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Vaccine Recommendations by AOR

For general policy guidance on every vaccine, please see the Joint Regulation on Immunizations and Chemoprophylaxis for the Prevention of Infectious Diseases (AR 40-562, BUMEDINST 6230.15B, AFI 48-110_IP, CG COMDTINST M6230.4G).

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USAFRICOM

Vaccine	Administration	Required for AFRICOM
Chickenpox	Schedule: 0, 4-8w (2 dose) or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Hepatitis A	Schedule: 0, 6m (2 dose) or + serologic testing Route: Intramuscular Dose: 1-18 years, 0.5ml; >=19 years, 1 ml; Twinrix >=18 years, 1ml	Required.
Hepatitis B	Schedule: Engerix-B, Recombivax, Twinrix: 0,1,6m (3 dose)or Heplisav-B: 0,1m (2 dose) or + serologic testing Route: Intramuscular Dose: Engerix-B or Recombivax: 0-19 years, 0.5ml; >=20 years, 1 ml; Twinrix >=18 years, 1ml; Heplisav-B >=18 years, 0.5mL	Required.
Influenza - Seasonal	Schedule: 1 dose annually Route: Intramuscular, Intranasal Dose: IM 0.5ml; Intranasal 0.2ml	Required.
M-M-R	Schedule: 2 lifetime doses or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Meningococcal	Schedule: If at prolonged risk of disease exposure, vaccinate every 5 yrs. Route: Menomune, Subcutaneous; Menactra and Menveo, Intramuscular Dose: 0.5ml	Required.
Pneumococcal	Schedule: High risk: 1 dose, Asplenic Only: 1 dose + 1 time booster if 5 yrs or greater since 1st dose Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required for high risk health conditions per ACIP.
Polio	Schedule: 1 dose as adult Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required. See additional guidance for travel to and from USAFRICOM countries affected by polio. See also Interim CDC Guidance for Travel to high risk countries.
Rabies	Schedule: Pre-Exposure: 0,7,(21 or 28d) Booster: 2-5 yr (when titer drops >1:5) Route: Intramuscular Dose: 1ml	Required for personnel at high risk for exposure IAW Service-Specific guidelines.
Tdap	Schedule: 1 lifetime dose of Tdap, Td boosters every 10 yrs. For adults who previously have not received a dose of Tdap, 1 dose should be given regardless of interval since last tetanus vaccine. Route: Intramuscular (Tdap, Td, Tetanus Toxoid) Dose: 0.5ml (Tdap, Td, Tetanus Toxoid)	Required.
Typhoid	Schedule: Injectable: every 2 yr; Oral: every 5 yr Route: Intramuscular or Oral Dose: IM 0.5ml; Oral, 4 capsules (day 1,3,5,7)	Required.
Yellow Fever	Schedule: 1 lifetime dose. Must be administered 10 days prior to travel. Route: Subcutaneous Dose: 0.5ml	Required except for Comoros, Morocco and Tunisia. All YF vaccinations must be documented on a CDC 731. See exception for Ascension Island.

USCENTCOM

Vaccine	Administration	Required for CENTCOM
Anthrax	Schedule: 0,4w,6,12,18m + annual booster Route: Intramuscular Dose: 0.5ml	Required for 15 or more days in theater.
Chickenpox	Schedule: 0, 4-8w (2 dose) or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required. Documentation must include one of the following: Born before 1980, history of disease, sufficient varicella titer, or administration of vaccine.
Hepatitis A	Schedule: 0, 6m (2 dose) or + serologic testing Route: Intramuscular Dose: 1-18 years, 0.5ml; >=19 years, 1 ml; Twinrix >=18 years, 1ml	Required.
Hepatitis B	Schedule: Engerix-B, Recombivax, Twinrix: 0,1,6m (3 dose)or Heplisav-B: 0,1m (2 dose) or + serologic testing Route: Intramuscular Dose: Engerix-B or Recombivax: 0-19 years, 0.5ml; >=20 years, 1 ml; Twinrix >=18 years, 1ml; Heplisav-B >=18 years, 0.5mL	Required.
Influenza - Seasonal	Schedule: 1 dose annually Route: Intramuscular, Intranasal Dose: IM 0.5ml; Intranasal 0.2ml	Required.
M-M-R	Schedule: 2 lifetime doses or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required. Documentation must include one of the following: Born before 1957, effective immunity by titer, or administration of two lifetime doses.
Pneumococcal	Schedule: High risk: 1 dose, Asplenic Only: 1 dose + 1 time booster if 5 yrs or greater since 1st dose Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required for high risk health conditions per ACIP.
Polio	Schedule: 1 dose as adult Route: Subcutaneous or Intramuscular Dose: 0.5ml	For individuals traveling for > 4 weeks, vaccination required to be administered within 12 months of DEPARTURE FROM Afghanistan and Pakistan.
Rabies	Schedule: Pre-Exposure: 0,7,(21 or 28d) Booster: 2-5 yr (when titer drops >1:5) Route: Intramuscular Dose: 1ml	Required for personnel at high risk for exposure IAW Service-Specific guidelines.
Tdap	Schedule: 1 lifetime dose of Tdap, Td boosters every 10 yrs. For adults who previously have not received a dose of Tdap, 1 dose should be given regardless of interval since last tetanus vaccine. Route: Intramuscular (Tdap, Td, Tetanus Toxoid) Dose: 0.5ml (Tdap, Td, Tetanus Toxoid)	Required.
Typhoid	Schedule: Injectable: every 2 yr; Oral: every 5 yr Route: Intramuscular or Oral Dose: IM 0.5ml; Oral, 4 capsules (day 1,3,5,7)	Required.

USEUCOM

Vaccine	Administration	Required for EUCOM
Chickenpox	Schedule: 0, 4-8w (2 dose) or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Hepatitis A	Schedule: 0, 6m (2 dose) or + serologic testing Route: Intramuscular Dose: 1-18 years, 0.5ml; >=19 years, 1 ml; Twinrix >=18 years, 1ml	Required.
Hepatitis B	Schedule: Engerix-B, Recombivax, Twinrix: 0,1,6m (3 dose)or Heplisav-B: 0,1m (2 dose) or + serologic testing Route: Intramuscular Dose: Engerix-B or Recombivax: 0-19 years, 0.5ml; >=20 years, 1 ml; Twinrix >=18 years, 1ml; Heplisav-B >=18 years, 0.5mL	Required.
Influenza - Seasonal	Schedule: 1 dose annually Route: Intramuscular, Intranasal Dose: IM 0.5ml; Intranasal 0.2ml	Required.
M-M-R	Schedule: 2 lifetime doses or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Meningococcal	Schedule: If at prolonged risk of disease exposure, vaccinate every 5 yrs. Route: Menomune, Subcutaneous; Menactra and Menveo, Intramuscular Dose: 0.5ml	Specific countries only - See NCMI recommendations.
Pneumococcal	Schedule: High risk: 1 dose, Asplenic Only: 1 dose + 1 time booster if 5 yrs or greater since 1st dose Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required for high risk health conditions per ACIP.
Polio	Schedule: 1 dose as adult Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required.
Rabies	Schedule: Pre-Exposure: 0,7,(21 or 28d) Booster: 2-5 yr (when titer drops >1:5) Route: Intramuscular Dose: 1ml	Required for personnel at high risk for exposure IAW Service-Specific guidelines.
Tdap	Schedule: 1 lifetime dose of Tdap, Td boosters every 10 yrs. For adults who previously have not received a dose of Tdap, 1 dose should be given regardless of interval since last tetanus vaccine. Route: Intramuscular (Tdap, Td, Tetanus Toxoid) Dose: 0.5ml (Tdap, Td, Tetanus Toxoid)	Required.
Typhoid	Schedule: Injectable: every 2 yr; Oral: every 5 yr Route: Intramuscular or Oral Dose: IM 0.5ml; Oral, 4 capsules (day 1,3,5,7)	Required for countries with intermediate or high risk per NCMI, to include: Albania, Georgia, Israel, Kosovo, Macedonia, Moldova, Montenegro, Romania, Russia, Serbia, Turkey and Ukraine.
Yellow Fever	Schedule: 1 lifetime dose. Must be administered 10 days prior to travel. Route: Subcutaneous Dose: 0.5ml	Specific countries only - See YF vaccine transiting requirements.

USINDOPACOM

Vaccine	Administration	Required for INDOPACOM
Anthrax	Schedule: 0,4w,6,12,18m + annual booster Route: Intramuscular Dose: 0.5ml	Required for travel of 15 days or longer to Korea, to include forward deployed naval forces. All others per DoD policy.
Chickenpox	Schedule: 0, 4-8w (2 dose) or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Hepatitis A	Schedule: 0, 6m (2 dose) or + serologic testing Route: Intramuscular Dose: 1-18 years, 0.5ml; >=19 years, 1 ml; Twinrix >=18 years, 1ml	Required.
Hepatitis B	Schedule: Engerix-B, Recombivax, Twinrix: 0,1,6m (3 dose)or Heplisav-B: 0,1m (2 dose) or + serologic testing Route: Intramuscular Dose: Engerix-B or Recombivax: 0-19 years, 0.5ml; >=20 years, 1 ml; Twinrix >=18 years, 1ml; Heplisav-B >=18 years, 0.5mL	Required.
Influenza - Seasonal	Schedule: 1 dose annually Route: Intramuscular, Intranasal Dose: IM 0.5ml; Intranasal 0.2ml	Required.
Japanese encephalitis	Schedule: 0,28 d (2 dose). One-time booster dose if >11 months after series complete and still in endemic area. Route: Intramuscular Dose: 0.5ml	Required for the following countries and groups: Korea, SOF and III MEF. Required in Japan for PACFLT and USAF in addition to those previously listed. Recommended for all others.
M-M-R	Schedule: 2 lifetime doses or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Pneumococcal	Schedule: High risk: 1 dose, Asplenic Only: 1 dose + 1 time booster if 5 yrs or greater since 1st dose Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required for high risk health conditions per ACIP.
Polio	Schedule: 1 dose as adult Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required. In the setting of a polio outbreak, comply with CDC or WHO recommendations and if in-country deployment is > 4 weeks, vaccination is required prior to arriving in country.
Rabies	Schedule: Pre-Exposure: 0,7,(21 or 28d) Booster: 2-5 yr (when titer drops >1:5) Route: Intramuscular Dose: 1ml	Required for personnel at high risk for exposure IAW Service-Specific guidelines
Smallpox	Schedule: 1 dose, every 10 yr Route: 15 percutaneous jabs for primary and re-vaccinees, over deltoid.	Required for travel of 15 days or longer to Korea, to include forward deployed naval forces. All others per DoD policy.
Tdap	Schedule: 1 lifetime dose of Tdap, Td boosters every 10 yrs. For adults who previously have not received a dose of Tdap, 1 dose should be given regardless of interval since last tetanus vaccine. Route: Intramuscular (Tdap, Td, Tetanus Toxoid) Dose: 0.5ml (Tdap, Td, Tetanus Toxoid)	Required.
Typhoid	Schedule: Injectable: every 2 yr; Oral: every 5 yr Route: Intramuscular or Oral Dose: IM 0.5ml; Oral, 4 capsules (day 1,3,5,7)	Required for Korea, III MEF and Operational Forces. All others per DoD policy.

USNORTHCOM

Vaccine	Administration	Academies - ROTC	Coast Guard	Initial Entry Training	Service members in USA
Anthrax	Schedule: 0,4w,6,12,18m + annual booster Route: Intramuscular Dose: 0.5ml	N/A	Per USCG Policy.	N/A	Per DoD Policy.
Chickenpox	Schedule: 0, 4-8w (2 dose) or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.	Required.	Required.	Required.
Hepatitis A	Schedule: 0, 6m (2 dose) or + serologic testing Route: Intramuscular Dose: 1-18 years, 0.5ml; >=19 years, 1 ml; Twinrix >=18 years, 1ml	Required.	Required.	Required.	Required.
Hepatitis B	Schedule: Engerix-B, Recombivax, Twinrix: 0,1,6m (3 dose)or Heplisav-B: 0,1m (2 dose) or + serologic testing Route: Intramuscular Dose: Engerix-B or Recombivax: 0-19 years, 0.5ml; >=20 years, 1 ml; Twinrix >=18 years, 1ml; Heplisav-B >=18 years, 0.5mL	Required.	Required.	Required.	Per DoD Policy.
Influenza - Seasonal	Schedule: 1 dose annually Route: Intramuscular, Intranasal Dose: IM 0.5ml; Intranasal 0.2ml	Required.	Required.	Required.	Required.
M-M-R	Schedule: 2 lifetime doses or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.	Required.	Required.	Required.
Meningococcal	Schedule: If at prolonged risk of disease exposure, vaccinate every 5 yrs. Route: Menomune, Subcutaneous; Menactra and Menveo, Intramuscular Dose: 0.5ml	Required Academies Only.	N/A	Required.	N/A
Pneumococcal	Schedule: High risk: 1 dose, Asplenic Only: 1 dose + 1 time booster if 5 yrs or greater since 1st dose Route: Subcutaneous or Intramuscular Dose: 0.5ml	N/A	Required for asplenic and other high risk health conditions per ACIP.	San Diego: 1 dose. Parris Island: 1 dose. Cape May: 1 dose.	Required for high risk health conditions per ACIP.
Polio	Schedule: 1 dose as adult Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required.	Required.	Required.	Required.
Rabies	Schedule: Pre-Exposure: 0,7,(21 or 28d) Booster: 2-5 yr (when titer drops >1:5) Route: Intramuscular Dose: 1ml	N/A	Per USCG Policy.	N/A	Required for personnel at high risk for exposure IAW Service-Specific guidelines
Smallpox	Schedule: 1 dose, every 10 yr Route: 15 percutaneous jabs for primary and re-vaccinees, over deltoid.	N/A	Per USCG Policy.	N/A	Per DoD Policy.
Tdap	Schedule: 1 lifetime dose of Tdap, Td boosters every 10 yrs. For adults who previously have not received a dose of Tdap, 1 dose should be given regardless of interval since last tetanus vaccine. Route: Intramuscular (Tdap, Td, Tetanus Toxoid) Dose: 0.5ml (Tdap, Td, Tetanus Toxoid)	Required.	Required.	Required.	Required.
Typhoid	Schedule: Injectable: every 2 yr; Oral: every 5 yr Route: Intramuscular or Oral Dose: IM 0.5ml; Oral, 4 capsules (day 1,3,5,7)	N/A	Per USCG Policy.	N/A	Per NORAD & USNORTHCOM Instruction 44-163.

USSOUTHCOM

Vaccine	Administration	Required for SOUTHCOM (includes Haiti)
Chickenpox	Schedule: 0, 4-8w (2 dose) or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Hepatitis A	Schedule: 0, 6m (2 dose) or + serologic testing Route: Intramuscular Dose: 1-18 years, 0.5ml; >=19 years, 1 ml; Twinrix >=18 years, 1ml	Required.
Hepatitis B	Schedule: Engerix-B, Recombivax, Twinrix: 0,1,6m (3 dose)or Heplisav-B: 0,1m (2 dose) or + serologic testing Route: Intramuscular Dose: Engerix-B or Recombivax: 0-19 years, 0.5ml; >=20 years, 1 ml; Twinrix >=18 years, 1ml; Heplisav-B >=18 years, 0.5mL	Required.
Influenza - Seasonal	Schedule: 1 dose annually Route: Intramuscular, Intranasal Dose: IM 0.5ml; Intranasal 0.2ml	Required.
M-M-R	Schedule: 2 lifetime doses or + serologic testing Route: Subcutaneous Dose: 0.5ml	Required.
Pneumococcal	Schedule: High risk: 1 dose, Asplenic Only: 1 dose + 1 time booster if 5 yrs or greater since 1st dose Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required for high risk health conditions per ACIP.
Polio	Schedule: 1 dose as adult Route: Subcutaneous or Intramuscular Dose: 0.5ml	Required.
Rabies	Schedule: Pre-Exposure: 0,7,(21 or 28d) Booster: 2-5 yr (when titer drops >1:5) Route: Intramuscular Dose: 1ml	Required for personnel at high risk for exposure IAW Service-Specific guidelines.
Tdap	Schedule: 1 lifetime dose of Tdap, Td boosters every 10 yrs. For adults who previously have not received a dose of Tdap, 1 dose should be given regardless of interval since last tetanus vaccine. Route: Intramuscular (Tdap, Td, Tetanus Toxoid) Dose: 0.5ml (Tdap, Td, Tetanus Toxoid)	Required.
Typhoid	Schedule: Injectable: every 2 yr; Oral: every 5 yr Route: Intramuscular or Oral Dose: IM 0.5ml; Oral, 4 capsules (day 1,3,5,7)	Required.
Yellow Fever	Schedule: 1 lifetime dose. Must be administered 10 days prior to travel. Route: Subcutaneous Dose: 0.5ml	Required for countries where the disease is endemic, per the CDC. Required if traveling from an endemic area to those countries with transiting requirements (per WHO) and per USSOUTHCOM memo dated November 28, 2018.

Regional Vaccine Recommendations provided for informational reference purposes only.
Always vaccinate according to package inserts and DoD/Service guidelines.

Page last updated: December 10, 2018

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Vaccine Recommendations by AOR

USAFRICOM

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USEUCOM

USINDOPACOM

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USSOUTHCOM

Page last updated: December 10, 2018

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International Certificate of Vaccination or Prophylaxis