title: Simultaneous vaccination in Japanese travelers.
abstract: BACKGROUND
  Simultaneous vaccination is not common in Japan because there is little information available on its effects. Some people are quite concerned about the possibility of adverse reactions due to simultaneous vaccination. The objective of this study was to evaluate whether the frequency and severity of adverse effects are increased by simultaneous vaccination in comparison to single vaccination.
  
  
  METHODS
  A retrospective observational study was conducted in 399 asymptomatic travelers who visited the travel clinic during the period January-July 2005. One hundred forty-two participants were given a single vaccination, 257 participants were given simultaneous vaccination. Travel-specific vaccinations were for hepatitis A, hepatitis B, tetanus, rabies and Japanese encephalitis, and routine vaccines were for diphtheria+tetanus, measles, mumps and oral polio vaccine. To evaluate adverse effects, travelers were asked to complete a prepared questionnaire after vaccination.
  
  
  RESULTS
  Adverse effects were reported by 26.3% of travelers, with 21.8% reporting local reactions and 4.5% reporting systemic reactions. The simultaneous vaccination group reported significantly more frequent adverse effects than those reported by the single vaccination group. Particularly, tetanus vaccination was shown to significantly raise the risk of adverse effects (P<0.001). However, no serious adverse effects were reported.
  
  
  CONCLUSIONS
  Simultaneous vaccination was feasible for Japanese travelers because most problems were generally minor and related to local reactions at the sites of injections. Provision of a simultaneous vaccination schedule should motivate more Japanese travelers to obtain immunizations and thereby reduce the risk of vaccine-preventable diseases.
authors.affiliation: Travel Clinic, Disease Control and Prevention Center, International Medical Center of Japan, Tokyo 162-8655, Japan. y-mizuno@it.imcj.go.jp
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kano
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Urashima
authors.forename: Ikumi
authors.initials: I
authors.lastname: Genka
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kanagawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kudo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D022362:Hepatitis A Vaccines / Q000008:administration & dosage; D017325:Hepatitis B Vaccines / Q000008:administration & dosage; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D007564:Japan; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage; D008499:Medical Records; D008875:Middle Aged; D009108:Mumps Vaccine / Q000008:administration & dosage; D017060:Patient Satisfaction; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013745:Tetanus Toxoid / Q000008:administration & dosage; D014195:Travel; D014611:Vaccination / Q000009:adverse effects / Q000379:methods*
chemical_list: D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D008458:Measles Vaccine; D009108:Mumps Vaccine; D011055:Poliovirus Vaccine, Oral; D013745:Tetanus Toxoid