title: Tolerability of multiple vaccinations in travel medicine.
abstract: BACKGROUND
  Due to time constraints imposed by pending departure dates of travelers, the application of multiple vaccinations is commonly practiced in pretravel counseling. However, data regarding the tolerability of schedules with simultaneous vaccinations with different products are sparse.
  
  
  METHODS
  In order to investigate effects of this practice, a prospective study was conducted with 1,183 healthy travelers who presented prior to their departure. Standardized questionnaires covering possible side effects were collected during and after vaccination.
  
  
  RESULTS
  Results showed an increase of the overall frequency of side effects with an increasing number of simultaneously applied vaccines. In travelers with two or more vaccinations, side effects occurred less frequently than previously published. In double vaccinations, side effects occurred in 36.7% of vaccinees, triple vaccinations in 40.3%, in more than three vaccinations in 50.0%. Subjective rating by the vaccinees showed an excellent tolerability of multiple vaccinations.
  
  
  CONCLUSIONS
  Multiple vaccines can be given at the same time with limited subjective side effects. These findings may increase the acceptability of vaccinations given in combination to travelers.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, University of Munich, Munich, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Börner
authors.forename: Nikolai
authors.initials: N
authors.lastname: Mühlberger
authors.forename: Tomas
authors.initials: T
authors.lastname: Jelinek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004334:Drug Administration Schedule; D005260:Female; D005858:Germany; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014195:Travel; D014612:Vaccines / Q000008:administration & dosage*
chemical_list: D014612:Vaccines