Pre-Travel Vaccination Guide for Guam | Pharmacist-Recommended Immunization Schedule and Costs
Guam is a popular tourist destination with warm weather, but getting vaccinated before travel is an important part of maintaining your health. This article explains which vaccinations are recommended for travel to Guam, vaccination schedules, and costs from a pharmacist's perspective. Always verify the latest information with Japan's Ministry of Foreign Affairs and the embassy.
Types of Vaccinations Recommended for Travel to Guam
Classification of Required and Recommended Vaccinations
There are no vaccinations legally required for travel to Guam. However, several vaccinations are recommended based on infection risk considerations.
| Vaccination | Recommendation | Target Group | Importance |
|---|---|---|---|
| Measles-Rubella (MR) | ★★★ | All travelers | High |
| Japanese Encephalitis | ★★☆ | Long-term residents | Moderate |
| Hepatitis A | ★★★ | All travelers | High |
| Hepatitis B | ★★☆ | All travelers | Moderate |
| Tetanus | ★★★ | All travelers | High |
| Rabies | ★☆☆ | Those planning animal contact | Low–Moderate |
| Typhoid | ★☆☆ | Areas with sanitation concerns | Low |
| Yellow Fever | — | Not required | — |
| Polio | ★☆☆ | Unvaccinated individuals | Low |
Pharmacist's note Guam is U.S. territory with relatively good sanitation standards. However, if traveling via Southeast Asia, verify infectious disease information for transit countries as well.
Priority-Based Vaccination Details
Top Priority: Measles-Rubella (MR)
Reason for vaccination: Measles cases have been reported in Guam and other overseas destinations. Regular outbreaks occur in Japan, so all travelers should verify immunity.
- Target recipients: Adults born in 1972 or later without documented record of two doses
- Number of doses: 2 doses required (if previously infected or received only one dose)
- Interval between doses: At least 4 weeks between first and second dose
- Immunity onset: Immune protection established 2 weeks after second dose
Recommended schedule example (begin 3 months before travel)
- First dose: 120 days before departure
- Second dose: 90 days before departure
High Priority: Hepatitis A
Reason for vaccination: Although Guam's tap water is safe, infection risk exists through food sources. Particularly high risk from shellfish and undercooked foods.
- Vaccine type: Inactivated vaccine (approved in Japan)
- Number of doses: 2 or 3 doses (depends on vaccine type)
- Basic schedule
- First dose: 6 months before travel
- Second dose: 2 weeks after first dose
- Third dose: 6 months after first dose (for long-term immunity)
Short-stay option: Basic immunity can be achieved with 2 doses. Consult a physician if time is limited before departure.
Pharmacist's note Two types of Hepatitis A vaccine are available:
- VAQTA (Merck): 3-dose schedule
- Havrix (GSK): Can be completed with 2 doses (second dose 6–12 months later)
Havrix-type vaccines are primarily used in Japan, with an accelerated schedule available starting 30 days before travel.
Recommended: Tetanus (Td/DPT)
Reason for vaccination: Risk of tetanus infection from cuts and wounds sustained in Guam. Additional dose recommended if more than 10 years have passed since last vaccination.
- Target recipients: Those whose last vaccination was more than 10 years ago
- Basic schedule: 60 days before departure
- Duration: Single dose completes vaccination
Moderate Priority: Hepatitis B
Reason for vaccination: Risk from healthcare facility use, tattoos, piercings, and sexual contact.
- Number of doses: 3 doses
- Schedule
- First dose: 180 days before departure
- Second dose: 30 days after first dose
- Third dose: 180 days after first dose
Accelerated schedule: In cases of medical necessity, doses can be administered on days 0, 7, and 21 (though effectiveness may be lower than the standard schedule)
For Long-Term Stays: Japanese Encephalitis
Reason for vaccination: Planned stay of 3 months or longer, especially during rainy season (June–November) or extended stays near Guam.
- Outbreak risk in Guam: Low (U.S. territory with established mosquito control measures)
- Recommended if: Long-term stay or traveling via Southeast Asia
- Number of doses: 2 doses
- Schedule
- First dose: 28 days before departure
- Second dose: 7 days after first dose
Pharmacist's note Japanese Encephalitis vaccines include:
- Inactivated cell culture vaccine (Japan standard): 2 doses, 1-week interval
- Vero cell-derived vaccine: 2 doses, faster scheduling options available
If your Guam stay is short (2 weeks or less), lower this vaccination's priority.
Target-Specific: Rabies
Reason for vaccination: If planning contact with wildlife in Guam (bats, raccoons, etc.).
- Target recipients: Those planning animal handling or extensive outdoor activities
- Number of doses: 3 doses
- Schedule
- First dose: 30 days before departure
- Second dose: 7 days after first dose
- Third dose: 21 or 28 days after first dose
Post-exposure response: Without prior vaccination, emergency vaccination within 4 weeks of bite can provide protection. Verify Guam healthcare facility capabilities beforehand.
Vaccination Schedules by Travel Pattern
Pattern 1: Short-term Tourism (7–14 days) [Minimum 30+ days before departure]
| Vaccination | 120 days prior | 90 days prior | 60 days prior | 30 days prior | Complete |
|---|---|---|---|---|---|
| MR (dose 1) | ○ | ||||
| MR (dose 2) | ○ | ✓ | |||
| Tetanus | ○ | ✓ | |||
| Hepatitis A (accelerated) | ○ | △ |
Hepatitis A provides basic immunity with a single dose 30 days before travel, but a second dose is needed for complete long-term immunity.
Pattern 2: Mid-Length Stay (3 weeks–1 month) [Minimum 90+ days before departure]
| Vaccination | 120 days prior | 90 days prior | 60 days prior | 30 days prior | Complete |
|---|---|---|---|---|---|
| MR (dose 1) | ○ | ||||
| MR (dose 2) | ○ | ✓ | |||
| Hepatitis A (dose 1) | ○ | ||||
| Hepatitis A (dose 2) | ○ | ✓ | |||
| Tetanus | ○ | ✓ | |||
| Hepatitis B (dose 1) | ○ | ||||
| Hepatitis B (dose 2) | ○ | ||||
| Hepatitis B (dose 3) | ○ | ✓ |
Pattern 3: Long-term Stay (1+ months) [Minimum 180+ days before departure]
Recommended vaccinations include MR, Hepatitis A, Hepatitis B, Tetanus, plus Japanese Encephalitis. Planning should ideally begin 180 days before departure.
Vaccination Cost Guide
Vaccination Costs in Japan
| Vaccine | Cost per dose | Notes |
|---|---|---|
| Measles-Rubella | ¥9,000–¥13,000 | 2 doses required |
| Hepatitis A | ¥7,000–¥10,000 | 2–3 doses required |
| Hepatitis B | ¥5,000–¥8,000 | 3 doses required |
| Tetanus (Td) | ¥3,000–¥5,000 | 1 dose |
| Japanese Encephalitis | ¥8,000–¥12,000 | 2 doses required |
| Rabies | ¥18,000–¥22,000 | 3 doses required |
Total cost estimate: Short-term tourism ¥30,000–¥50,000; mid-length stay ¥50,000–¥100,000
Pharmacist's note Vaccination costs in Japan are out-of-pocket expenses (not covered by routine immunization programs). Prices vary by clinic, so checking multiple facilities is recommended. Some municipalities offer partial subsidies. Check your local government website in advance.
Vaccination in Guam
Vaccinations are available in Guam. However, vaccination in Japan before departure is recommended for these reasons:
- Maintaining vaccination schedule during travel can be difficult
- English-language vaccination records may be required in some situations
- Medical costs tend to be higher than in Japan
Important Notes and Contraindications
Pre-Vaccination Confirmation
Pregnancy and breastfeeding
- Live vaccines (MR, varicella, Japanese Encephalitis) are contraindicated
- Inactivated vaccines (Hepatitis A, Hepatitis B) may be possible (physician judgment required)
Immunocompromised state
- HIV infection, active cancer treatment, post-transplant: live vaccines contraindicated
- Prior physician consultation mandatory
Allergy history
- Vaccine component allergies (neomycin, gentamicin, etc.)
- Egg allergies (some vaccines contain egg components)
Pharmacist's note Multiple vaccines can be administered simultaneously. Giving injections at different sites allows schedule compression. However, if both vaccines are live vaccines, maintain at least 27 days between doses.
Post-Vaccination Care
- 30 minutes after vaccination: Observe for anaphylaxis
- Day of vaccination: Avoid strenuous exercise and alcohol
- 2–3 days after: Local swelling and mild fever are normal reactions
Vaccination Record Preparation
Required Documentation
- Vaccination handbook: Record of all vaccinations received in Japan
- English-language vaccination record: Request from clinic (fee applies)
- Yellow Fever Certificate: Only if applicable (not required for Guam)
English record should include
- Vaccine name (English)
- Vaccination date
- Healthcare facility name
- Physician signature and facility stamp
Guam does not typically require submission of vaccination records, but they are useful for transit through other countries or in emergency situations.
Pharmacist's note English vaccination records can take 1–2 weeks to issue from some healthcare facilities. Request this 2 weeks before departure.
Health Management and Medical Information Upon Arrival in Guam
Healthcare Facilities in Guam
Guam's medical standards follow U.S. guidelines and are relatively high-quality. Note the following:
- Guam Regional Medical City: Primary hospital (English-speaking staff)
- Private clinics: Numerous locations around tourist areas
- Medical costs: High, comparable to U.S. rates. International travel insurance is essential
Infection Prevention After Vaccination
While vaccinated, practice good hygiene and food safety:
- Wash hands frequently
- Drink bottled or boiled water (tap water is safe, but caution with unfamiliar sources)
- Eat cooked foods; avoid raw or undercooked items
- Use insect repellent for mosquito-borne illnesses