance Patient Education Notes

Vectorborne

Chikungunya  Chikungunya (CDC  Chikungunya Mosquitoes carrying chikungunya bite during the day and night,
Yellow Book)  Avoid Bug Bites both indoors and outdoors, and often live around buildings
 Chikungunya Fever
 Map

Dengue  Dengue (CDC Yellow  Dengue  More risk in urban and residential areas than for other
Book)  Avoid Bug Bites vectorborne diseases
 Dengue  Leading cause of febrile illness among travelers returning
 Western Hemisphere from the Caribbean, South America, and South and
Map Southeast Asia
 Eastern Hemisphere
Map
Vaccine Recommendation for travelers to Indonesia

Guidance Patient Education Notes

 DengueMap(interactive
map)

Airborne & Droplet

H5N1 Avian  Highly Pathogenic Avian  Avian Flu  Human cases have been reported during the time since 2003
Influenza Influenza A (H5N1) in  Endemic among poultry in Indonesia
People
 Influenza (CDC Yellow
Book)

Tuberculosis (TB)  Tuberculosis (CDC  Tuberculosis  Risk generally low for most tourist travelers
Yellow Book)  High burden of MDR TB in Indonesia
 Tuberculosis  Those anticipating possible prolonged exposure to TB
 Map environments (such as working in hospitals, prisons, or
 Multidrug resistant homeless shelters) or those who stay for years in an endemic
(MDR) TB (map) country should have a 2-step tuberculin skin test (TST) or a
single interferon-γ release assay (IGRA) before leaving the
US. If predeparture test is negative, a single TST or IGRA
should be repeated 8–10 weeks upon return.
Vaccine Recommendation for travelers to Indonesia

Vaccines to prevent hepatitis A

VACCINE TRADE NAME AGE (Y) DOSE ROUTE SCHEDULE BOOSTER
(MANUFACTURER)
Hepatitis A vaccine, Havrix (GlaxoSmithKline) 1–18
0.5 mL (720 ELU) IM 0, 6–12 mo None
inactivated ≥19
1.0 mL (1,440 ELU) IM 0, 6–12 mo None

Hepatitis A vaccine, Vaqta (Merck & Co., Inc.)

1–18 0.5 mL (25 U) IM 0, 6–18 mo None
inactivated
≥19 1.0 mL (50 U) IM 0, 6–18 mo None

Combined hepatitis A and B Twinrix (GlaxoSmithKline)

≥18 (primary) 1.0 mL (720 ELU HAV + 20 IM 0, 1, 6 mo None
vaccine
μg HBsAg)
≥18 IM 0, 7, 21–30 12 mo
(accelerated) same as above d

Vaccines to prevent hepatitis B

VACCINE TRADE NAME AGE (Y) DOSE ROUTE SCHEDULE BOOSTER
(MANUFACTURER)
Hepatitis B vaccine, Engerix-B (GlaxoSmithKline)
0–19 (primary) 0.5 mL (10 μg HBsAg) IM 0, 1, 6 mo None
recombinant1
0.5 mL (10 μg HBsAg)
0–10 (accelerated) IM 0, 1, 2 mo 12 mo
1.0 mL (20 μg HBsAg)

1.0 mL (20 μg HBsAg)

11–19 (accelerated) IM 0, 1, 2 mo 12 mo
1.0 mL (20 μg HBsAg)

≥20 (primary) IM 0, 1, 6 mo None

Vaccine Recommendation for travelers to Indonesia

VACCINE TRADE NAME AGE (Y) DOSE ROUTE SCHEDULE BOOSTER

(MANUFACTURER)

≥20 (accelerated) IM 0, 1, 2 mo 12 mo

Hepatitis B vaccine, Recombivax HB (Merck &

0–19 (primary) 0.5 mL (5 μg HBsAg) IM 0, 1, 6 mo None
recombinant1 Co., Inc.)
1.0 mL (10 μg HBsAg)
11–15 (adolescent IM 0, 4–6 mo None
1.0 mL (10 μg HBsAg)
accelerated)

IM 0, 1, 6 mo None
≥20 (primary)

Combined hepatitis A and Twinrix (GlaxoSmithKline)

≥18 (primary) 1.0 mL (720 ELU HAV + IM 0, 1, 6 mo None
B vaccine
20 μg HBsAg)

same as above
IM 0, 7, 21–30 12 mo
d
≥18 (accelerated)

Vaccine to prevent Japanese encephalitis (JE)

VACCINE TRADE NAME (MANU- AGE DOSE ROUTE SCHEDULE BOOSTER1
FACTURER)
JE vaccine, inactivated Ixiaro (Valneva) ≥17 y 0.5 mL IM 0, 28 d ≥1 y after primary series
3–16 y 0.5 mL IM 0, 28 d Data not available
2 mo–2 y 0.25 mL IM 0, 28 d Data not available
Vaccine Recommendation for travelers to Indonesia

MALARIA CHEMOPROPHYLAXIS

All areas of eastern Indonesia (provinces of Maluku, Maluku Utara, Nusa

Tenggara Timur, Papua, and Papua Barat) including town of Labuan Bajo

and Komodo Islands in the Nusa Tengarra region. Rural areas of

Kalimantan (Borneo), Nusa Tenggara Barat (includes the island of Species:

P. falciparum 57%, P. Recommended:
Lombok), Sulawesi, and Sumatra. Resistant to Chloroquine
vivax 43%, Atovaquone-proguanil,
Indonesia (P. falciparum and P.
P. knowlesi, doxycycline, or
vivax)
Low transmission in rural areas of Java including Pangandaran, Sukalumi, P. malariae, mefloquine
ovale rare
and Ujung Kulong.

None in the cities of Jakarta, and Ubud, or resort areas of Bali and Java,

and Gili Islands, and the Thousand Islands (Pulau Seribu).

Drugs used in the prophylaxis of malaria

DRUG USAGE ADULT DOSE PEDIATRIC DOSE COMMENTS
Atovaquone- Prophylaxis in all Adult tablets contain 250 Pediatric tablets Begin 1–2 days before travel to malarious areas. Take
proguanil areas mg atovaquone and 100 contain 62.5 mg daily at the same time each day while in the malarious
mg proguanil atovaquone and 25 area and for 7 days after leaving such areas.
hydrochloride. 1 adult mg proguanil Contraindicated in people with severe renal impairment
tablet orally, daily hydrochloride. (creatinine clearance <30 mL/min). Atovaquone-proguanil
should be taken with food or a milky drink. Not
5–8 kg: 1/2 pediatric recommended for prophylaxis for children weighing <5 kg,
tablet daily pregnant women, and women breastfeeding infants
weighing <5 kg. Partial tablet doses may need to be
>8–10 kg: 3/4 pediatric prepared by a pharmacist and dispensed in individual
tablet daily capsules, as described in the text.

>10–20 kg: 1 pediatric

tablet daily

>20–30 kg: 2 pediatric

Vaccine Recommendation for travelers to Indonesia

DRUG USAGE ADULT DOSE PEDIATRIC DOSE COMMENTS

tablets daily

>30–40 kg: 3 pediatric

tablets daily

>40 kg: 1 adult tablet

daily
Doxycycline Prophylaxis in all 100 mg orally, daily ≥8 years of age: 2.2 Begin 1–2 days before travel to malarious areas. Take
areas mg/kg up to adult dose daily at the same time each day while in the malarious
of 100 mg/day area and for 4 weeks after leaving such areas.
Contraindicated in children <8 years of age and pregnant
women.
Mefloquine Prophylaxis in 228 mg base (250 mg ≤9 kg: 4.6 mg/kg base Begin ≥2 weeks before travel to malarious areas. Take
areas with salt) orally, once/week (5 mg/kg salt) orally, weekly on the same day of the week while in the malarious
mefloquine- once/week area and for 4 weeks after leaving such areas.
sensitive malaria Contraindicated in people allergic to mefloquine or related
>9–19 kg: 1/4 tablet compounds (quinine, quinidine) and in people with active
once/week depression, a recent history of depression, generalized
anxiety disorder, psychosis, schizophrenia, other major
>19–30 kg: 1/2 tablet psychiatric disorders, or seizures. Use with caution in
once/week persons with psychiatric disturbances or a previous history
of depression. Not recommended for persons with cardiac
>30–45 kg: 3/4 tablet conduction abnormalities.
once/week

>45 kg: 1 tablet

once/week

Preexposure immunization for rabies

VACCINE DOSE (mL) NUMBER OF DOSES SCHEDULE (DAYS) ROUTE
HDCV, Imovax (Sanofi) 1.0 3 0, 7, and 21 or 28 IM
PCEC, RabAvert (Novartis) 1.0 3 0, 7, and 21 or 28 IM
Vaccine Recommendation for travelers to Indonesia

Postexposure immunization for rabies

IMMUNIZATION VACCINE/ DOSE NUMBER OF SCHEDULE (DAYS) ROUTE
STATUS PRODUCT DOSES
Not previously immunized RIG plus 20 IU/kg body 1 0 Infiltrated at bite site (if possible);
weight remainder IM
HDCV or 1.0 mL 4 0, 3, 7, 14 (28 if IM
PCEC immuno-
compromised3)
Previously immunized4,5 HDCV or 1.0 mL 2 0, 3 IM
PCEC

Vaccines to prevent typhoid fever

VACCINATION AGE (y) DOSE, MODE OF ADMINISTRATION NUMBER OF DOSES DOSING INTERVAL BOOSTING INTERVAL
Oral, Live, Attenuated Ty21a Vaccine (Vivotif)1
Primary series ≥6 1 capsule,2 oral 4 48 hours Not applicable
Booster ≥6 1 capsule,2 oral 4 48 hours Every 5 years
Vi Capsular Polysaccharide Vaccine (Typhim Vi)
Primary series ≥2 0.50 mL, intramuscular 1 Not applicable Not applicable
Booster ≥2 0.50 mL, intramuscular 1 Not applicable Every 2 years

Vaccine to prevent yellow fever

VACCINE TRADE NAME (MANU- AGE DOSE ROUTE SCHEDULE BOOSTER
FACTURER)
17D yellow fever vaccine YF-Vax (Sanofi Pasteur) ≥9 months1 0.5 mL2 SC 1 dose Not recommended for
most3
Vaccine Recommendation for travelers to Indonesia

Immunity information at a glance

No of Doses Interval Between Interval Between 2nd & Onset of Duration of

Disease
(Jabs) 1st & 2nd Dose 3rd Dose Protection Protection

Yellow Fever 1 --- --- After 10 to 14 days 10 years

Typhoid 1 --- --- After 10 to 14 days 3 years

Hepatitis A 2 3 to 6 months --- After 10 to 14 days 10 years

Immunoglobulin (HNIG) 1 --- --- Immediate 3 to 6 months

Diphtheria* 1 --- --- Immediate 10 years

Tetanus* 1 --- --- Immediate 10 years

Polio* 1 --- --- Immediate 10 years

Meningitis 1 --- --- After 14 to 21 days 3 to 5 years

Rabies 3 7 days 21 days 2 days after last dose 2 years

Hepatitis B 3 28 days 5 months 2 days after last dose 5 years

Japanese B
2 28 days --- 7 days after last dose unknown
Encephalitis

Tick Borne
3 7 days 21 days 2 days after last dose 2 years
Encephalitis

Cholera 2 7 to 28 days --- 7 days after last dose 3 months

Vaccine Recommendation for travelers to Indonesia