Market Overview

Survey Reveals That Travelers Don't Seek Out Health Advice When Going Abroad, Even if Visiting Areas With Known Mosquito-Borne Diseases


Disease Awareness and Use of Preventative Vaccines Are Low Among
at-Risk Travelers, Including Those Visiting Japanese
Encephalitis-Endemic Regions

Results of a new survey commissioned by Valneva USA, Inc., the U.S.
subsidiary of global vaccine biotech company Valneva SE, revealed low
awareness of endemic diseases among people traveling to international
destinations. Despite an uptick in travel to Asian-Pacific countries1,
many do not seek preventative healthcare from a qualified travel health
specialist prior to their travel to guard against infection or illness.

Findings from the survey of 776 U.S. adults who visited Asia for 10 or
more days found that only 18 percent visited a travel health specialist
to discuss health-related preparations for travel. Results also revealed
that awareness and preventative measures for Japanese encephalitis (JE)
– a rare but serious disease and the most common form of
vaccine-preventable encephalitis and viral-induced neurologic disability
in Asia – was extremely low: only 33 percent of respondents were aware
of the disease, and just 16 percent of travelers considered to be
high-risk received a preventative vaccine.

"Most Americans are vaccinated for diseases common to our country as
children, but aren't always protected when traveling abroad," said Dr.
Scott Morcott, family physician and Medical Director of Passport Health
Chicago. "I encourage anyone planning international travel, especially
those who may be abroad for extended periods of time such as students,
business people, adventure travelers and volunteers, to visit a travel
health practitioner to learn about preventative measures for
travel-related diseases."

According to the World Health Organization, JE is endemic to 24
countries across Asia and parts of the western Pacific. While most
people infected with JE virus – which is transmitted by mosquitoes – are
asymptomatic or experience only mild symptoms2, it can be
fatal or cause long-term serious complications. There is no specific
treatment for JE, and the Centers for Disease Control and Prevention
(CDC) recommends that, in addition to personal protective measures such
as use of insect repellant and protective bed netting, travelers who
spend 30 days or more in a JE-endemic region be vaccinated prior to
arrival. In addition, shorter-term travelers should consider vaccination
if their activities or location put them at risk for a mosquito bite.

Other key findings from the survey include:

  • Personal protective measures against mosquito bites were not routinely
    used or available
    • 53 percent reported that hotels or accommodations did not provide
      bed nets to guard against mosquitoes
    • 42 percent reported that they did not use an insect repellent
      while in Asia
  • The majority of travelers reported visiting areas or participating in
    activities that increased their risk for the JE virus
    • 72 percent of respondents visited at least one area of increased
      risk for JE, such as suburban or rural areas, beach resorts
      outside major cities, or wilderness areas
    • 66 percent participated in at least one of the following outdoor
      activities while traveling, which could increase the risk of
      mosquito bites: hiking/trekking, camping, biking, fishing or
      hunting, and other outdoor activities
  • Only 15 percent of those surveyed fell into the "Not Recommended"
    category for vaccination against JE under current CDC guidelines

Travel health practitioners provide destination-specific care to
international travelers. A travel health physician or nurse can advise
patients on diseases endemic to countries around the globe and the best
methods to protect themselves from exposure. These recommendations might
include how to avoid contaminated food or water, guarding against
vector-borne disease, and when vaccination is recommended.

To learn more about travel health, visit the CDC at
For more information on JE, visit

About the Survey

The survey of 776 U.S. adults (18+) from across the United States was
conducted in May-June 2018 to better understand the awareness and
knowledge of health risks related to international travel. Of those
queried, 514 participants had traveled to Asia for 10-29 days within the
past 24 months, and 262 participants had traveled for 30 or more days.


Valneva is the manufacturer of IXIARO®, a vaccine indicated
for the prevention of disease caused by JE virus, approved for use in
individuals 2 months of age and older.


Severe allergic reaction after a previous dose of IXIARO, any other JE
vaccine, or any component of IXIARO, including protamine sulfate ─ a
compound known to cause hypersensitivity reactions in some individuals ─
is a contraindication to administration of IXIARO. Individuals with a
history of severe allergic reaction to another JE vaccine may be
referred to an allergist for evaluation if immunization with IXIARO is

Vaccination with IXIARO may not protect all individuals. Individuals
with a weakened immune system may have a diminished immune response to
IXIARO. Fainting may occur when receiving any injection, including
IXIARO. Tell your healthcare practitioner if you have a history of
fainting from injections.

The most common (>10%) adverse reactions were: fever, irritability,
diarrhea, and injection site redness in infants 2 months to <1 year of
age; fever in children 1 to <12 years of age; pain and tenderness in
adolescents 12 to <18 years of age; and, headache, muscle pain, and
injection site pain and tenderness in adults.

You are encouraged to report negative side effects of vaccines to the US
Food and Drug Administration (FDA) and the Centers for Disease Control
and Prevention (CDC). Visit
or call 1-800-822-7967. You should ask your healthcare practitioner for
medical advice about adverse events.

For more information, please see the physician's Prescribing Information
and ask your healthcare practitioner about the risk and benefits of

About Japanese Encephalitis

JE is a deadly infectious disease that is endemic to 24 countries across
Asia, Southeast Asia, and the western Pacific. About 68,000 cases of JE
are estimated to occur each year, although the actual number of cases is
likely much higher due to underreporting in rural areas. JE is fatal in
up to 30 percent of those who show symptoms, and up to half of survivors
continue to have neurologic, cognitive, and psychiatric impairment. In
2005, JE killed more than 1,200 children in only one month during an
epidemic outbreak in Uttar Pradesh, India, and Nepal.

According to the CDC3, the risk of JE is low for most
travelers to Asia but can vary based on various factors, such as where a
person spends time, when and for how long they are traveling and their
activities. Travelers staying one month or longer (for example, military
members and their families, study abroad students, or employees with
extended work assignments) in parts of Asia where the JE virus is found
are recommended for vaccination. Vaccination should be considered for
travelers who have an increased risk of being exposed to mosquitoes
carrying JE virus if they spend substantial time outdoors or in rural
areas, especially at night; participate in extensive active outdoor
activities such as camping, hiking, biking, fishing, or hunting, or
sleep in accommodations without mosquito nets; or whose plans are
uncertain or may change. JE vaccine is not recommended for short-term
travel restricted to urban areas or outside of the JE virus transmission


Valneva USA, Inc. is a subsidiary of Valneva SE, a fully integrated,
commercial stage biotech company focused on developing innovative
life-saving vaccines.

Valneva USA is focused on the marketing and distribution of Valneva's
vaccines, including IXIARO®, in the United States. For more information,
or follow Valneva on Twitter @ValnevaUSA
or on Facebook.

Tourism Highlights: 2017 Edition | World Tourism Organization"

2 World Health Organization. Japanese encephalitis Fact sheet
no.386. December 2015.
March 27, 2018.

3 Prevention, C. (2018). Japanese Encephalitis - Chapter 3 -
2018 Yellow Book | Travelers' Health | CDC. [online]
Available at:
[Accessed 28 Jun. 2018].

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