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. 2022 Aug 3;9(8):ofac399.
doi: 10.1093/ofid/ofac399. eCollection 2022 Aug.

High-risk US International Travelers Seeking Pretravel Consultation During the COVID-19 Pandemic

Emily P Hyle  1 , Mylinh H Le  1 , Sowmya R Rao  2 , Nora M Mulroy  1 , Allison T Walker  3 , Edward T Ryan  4 , Regina C LaRocque  4
Affiliations

High-risk US International Travelers Seeking Pretravel Consultation During the COVID-19 Pandemic

Emily P Hyle et al. Open Forum Infect Dis. .

Abstract

Background: To assess the implications of coronavirus disease 2019 (COVID-19)-related travel disruptions, we compared demographics and travel-related circumstances of US travelers seeking pretravel consultation regarding international travel at US Global TravEpiNet (GTEN) sites before and after the initiation of COVID-19 travel warnings.

Methods: We analyzed data in the GTEN database regarding traveler demographics and travel-related circumstances with standard questionnaires in the pre-COVID-19 period (January-December 2019) and the COVID-19 period (April 2020-March 2021), excluding travelers from January to March 2020. We conducted descriptive analyses of differences in demographics, travel-related circumstances, routine and travel-related vaccinations, and medications.

Results: Compared with 16 903 consultations in the pre-COVID-19 period, only 1564 consultations were recorded at GTEN sites during the COVID-19 period (90% reduction), with a greater proportion of travelers visiting friends and relatives (501/1564 [32%] vs 1525/16 903 [9%]), individuals traveling for >28 days (824/1564 [53%] vs 2522/16 903 [15%]), young children (6 mo-<6 y: 168/1564 [11%] vs 500/16 903 [3%]), and individuals traveling to Africa (1084/1564 [69%] vs 8049/16 903 [48%]). A smaller percentage of vaccine-eligible travelers received vaccines at pretravel consultations during the COVID-19 period than before, except for yellow fever and Japanese encephalitis vaccinations.

Conclusions: Compared with the pre-COVID-19 period, a greater proportion of travelers during the COVID-19 period were young children, were planning to visit friends and relatives, were traveling for >28 days, or were traveling to Africa, which are circumstances that contribute to high risk for travel-related infections. Fewer vaccine-eligible travelers were administered travel-related vaccines at pretravel consultations. Counseling and vaccination focused on high-risk international travelers must be prioritized during the COVID-19 pandemic.

Keywords: COVID-19; global travEpiNet; international travel.

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Conflict of interest statement

Potential conflicts of interest. The authors: no reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Changes in the number of pretravel consultations at Global TravEpiNet (GTEN) sites during the pre-COVID-19 and COVID-19 periods, stratified by calendar quarter. We excluded pretravel consultations from the first quarter of 2020 (January 1, 2020–March 31, 2020) due to traveler uncertainty, travel disruptions, and government restrictions. Abbreviation: COVID-19, coronavirus disease 2019.
Figure 2.
Figure 2.
Administration of vaccines and reasons for nonvaccination among vaccine-eligible international travelers evaluated at pretravel consultations at Global TravEpiNet (GTEN) sites during the pre-COVID-19 and COVID-19 periods. For each type of travel-related vaccination, vaccine-eligible travelers were categorized into those vaccinated at the pretravel consultation (blue) and not vaccinated (orange). We then categorized reasons for nonvaccination into provider decision (solid), referral to another provider (dots), traveler refusal (striped), or other (hatched). Abbreviations: COVID-19, coronavirus disease 2019; MMR, measles-mumps-rubella.
Figure 3.
Figure 3.
Changes in the distribution of travel duration A and reason for travel B among international travelers evaluated at pretravel consultations at Global TravEpiNet (GTEN) sites during the pre-COVID-19 and COVID-19 periods, stratified by the calendar quarter of the consultation. Duration of travel was categorized as 1–7 d (blue), 8–14 d (gray), 15–28 d (black), 29–180 d (gold), and >6 m (red). Reason for travel was categorized as visiting friends and relatives (red), business (black), humanitarian or service work (gold), research/education (gray), leisure (blue), and other (green). Abbreviations: COVID-19, coronavirus disease 2019; VFR, visiting friends and relatives.
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