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Traveling safely

People with primary immunodeficiency (PI) don’t have to stay home—it may take a bit of extra planning, but you can get out and see the world, just like anyone else. However, taking your PI into consideration while planning your trip is crucial to safe, healthy, and enjoyable travel.

Where are you going?

Some places and activities are riskier for a person with PI. For example, some immunologists tell people with chronic granulomatous disease (CGD) not to swim in the ocean or fresh water. Likewise, people who do not respond to vaccines shouldn’t visit places where they are likely to be around hard-to-treat germs.

If you do not respond to vaccines and are on immunoglobulin (Ig) replacement therapy, your Ig product contains antibodies for, and will protect you against, germs that are covered by routine vaccinations or that circulate widely in the U.S. For example, your Ig protects you against measles and chickenpox. Your Ig product will not protect you from germs that circulate widely in other countries but not in the U.S. and that aren’t covered by routine vaccinations, such as yellow fever or typhoid.

The first step to safe travel is to research health hazards in the place(s) you are going:

Before you book your travel, talk to your immunology team to make sure it is safe for you to travel to each place you plan to go. Your healthcare provider may refer you to a travel clinic with staff familiar with immunodeficiencies who can tell you about precautions to take in the specific place(s) you are visiting.

Are you flying?

  • The air on most planes is HEPA filtered so flying is generally safe, even without a mask. However, you can wear a KN95 or N95 mask for added protection and peace of mind.
  • The Transportation Security Administration (TSA) has a notification card for travelers with disabilities or medical conditions that alerts security that you may need alternate screening or other accommodations.

Are you traveling outside the U.S.?

Look up the countries you plan to visit on both the U.S. Department of State and the CDC websites to answer the following questions:

  • What diseases are common in the places you’d like to go?
  • Does the CDC recommend any additional vaccines? If you don’t respond to vaccines and depend on your Ig product to protect you, are there antibodies in your product for the diseases found in those places?
    • Talk to your healthcare provider about additional vaccines if you’re traveling internationally. Your healthcare provider can check CDC’s Yellow Book chapter on immunocompromised travelers for detailed recommendations.
    • Keep in mind that some vaccines contain live, weakened germs that might not be safe for people with certain PIs.
    • In general, Ig products will not contain antibodies against germs that are not covered by routine vaccinations or that do not circulate widely in the U.S.
  • Do the countries you’re visiting require proof of vaccination? If you don’t get vaccines because you don’t respond to them, you will need a letter from your immunologist explaining why you are not vaccinated.
  • What are the rules for bringing prescription drugs or medical supplies/equipment with you?

Register with the State Department’s Smart Traveler Enrollment Program (STEP) as well. The program connects you with the local U.S. embassy or consulate in case you have an emergency at your destination and keeps you informed about local safety conditions.

Will you need to take medication or medical supplies and equipment with you? 

People on multiple times-per-week medications, like interferon gamma, need to take their medications with them when they travel. However, if you are on Ig therapy, you may be able to travel without your Ig.

IVIG: Generally, you will need to time your travel around infusions or consider a temporary switch to SCIG.

  • The length of your trip may be limited by your infusion schedule.
  • If you are traveling for an extended period within the U.S., you may be able to arrange to receive your infusions out of state by talking to your healthcare provider, insurance company, and specialty pharmacy. You will need to:
    • Submit prior authorization from a healthcare provider licensed in the state you are visiting to your insurance company—note that this process can take several months and may require appeals.
    • Find an infusion site covered by your insurance in the state you are visiting.
    • You may also need to use a different specialty pharmacy if your usual pharmacy is not licensed to ship to the state you are visiting.
  • Note that IVIG is very difficult, if not impossible, to set up internationally.

SCIG: Talk to your healthcare provider.

  • Most SCIG products can be given at any interval up to every fourteen days. If you are going away for two weeks or less, it may be possible for you to do a double infusion (twice your usual dose of Ig) before you leave so you don't have to take your Ig with you. Remember that you may have to modify your infusion supplies, as a double dose could require extra syringes or needle sets.
  • If you are traveling outside the U.S. for an extended period, research the country's rules on bringing in medications and work with your insurance and prescriber to leave with enough medication and supplies for your stay.
  • If you take your SCIG with you, don’t forget ALL your infusion supplies!

If you are taking medication or medical equipment with you, have a plan to transport and store it:

  • Don’t leave your medications in a hot car.
  • Carry an empty thick plastic jar (like a peanut butter or mayonnaise container) with you for sharps disposal.
  • If you are flying, take your medications in your carry-on luggage; it’s generally too cold in the baggage compartment.
    • Medically necessary liquids or gels over three ounces are allowed through TSA checkpoints at U.S. airports once they've been screened. Medical equipment, like freezer packs, IV bags, pumps, and syringes, can also be carried on after they've been inspected by TSA.
    • Before traveling, review the TSA guidelines for medical supplies and check out the special procedures section of the TSA website.
    • Keep medications in their original containers with the prescription label and let security know you have medication or supplies that may need to be screened.
    • Ask your healthcare provider to write a letter of necessity for all medications and medical equipment and carry it with you. This letter is especially important if you are carrying on liquid medications, needles or other sharps, or will be going through customs.
  • Make sure there is an appropriate place to store your medication where you are staying. For example, you may need to request a hotel room with air conditioning or a refrigerator if you are traveling to a hot place.

Staying healthy

Think about good hygiene and what you eat and drink to avoid getting ill while you are away from home, especially if you’re traveling abroad.

  • Wash your hands often and carry alcohol-based hand sanitizer to use when soap and water are not available.
  • Rest as much as possible.
  • Make sure meat, poultry, shellfish, and fish are thoroughly cooked.
  • Do not eat unpasteurized, or ‘raw,’ dairy.
  • Wash or peel fruits and vegetables.
  • Drink and brush your teeth with bottled or boiled water if the water is not drinkable (potable) or comes from a well.
  • Eat prepared food only if it’s purchased in a store or restaurant subject to health codes; avoid ‘street food.’
  • Whether you are traveling by plane, train, or automobile, take disposable antiseptic wipes to wipe down seats, armrests, and other surfaces.
  • In you choose to, you can wear a well-fitted KN95 or N95 mask over your nose and mouth and/or distance yourself from others while traveling to avoid germs.
  • Ask your immunologist if there are other precautions you should take while traveling.

Traveling with PI checklist

Use this checklist to stay safe and healthy no matter where your travels take you!

Download checklist

Are you prepared for a health emergency?

Depending on where you are going, your insurance coverage may change, so plan ahead and know your options during your travels.

  • Always carry a copy of your insurance card.
  • If you’re traveling out of state or outside the U.S., contact your insurance company regarding coverage in the places you are visiting.
  • Determine whether you need to purchase additional medical coverage. Some companies specialize in travel medical insurance for those with pre-existing conditions and others have a process for obtaining a pre-existing condition waiver. Note that to qualify for a waiver, you usually have to purchase the insurance within 1-3 weeks of booking your travel.

Always plan for an emergency, no matter how far you’re traveling.

  • Carry a copy of your “I Am Immunocompromised” card with you, a list of all medications and their dosage, contact information for your healthcare provider(s), as well as any additional emergency information.
    • If you have had a bone marrow or hematopoietic stem cell transplant in the last year, download the “I Am a Transplant Patient” care as well.
  • Ask your immunologist for the name and contact information of a medical facility or immunologist in the area to which you are traveling or use IDF's Clinician Finder (U.S. only).
  • Some healthcare providers will prescribe ‘just in case’ antibiotics or antifungals for people who are immunocompromised and struggle with a particular type of infection, especially if you are traveling outside the U.S. Talk to your provider about whether this precaution is appropriate for you.

Additional resources for travelers with PI

More resources to help navigate everyday life

Workplace issues

Finding the right job can help people living with PI be successful and earn health benefits.

Manage your career

Communicating with schools

Students with PI deserve to receive the same education opportunities as their peers.

Focus on education

This page contains general medical and/or legal information that cannot be applied safely to any individual case. Medical and/or legal knowledge and practice can change rapidly. Therefore, this page should not be used as a substitute for professional medical and/or legal advice. Additionally, links to other resources and websites are shared for informational purposes only and should not be considered an endorsement by the Immune Deficiency Foundation.

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