Immunizations are not a requirement for missionary service, but those who decline or are unable to receive immunizations will serve in their home countries where their risk for contracting and transmitting the illness is not increased. Vaccines must be approved by the Advisory Committee on Immunization Practices (ACIP) in the United States or by an approved government agency internationally. Some vaccines contain live viruses and certain precautions apply. MMR, chickenpox, influenza by nasal spray, yellow fever, and shingles vaccines contain live viruses. They must be given on the same day, or separated by 28 days before another live virus vaccine can be given.
Note: Regarding yellow fever vaccine only, when not administered on the same day, the CDC recommends that yellow fever vaccine and other parenteral or nasal live vaccines should be separated by at least 30 days, if possible. Because of concern about protection from yellow fever, CDC recommends postponing travel if the 30 day interval cannot be established between other live vaccines.
Each missionary should complete their immunizations BEFORE entering the MTC.
Tdap is the preferred vaccine. A primary series should have been received in childhood. A booster dose is required within five years.
This vaccine is not needed for those born before 1957. Two doses of the MMR vaccine should have been received, usually ages 12 months and 4-6 years. If only one dose was given, or if a person is unsure, a second dose should be given.
Hepatitis A is a two-dose series given on days 0, and 180 for lifetime protection. One dose protects for two years. Persons from developing countries may not need Hepatitis A vaccine.
Hep B is a 2 dose or 3-dose series depending on brand. The 2 dose series is administered 1 month apart. The 3 dose series are given on a 0, 30, and 180-day schedule. For the 3 dose series, at least 2 doses must be received before entering the MTC but gives only 60-70% protection during the mission. If only 2 doses of the 3 dose series are given before missionary service, a 3rd dose should be given at least 5 months after the 2nd dose during the mission or following its completion. The 3 dose series is approved for an accelerated schedule of 0, 7, 21-30 days, with a 4th dose after 12 months (or after completion of mission).
This vaccine is available and is approved for an accelerated schedule of 0, 7, and 21-30 days, with a 4th dose recommended after 12 months for lifetime protection. If a person has started Hepatitis A and/or Hepatitis B vaccines separately, Twinrix may be used to complete the immunization.
Either injectable or inhaled (live virus) vaccine should given at least two weeks BEFORE entering the MTC during September through March in the northern hemisphere, and March through August in the southern hemisphere, to prevent epidemics under dormitory living conditions. Missionaries should be certain they receive the current vaccine.
In some locations, all vaccines may not be available, and immunizations may need to be completed during MTC training. An appropriate fee may be charged to the missionary or home stake for this service. With reduced duration of the MTC training period, every attempt should be made by the family and/or local priesthood to complete immunizations before entering the MTC.
Each missionary will be notified if these vaccinations are required in their assigned mission.
Only those serving in countries where polio is endemic (see table) need to have a booster dose. If a person’s vaccination status is unknown, and current protection is needed, two injections of inactivated polio vaccine (IVP) should be given at least four weeks apart. Some countries use the oral live virus vaccine. Either vaccine is acceptable.
Two types of vaccine are available (not always in developing countries). The preferred method is an oral dosing, taking one capsule on a 0, 2, 4, and 6 day schedule. The doses should not be taken while on an antibiotic. The injection is a single dose, and is the method used at MTCs because of dosing problems with the oral capsules in that setting.
Vaccine is available only in travel clinics or health departments, and should be given in advance of entering the MTC because of common mild adverse reactions (10-30%). Those over age 60, especially if they have never previously been vaccinated for YF, have increased reaction risks, some of which are serious. If the YF risk is low, a medical waiver may be advisable.
The present U.S. vaccine (JEV or Ixiaro) is given in two injections four weeks apart with the second dose given at least one week before travelling to the country of risk. Missionaries who stay at the MTC only 1-2 weeks MUST get the first dose at least three weeks before entering the MTC, so that the second dose may be given at the proper interval. We require JEV for those going to hyperendemic (high-risk) countries as the CDC advises, but simply recommend it for endemic countries. Missionaries should understand the risk, benefit, and cost of this vaccine, and then make an informed decision if they are going to an endemic country. See table under the JE column: JEV is required in countries marked X, and optional in those marked OPT.
All young adult missionaries should receive meningococcal meningitis vaccine at least 10 days before entering an MTC. If one dose has been received more than five years before beginning the mission, a booster dose is advisable. Senior missionaries going to high-risk countries (see table) also must be vaccinated. It is now approved for individuals over 65.
This single injection vaccine is especially advised for seniors over age 65, those with chronic heart or lung conditions, including asthmatics taking prevention medications, and those with sickle cell disease, diabetes or post splenectomy or other immune challenged conditions.
This two-injection, live virus vaccine is given four weeks apart and is advised for those who have never been vaccinated or never had the disease. Persons born before 1980 in the U. S. do not need the vaccine.
Seniors over age 50 may reduce the risks of shingles and neuralgia with a single dose of this live virus vaccine (Zostrix).
Specific immunizations are required for missionaries serving in certain countries, such as malaria prevention. Countries not listed require the basic immunizations. For information on the specific countries that require malaria prevention, yellow fever, meningococcal or other vaccines, visit the Traveler’s Health website.