Missionary Vaccine Recommendations
Missionary Vaccine Recommendations
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. Contact MTC for the most up-to-date guidelines
Immunizations Required for ALL Countries
Tetanus-Diphtheria-Pertussis:Tdap is the preferred vaccine. A primary series should have been received in childhood. Tdap must be received within 8 years of starting a mission in order to give protection throughout the service.
Measles-Mumps-Rubella (MMR- live virus):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: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.
Hepatitis B: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).
Combined Hepatitis A/Hepatitis B (Twinrix):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.
COVID-19 Vaccine:All missionaries are encouraged to be “good global citizens” (First Presidency, 1/19/2021) and be vaccinated against COVID-19, including the primary series and boosters. For senior missionaries to serve outside their home country, this vaccination is required. It is recommended but not required for young missionaries serving outside their home country unless the assigned country requires it.
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.
Limited Required Immunizations
Each missionary will be notified if these vaccinations are required in their assigned mission.
Polio (P):A primary series is usually given in childhood, but if no vaccine has been given or if immunization status is unknown, a catch-up schedule with 3 injections of inactivated polio vaccine (IPV) at 0, 28, and 56 days should be given. A booster dose is required if one is called to serve in a high-risk country. A single booster following the primary series gives lifetime immunity
Typhoid (TY):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.
Yellow Fever (YF-live virus):Certain countries may require the yellow fever vaccine. 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 65, especially if they have never been vaccinated for YF, have increased adverse reaction risk, some of which are serious. These persons should consult their personal physicians regarding their risks of vaccine reaction versus the disease risk in their assigned missions. It is now generally accepted that a single shot of YF-VAX confers lifetime immunity, although some countries still require a booster dose after 10 years.
Japanese Encephalitis (JE):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 required to receive JEV attend one of 3 MTCs: Provo, Philippines, or New Zealand. Only Ixiaro is available in Provo and New Zealand. The availability of either Ixiaro or Imojev has been unreliable at the Philippines MTC. If is preferred that immunizations be completed before entering an MTC, but if cost or availability prevents this from being accomplished, JEV can be provided at Provo and New Zealand, but only possibly at the Philippines. In some circumstances, it may be necessary to get the preferred or acceptable JEV on arrival in the mission and before being sent to higher JE risk rural areas. 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.
InfluenzaEither 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.
MeningitisAll 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.Men B vaccine is recommended for those with an increased risk of meningococcal disease: people with complement deficiencies, anatomic or functional asplenia, and any exposed persons during an outbreak of type B meningitis. Senior missionaries going to high-risk countries (see table) also must be vaccinated. It is now approved for individuals over 65.
PneumoniaThis 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. Whether a person takes one or both vaccines should be determined after an informed discussion with his or her personal physician.
Chickenpox (Varicella-live virus)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.
Shingles (H. Zoster-live virus)Shingrix is the only approved vaccine in the US, Zostavax is no longer available. Shingrix is 97% effective and is two dose injections given at 0 and 60 to 180 days. It is recommended for those over age 50, even in those previously vaccinated with Zostavax, and also in those over age 18 with serious immune deficiencies.
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.