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Vaccines for Travelers

Vaccines protect travelers from serious diseases. Depending on where you travel, you may come into contact with diseases that are rare in the United States, like yellow fever. Some vaccines may also be required for you to travel to certain places.

Getting vaccinated will help keep you safe and healthy while you’re traveling. It will also help make sure that you don’t bring any serious diseases home to your family, friends, and community.

On this page, you'll find answers to common questions about vaccines for travelers.

Which vaccines do I need before traveling?

The vaccines you need to get before traveling will depend on few things, including:

  • Where you plan to travel . Some countries require proof of vaccination for certain diseases, like yellow fever or polio. And traveling in developing countries and rural areas may bring you into contact with more diseases, which means you might need more vaccines before you visit.
  • Your health . If you’re pregnant or have an ongoing illness or weakened immune system, you may need additional vaccines.
  • The vaccinations you’ve already had . It’s important to be up to date on your routine vaccinations. While diseases like measles are rare in the United States, they are more common in other countries. Learn more about routine vaccines for specific age groups .

How far in advance should I get vaccinated before traveling?

It’s important to get vaccinated at least 4 to 6 weeks before you travel. This will give the vaccines time to start working, so you’re protected while you’re traveling. It will also usually make sure there’s enough time for you to get vaccines that require more than 1 dose.

Where can I go to get travel vaccines?

Start by finding a:

  • Travel clinic
  • Health department
  • Yellow fever vaccination clinic

Learn more about where you can get vaccines .

What resources can I use to prepare for my trip?

Here are some resources that may come in handy as you’re planning your trip:

  • Visit CDC’s travel website to find out which vaccines you may need based on where you plan to travel, what you’ll be doing, and any health conditions you have.
  • Download CDC's TravWell app to get recommended vaccines, a checklist to help prepare for travel, and a personalized packing list. You can also use it to store travel documents and keep a record of your medicines and vaccinations.
  • Read the current travel notices to learn about any new disease outbreaks in or vaccine recommendations for the areas where you plan to travel.
  • Visit the State Department’s website to learn about vaccinations, insurance, and medical emergencies while traveling.

Traveling with a child? Make sure they get the measles vaccine.

Measles is still common in some countries. Getting your child vaccinated will protect them from getting measles — and from bringing it back to the United States where it can spread to others. Learn more about the measles vaccine.

Find out which vaccines you need

CDC’s Adult Vaccine Quiz helps you create a list of vaccines you may need based on your age, health conditions, and more.

Take the quiz now !

Get Immunized

Getting immunized is easy. Vaccines and preventive antibodies are available at the doctor’s office or pharmacies — and are usually covered by insurance.

Find out how to get protected .

Get Vaccinated Before You Travel

It’s important to plan ahead to get the shots required for all countries you and your family plan to visit.

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Protect your child and family when traveling in the United States or abroad by:

  • Getting the shots required for all countries you and your family plan to visit during your trip
  • Making sure you and your family are up-to-date on all routine U.S. vaccines
  • Staying informed about travel notices and alerts and how they can affect your family’s travel plans

Avoid getting sick or coming back home and spreading the disease to others.

Vaccinate at least a month before you travel

See your doctor when you start to plan your trip abroad. It’s important to do this well in advance.

  • Your body needs time to build up immunity.
  • You may need several weeks to get all the doses of the vaccine.
  • Your primary doctor may not stock travel vaccines. Visit a travel medical clinic .
  • You’ll need time to prepare for your pre-travel appointment .
  • If the country you visit requires a yellow fever vaccine , only a limited number of clinics have the vaccine and will probably be some distance from where you live. You must get it at least 10 days before travel.

Find out which vaccines are recommended or required for the countries you plan to visit .

TIP : Save time by getting routine vaccines during the same doctor visit. Use the Vaccine Self-Assessment Tool and discuss the results with your doctor. It tells you which U.S. recommended vaccines you (19 years and older) or your child (birth – 18 years) might need.

Last-minute travelers

When traveling to another country be aware your doctor may not carry a travel vaccine and you may have to visit a medical clinic.

Many travel vaccines require multiple shots or take time to become fully effective. But some multiple-dose vaccines (like hepatitis A) can still give you partial protection after just one dose. Some can also be given on an “accelerated schedule,” meaning doses are given in a shorter period of time.

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Which Vaccinations Are Required for Travel?

By Cassie Shortsleeve

Mountain hiking

A trip abroad requires you to be up-to-date on a whole checklist of things these days: travel insurance, airline policies, visas, passports , and, as far as your health is concerned, vaccines. Yet while the COVID-19 pandemic has made us acutely aware of the importance of staying healthy on the road, travel vaccines have always been a mainstay of safe travel—a crucial tool in avoiding the (often expensive) headaches of getting sick , and treating sicknesses, abroad.

Whether you have travel on the horizon or want to be prepared for 2023 trips and beyond, this guide will get you up to speed on the vaccinations required for travel depending on your destination, itinerary, and health status. Follow the below steps to protect your immune system in another country.

Make sure you’re current with routine vaccines

The Centers for Disease Control and Prevention (CDC) recommends all travelers be up to date on routine vaccines before travel. Routine vaccines include shots like COVID-19; chickenpox; Hepatitis A and B; Influenza; Measles, Mumps, Rubella (MMR); Polio; and more. The CDC has a full list of routine vaccines here .

“‘Routinely recommended vaccines’ are vaccines that have been considered very important to prevent common diseases in the population to start,” says Lin H. Chen , M.D. director of the Travel Medicine Center at Mount Auburn Hospital in Cambridge, Massachusetts, and the former president of the International Society of Travel Medicine (ISTM).

Routine vaccines protect against disease that exists at low levels (chickenpox) or barely exists at all (measles) in the U.S. They also protect against severe disease from diseases that are still present in the United States (influenza or COVID-19). Generally, they’re given in childhood or adolescence—though some are given through adulthood—so it’s always a good idea to double-check your vaccination records.

When traveling, routine shots are especially important because international travel increases your chances of both contracting and spreading diseases that aren’t common in the U.S. A good example of this is measles. While it’s practically non-existent in the U.S., international travel increases your risk of exposure and popular destinations including Europe still have measles outbreaks.

It’s worth double checking your status even if you think you’re up to date: “During the pandemic, some routine vaccination programs may have suffered lapses, so there is concern that diseases may become more common,” says Dr. Chen.

The routine vaccination recommendations have also changed over the years (the addition of the COVID-19 vaccine to the list is an example) and it’s easy to let vaccines like tetanus ( generally needed every 10 years ) lapse.

“It is even recommended at this time that certain adults who are traveling who have not had a polio vaccine for many years and are traveling to a risk area get an additional dose of the polio vaccine,” says Elizabeth D. Barnett , M.D., a professor at Boston University Medical School and a leader in the field of travel and tropical Medicine.

If you’re traveling with a child , talk to your pediatrician: Rules around vaccination can be different for babies traveling internationally. A baby who is not leaving the U.S., for example, gets their first dose of the MMR vaccine at 12 months; if they will be leaving the country, they get the first dose at six months .

Utilize official resources to learn more about vaccination recommendations around the world

“Understanding the epidemiology of where diseases are circulating is really important,” says Dr. Chen.

That’s why, generally, she sends travelers to the CDC’s website , which outlines exactly what additional vaccines you may need for essentially every country in the world. All you have to do is plug in your destination and you’ll find information about vaccines and medications, health travel notices, COVID-19 travel information, and more.

Start a conversation with your primary care doctor—then consider seeing a travel medicine specialist

It’s always good to start a conversation with your primary care doctor about vaccines before you travel, but if your itinerary is complex, involving multiple countries, being in rural areas, areas without good hygiene, or areas where you may not be able to protect yourself from mosquito- or food-borne illnesses, or if you have questions based on what you found on the CDC website or your own personal health history, consider asking your physician for a referral to a travel medicine specialist or travel clinic.

After all, when it comes to vaccinations required for travel, it’s not just about where you travel, but how you travel.

“The art of travel medicine is listening to where the person is going, what they're going to be doing, and making a decision based on the risk-benefit ratio,” says Dr. Barnett. A travel medicine doctor will be able to analyze disease trends and trip details such as how long you’ll be traveling or how well you’ll be able to protect yourself against mosquitoes. “You have to really dig into those things,” she says.

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Take a vaccine called the Japanese encephalitis vaccine, which prevents a type of encephalitis (inflammation of the brain). “We can't just say the risk is present in a specific country, because the risk depends on the time of year, whether the disease is being transmitted at that time, the exact location—rural areas, especially farming regions are associated with much higher risk — whether there's a local outbreak situation going on, and more.”

You may not be able to get every shot you need at your primary care doctor’s office either. The yellow fever vaccine, for example (which you may need if you’re traveling somewhere like Sub-Saharan Africa or specific parts of South America), is only available at special travel clinics or public health settings, says Dr. Barnett. You can find a list of travel medicine clinics on the CDC’s website.

Your health background (what diseases you’ve had in the past, whether or not you’re immune-suppressed, and if you’re more predisposed to a certain condition) also play a role in what vaccines to consider. (A very small subset of people vaccinated against yellow fever, for example, experience severe adverse events, says Dr. Barnett.)

The bottom line

For many people and many trips, discussing travel plans with your primary care doctor and using the CDC’s destination feature for vaccine guidance will suffice. Other, more complex trips require a visit to a travel clinic. If you’re aiming to get into one, start the process at least a month before your departure date—appointments can be hard to get and your body needs time to build up immunity from any additional vaccines you may require.

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immunizations for overseas travel

Joel Streed

9 common questions about vaccines and travel

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Travel does more than just transport you to a different place. It can broaden your perspective, increase your happiness, give you a chance to try new things, boost your creativity and help you recharge. Even planning a trip can be an exciting task. The anticipation of mapping an itinerary and scheduling your must-see attractions can bring a lot of joy and happiness.

One of the most important tasks before taking a trip is to make an appointment with a travel medicine specialist. These health care professionals help keep travelers safe and happy before and after their journeys.

Here are answers to common questions about travel medicine:

1. who should make an appointment with a travel medicine specialist.

Anyone planning a trip overseas can benefit from seeing a travel medicine specialist. However, a travel clinic appointment is critical if you are traveling to underdeveloped or developing countries where there's a higher risk of contracting severe communicable illnesses while abroad. It is also important for patients with certain medical conditions that make their immune systems weaker and more vulnerable to infectious diseases.

2. What vaccinations do I need to travel overseas?

All travelers should be vaccinated against the flu and current with COVID-19 vaccines and boosters.

In addition, it's important to complete the adult vaccination schedule that includes vaccinations for:

  • Chickenpox (varicella)
  • Diphtheria, tetanus and pertussis (DTP)
  • Pneumococcal
  • Measles, mumps and rubella (MMR)

Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary.

3. Are there travel destinations that have different vaccination recommendations?

Yes. Infectious diseases thrive in different climates. If you travel to a new climate, you may be exposed to diseases to which you don't have any immunity.

Some infections are more prevalent in tropical settings compared to temperate climates. For example, typhoid and hepatitis A are more common in Southeast Asia because these communicable diseases can be spread through contaminated water. Some areas of Africa and South America have a higher prevalence of yellow fever and malaria, which are mosquito-borne infections.

The  Centers for Disease Control and Prevention (CDC)  has good information online for travelers for each travel destination.

Recommended vaccines may include:

  • Hepatitis A
  • Hepatitis B
  • Japanese encephalitis
  • Yellow fever

4. Can my primary care provider give me travel vaccinations?

It depends on your travel destinations and vaccine recommendations. I recommend starting the conversation with your primary care provider and reviewing the  CDC recommendations .

If you have a complex itinerary with multiple countries or are traveling to Southeast Asia or Africa, it's better to make an appointment at the travel clinic. I also would recommend patients with organ transplants and immunocompromising conditions seek travel medicine consultation to reduce the risk of illness during travel. During that appointment, we will review your itinerary, provide necessary vaccinations and discuss ways to prevent mosquito-borne or tick-borne diseases.

5. How long before my trip should I go to the travel clinic?

Plan to have an appointment at least four weeks before you travel. Some vaccines require several weeks for immunity to develop, while others require more than one dose of vaccine for full protection.

If your trip is to an underdeveloped or developing country, you may need to schedule an appointment up to two months in advance to receive a complete set of immunizations. This gives your body time to produce the protective antibodies, so you are well protected when you land at your destination.

6. Can I only go to the travel clinic before I travel?

No. The Travel and Tropical Medicine Clinic is available before or after travel. The team can provide consultative services and treatment if you get sick after you return home.

7. I'm going to an all-inclusive resort. Will I have a lower risk of getting sick?

Maybe, but no traveler should take safety for granted. Even in an all-inclusive resort, knowing how food is prepared or the water supply quality is not possible. Mosquitos and other insects could still be a concern. It's important to take all necessary precautions and follow vaccination recommendations when you travel, regardless of your accommodations.

8. How do I lower my risk of malaria when traveling?

Malaria is a disease caused by a parasite. It's spread to humans through the bites of infected mosquitoes. Prophylactic malaria medications are available and are started before the travel, continued during the stay and for a certain duration after returning home. A travel medicine specialist can review the risks and benefits of all prevention and treatment options.

9. How do I stay healthy while traveling?

Nothing can ruin a trip like illness. Make sure all your vaccinations and boosters are up to date, and get any new vaccinations recommended for your destinations.

Food and water safety is important while traveling. Only eat well-cooked food. Avoid eating from roadside stands and uncooked foods, like salad and raw vegetables. Drink bottled beverages only, including bottled water. This is especially important if you travel in resource-limited regions, such as Southeast Asia or Africa.

Hand hygiene is important at home and overseas. Wash your hands often using soap and hot water. Avoid crowded places, follow respiratory etiquette and consider optional masking. Mosquitos and bugs can transmit parasites and diseases, like yellow fever and malaria. Use mosquito repellents. Mosquito nets may be appropriate in some parts of the world, as well.

As you make travel plans, schedule an appointment with a travel medicine specialist to get the vaccinations and information you need to be healthy and safe on your journey.

Raj Palraj, M.D. , is a physician in  Infectious Diseases  and  Travel and Tropical Medicine  in  La Crosse , Wisconsin.

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Updates on U.S. Travel Policy Requiring Vaccination

Press Statement

Ned Price, Department Spokesperson

October 25, 2021

Today, the White House and CDC announced details of the new vaccination policy that will go into effect for international travelers on November 8.  As of that date, foreign national air travelers to the United States will be required to be fully vaccinated and to provide proof of vaccination status prior to boarding an airplane to the United States.

This policy prioritizes public health, protecting U.S. citizens and residents as well as those who come to visit us.  Because it puts public health first, exceptions to this policy will be extremely limited:  including children under 18 and certain individuals in countries where vaccines are not yet readily accessible.

The updated travel guidelines also include new protocols around testing. To further strengthen protections, unvaccinated travelers – whether U.S. Citizens, lawful permanent residents (LPRs), or the small number of excepted unvaccinated foreign nationals – will now need to test within one day of departure.

For those who are vaccinated, the testing requirement remains three days before their flight. Ensure that you are ready to travel internationally and return by reviewing the information at  COVID-19 Traveler Information (state.gov)  and at  cdc.gov .

This policy will allow the resumption of regular international travel for those who are fully vaccinated.  Families and friends can see each other again, and tourists can visit our national parks and famous landmarks.  This policy will further boost economic recovery across the United States, and we are pleased to see it go into effect on November 8.

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COVID-19 international travel advisories

If you plan to visit the U.S., you do not need to be tested or vaccinated for COVID-19. U.S. citizens going abroad, check with the Department of State for travel advisories.

COVID-19 testing and vaccine rules for entering the U.S.

  • As of May 12, 2023, noncitizen nonimmigrant visitors to the U.S.  arriving by air  or  arriving by land or sea  no longer need to show proof of being fully vaccinated against COVID-19. 
  • As of June 12, 2022,  people entering the U.S. no longer need to show proof of a negative COVID-19 test . 

U.S. citizens traveling to a country outside the U.S.

Find country-specific COVID-19 travel rules from the Department of State.

See the  CDC's COVID-19 guidance for safer international travel.

LAST UPDATED: December 6, 2023

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9 Immunizations You Should Have Before Traveling Abroad

Woman who has gotten travel vaccines

Immunization before travel protects your own health and your investment in your trip. Expert travelers know that nothing ruins time at a special destination like getting sick. Immunization also protects you against diseases with long-term health consequences, like polio or encephalitis.

That is why, since 1944, international travelers have needed immunizations for travel. The goal then and now is to promote public health and reduce the spread of diseases. After 2021, many countries updated their visa and visitor requirements to require immunization against COVID-19, though many of these have since been lifted.  Read on to learn about immunization and travel today.

Related: Travel Insurance Requirements Keep Changing – Here are the Latest Mandates

Some Countries Still Require COVID-19 Immunization

Many countries have lifted their COVID-19 immunization and testing requirements for non-citizens and visitors to travel and visit. But in some places, things are still changing. Since each country has its own specific regulations, check to see what your destination requires. For a good example of this type of travel requirement, see the United States former COVID-19 vaccine requirements for international travelers .

How do you find out what you need for your own trip? First, check your specific destination and the airline you are using. If your destination requires COVID-19 immunization, check the types of COVID-19 vaccine your destination accepts. Some countries approve specific COVID-19 vaccines: others approve nearly all COVID-19 vaccinations.

While it’s rarer these days, you may still need to provide proof of immunization to your airline to book travel and board flights. Customs may ask you for proof when you are traveling. At your destination, you may need to show proof of immunization again to enter restaurants or lodging.

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Your Destination May Require Yellow Fever Immunization

Yellow fever is a disease transmitted by mosquitos that is endemic in parts of Africa and Central and South America. Over 60 countries have standards around yellow fever immunization for travelers. If you are traveling to or transiting through countries where yellow fever is present, get immunized against yellow fever before you go. Many countries will refuse entry if you have traveled through a yellow fever risk country and you do not have a valid yellow fever vaccination certificate. Learn more about countries with travel requirements for yellow fever immunization from the World Health Organization .

Get Up to Date with Routine Immunizations Before Travel

To reduce your risk of unexpected illness, many medical authorities recommend routine immunizations for travel. Both the World Health Organization and the United States Center for Disease Control (CDC) recommend that travelers are up to date with routine immunizations. These include:

  • Diphtheria-Tetanus-Pertussis (whooping cough)
  • Measles-Mumps-Rubella (MMR)
  • Typhoid Fever

As of 2022, polio was reappearing in more countries. The CDC has travel advisories around polio , recommending polio immunizations for high-risk destinations. India requires visitors coming from countries with endemic polio to have a current oral polio vaccine . Long-term visitors to Pakistan , visiting four weeks or longer, must provide proof of polio immunization to leave Pakistan.

Vial of Meningococcal vaccine

Some Destinations Call for Additional Immunizations

Some countries require or recommend that you have additional immunizations before you travel there. You may also want to safeguard yourself in remote locations with important selective vaccines.

If you plan to visit Saudi Arabia and see the global destination of Mecca, you must meet their meningitis immunization requirements . Meningococcal meningitis vaccines are also recommended for travel in many countries in sub-Saharan Africa .

Hepatitis A immunizations are recommended for most countries. Hepatitis B immunizations are recommended for many destinations in Asia and the Pacific, as well as Africa, South America and the Caribbean. These vaccines are usually three shots over a six-month period, so plan to get these well in advance.

Japanese encephalitis is an infection transmitted by mosquito bites. It causes a dangerous inflammation of the brain, and there is no cure for it. While the risk of a serious case of Japanese encephalitis is low, it is worthwhile getting vaccinated against it if you are visiting Asia, India, the South Pacific, and Australia.

Getting a rabies vaccine is worthwhile if you are traveling to have experiences with wild animals. Wildlife volunteers, and travelers who enjoy caving and spelunking, are at risk of rabies from animal bites or bat exposure in many locations.

Traveler with international vaccine record in back pocket of jeans

How to Provide Proof of Immunization for Travel

Doctors recommend getting most travel immunizations four to six weeks before you travel. This ensures that immunization takes effect. It also gives you time to get your proof of immunization for travel.

Many travel-related vaccines will be recorded in a signed printout called the International Certificate of Vaccine or Prophylaxis (ICVP) . This distinctive yellow document records which immunizations you have received and when. It is most often used to record yellow fever vaccines. The ICVP is not currently used for COVID-19 vaccination records.

Most countries that were requiring proof of COVID-19 immunization are no longer requiring that proof. However, the World Health Organization has launched a system called the Global Digital Health Certification Network to help track vaccinations internationally. This system seeks to protect against present threats as well as any future pandemics.

If you are traveling with children, make sure they are up to date on their vaccines before they travel. You will be responsible for providing their proof of immunization at borders and transit points, along with their passports and tickets.

Does Insurance Cover Travel Immunizations?

Travel immunizations are not always covered by standard health insurance. But it is worth asking, because your insurance may cover some or all immunizations.

It’s possible to get travel immunizations at a reasonable cost. Travel health clinics charge a premium to immunize you quickly. You can shop around for less expensive immunizations – your family doctor can help. They may even be able to provide some travel immunizations for free under public health policies.

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Get Accurate Information for Your Destination

To confirm vaccination requirements for your destination, go directly to official visa or immigration authorities. Each country has its own requirements. Your home country, countries you’ve visited, and countries where you have travel transfers all affect immunization requirements.

Many private websites claim to have vaccination information for travelers. But it is often incomplete, out of date, or echoes World Health Organization recommendations (which are not the same as visa requirements).

At this time, immunization requirements change often. Along with official immigration websites, here are reliable sources with information on immunizations needed for travel:

  • United States Center for Disease Control – Travelers’ Health: Destinations
  • United Kingdom National Health Service – Fit for Travel
  • European Union – Travel and COVID: Rules and Restrictions

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  • About the Handbook

Vaccination for international travellers

Ensure that travellers are up to date with routine vaccines. Also consider other vaccines based on travel itinerary, activities and risk of disease exposure.

Recently added

This page was added on  09 June 2018 .

Updates made

This page was updated on 23 October 2023 .  View history of updates

Millions of Australians travel overseas every year. More than half of these trips are to destinations other than New Zealand, North America and Europe. 1

This page helps with making decisions about travel vaccines. Also check the disease-specific chapters in this Handbook for details about specific vaccines.

See also Infographic. Vaccination for international travellers .

Health risks of overseas travel

Health risks associated with international travel include exposure to:

  • infective agents
  • altitude and temperature extremes
  • other physical, psychological and environmental hazards
  • poor-quality or limited access to clean water, shelter, hygiene and sanitation facilities, and health and medical care

The level of health risks depends on factors such as:

  • the traveller’s underlying physical and mental health and physiological state
  • the itinerary and activities undertaken
  • the duration of exposure to various hazards during travel

Travellers at increased risk of serious travel-associated infections include:

  • young children and infants
  • pregnant women
  • people with underlying medical conditions, especially immunocompromising conditions due to disease or medical treatment
  • people spending extended periods in multiple regions with poor resources or in remote areas
  • people participating in events where large numbers of people will gather, such as major sporting, cultural, social or religious events
  • migrant families travelling back to their region of origin to visit friends and relatives

Those travelling to visit friends and relatives are more likely to: 2

  • have closer contact with local populations
  • stay in remote or rural areas
  • consume higher-risk food and beverages

Those travelling to visit friends and relatives are less likely to: 2,3

  • recognise the health risks associated with travelling
  • seek pre-travel health advice
  • obtain the recommended vaccines or prophylaxis

Common infections acquired by travellers

Exposure to infectious diseases is one of the many health hazards of international travel. Some of these diseases are vaccine preventable. Although some of these diseases are present in Australia, the risk of acquiring them overseas may be higher because of:

  • higher disease incidence in other countries
  • increased risk of exposure from participating in certain activities while travelling

Foodborne and waterborne infections

It is common for travellers to ingest contaminated food or beverages, resulting in an illness. 4-6  Practicing safe eating and drinking habits is essential to minimise the risk of contracting food and waterborne diseases while travelling. These include treating water or only drinking bottled water, avoiding undercooked meat, and avoiding raw fruit and vegetables (unless they can be peeled or washed in safe water prior to eating). Most infections are diarrhoeal diseases due to enteric pathogens, but some are due to extra-intestinal microorganisms, such as hepatitis A virus and Salmonella enterica serotype Typhi (causing typhoid).

Vaccines are available against hepatitis A, typhoid and cholera.

Vector-borne infections

Insect-borne — especially mosquito-borne — infections, such as malaria and dengue, are important causes of fever in Australian travellers returning from endemic areas, particularly Southeast Asia and Oceania. 4,6

A dengue vaccine (Dengvaxia) is available for the prevention of secondary dengue infections (not primary prevention of initial dengue infection ) in select individuals. See Clinical advice: ATAGI statement on use of Dengvaxia® for Australians .

Japanese encephalitis occurs throughout much of Asia and the Western Pacific region, including eastern Indonesia and Papua New Guinea. 7 Yellow fever occurs only in parts of Africa and South America, 8 and tick-borne encephalitis occurs in parts of Europe and Asia. 9

Vaccines are available against Japanese encephalitis , yellow fever and tick-borne encephalitis .

Some other vector-borne diseases and parasitic (including protozoal and helminthic) diseases are also important for international travellers. Some are preventable through appropriate barrier precautions and chemoprophylaxis (for example, malaria). 9

Aerosol-borne infections

Vaccine-preventable infections transmitted by aerosols and/or droplets include: 9

  • influenza (the most common vaccine-preventable infection among travellers) 10
  • meningococcal disease
  • varicella (chickenpox)

The incidence of measles and mumps is higher in many overseas countries, including some developed countries, than in Australia.

Tuberculosis is a rare infection in travellers. 11 Expatriates who live in endemic areas for a long time are more likely to acquire tuberculosis than short-term visitors. 12

Vaccines are available against all of these diseases.

Bloodborne and sexually transmitted infections

Some Australian travellers may be at risk from bloodborne and sexually transmissible infections, such as chlamydia, gonorrhoea, hepatitis B, hepatitis C and HIV. In some areas, healthcare workers using non-sterile medical equipment or other poor infection control practices may transmit these viruses and other bloodborne agents.

Vaccines are available against hepatitis B.

Exotic infectious agents

Travellers may be exposed to a variety of other exotic infections, such as:

  • rabies from bites or scratches from rabid dogs, bats and other mammals in many countries
  • schistosomiasis from exposure to water infested with the parasites, especially in Africa
  • leptospirosis through activities such as rafting or wading in contaminated streams

Of these diseases, vaccines are available only against rabies.

Recommending travel vaccines

Although recommending appropriate vaccines is important, it is not the only part of a pre-travel medical consultation. Travel vaccines — those relevant for travelling — include all relevant vaccines, not just the ones that prevent diseases that most commonly occur overseas.

Do not recommend a vaccine based only on the destination country, because there is no single ‘correct’ list of vaccines for travel to any particular country.

There are 3 categories of travel vaccines:

  • routinely recommended vaccines (not specific to travelling overseas)
  • selected vaccines based on travel itinerary, activities and likely risk of disease exposure
  • vaccines required by the International Health Regulations 2005 (IHR) or for entry into specific countries

Questions for a pre-travel medical consultation

During a pre-travel medical consultation, ask questions about the traveller’s:

  • personal information, including age and whether they are pregnant or planning pregnancy
  • underlying medical conditions, particularly immunocompromising conditions, and current medicines
  • vaccination history (including adverse events following immunisation) and allergy history
  • purpose of travel and intended activities, especially those associated with various environmental risks and hazards
  • plans for travel insurance

Also ask about their itinerary in detail, including:

  • date of departure and time available for vaccinations
  • specific localities and routes
  • rural versus urban stay
  • duration of stay
  • likely access to health care and other services
  • likelihood of changing the planned itinerary

This information helps to tailor recommendations about preventive vaccination or chemoprophylaxis for exposure risks during the proposed trip. It also allows the clinician to advise about other appropriate preventive health measures (for example, food and water precautions, avoiding bites from mosquitoes or other arthropods) and about managing possible health conditions during travel.

Organisational requirements for vaccination

Some overseas organisations, such as schools, colleges and universities, require evidence of vaccination or immunity against some vaccine-preventable diseases, such as measles and meningococcal disease. Consider these requirements when planning and scheduling vaccines before departure.

Routinely recommended vaccines (not specific to travelling overseas)

Vaccinate all prospective travellers according to the recommended vaccination schedule appropriate for their age, underlying health conditions, occupation and lifestyle. Vaccines might include, for example, pneumococcal polysaccharide vaccine for an older person, or hepatitis B vaccine for a first aid officer. 

Also ensure that all children are vaccinated according to the National Immunisation Program schedule. In exceptional circumstances, give the National Immunisation Program vaccines at the minimum age rather than the recommended age (see Table. Minimum acceptable age for the 1st dose of scheduled vaccines in infants in special circumstances ). Children vaccinated using the minimum age rather than the recommended age may need extra vaccine doses to ensure adequate protection. Observe the minimum interval requirements between doses (see Table. Minimum acceptable dose intervals for children <10 years of age ). The chances of being exposed to some diseases, such as measles and mumps, may be greater during overseas travel, even to other developed countries.

For some itineraries, it may be appropriate for the traveller to receive some booster doses earlier than the routine recommended time. An example may be diphtheria-tetanus booster.

Diphtheria, tetanus and pertussis

Vaccinate adult travellers against tetanus before departure, particularly if:

  • their risk of sustaining a tetanus-prone wound is high
  • there could be delays in accessing health services where they can receive tetanus toxoid boosters safely, if required

Offer dTpa vaccine during a pre-travel consultation if the traveller has never received a dose of dTpa . This provides protection against pertussis (see Pertussis ). 

For high-risk travel, consider giving a booster dose of either dTpa or dT vaccine if more than 5 years have passed (see Tetanus ).

Hepatitis B

Most Australian children born since 2000 have been vaccinated against hepatitis B under the National Immunisation Program or state and territory school-based vaccination programs.

Hepatitis B vaccine is recommended for long-term or frequent travellers to regions of intermediate or high endemicity of hepatitis B, including:

  • Central and South America

This is because travellers may be exposed to hepatitis B virus through bloodborne routes (including during emergency medical or dental procedures) or sexual routes. According to 1 survey, about half of Australian travellers who spent at least 3 nights in Southeast or East Asia participated in at least 1 activity that had a risk of hepatitis B transmission. 13

See also Hepatitis B .

Influenza and pneumococcal disease

Older travellers and those with any relevant underlying medical or behavioural risk factors should receive pneumococcal vaccine. See Pneumococcal disease for more details.

Consider influenza vaccine for all travellers, especially if they are travelling to a region during its influenza season. Influenza vaccine is particularly relevant if:

  • there is an influenza epidemic at the traveller’s destination
  • the person is travelling in a large tourist group, especially one that includes older people
  • the person is travelling on cruises, where people are relatively confined for days to weeks

See also Influenza. 

Measles, mumps and rubella

Inadequately vaccinated young adult travellers are responsible for most current measles outbreaks in Australia. This occurs when they acquire the infection overseas and bring it back to Australia. Some countries, regions or communities — including developed countries — have a higher incidence of measles and mumps than Australia. 9

Australians born during or since 1966 who have not received the recommended 2 doses of MMR (measles-mumps-rubella)–containing vaccines are recommended to receive MMR vaccine before travelling. This also applies to infants 6–12 months old travelling to areas with measles outbreaks or where measles is endemic . The exception is for pregnant women, because MMR is a live vaccine and is contraindicated in pregnancy. 

People born before 1966 do not need to receive measles-containing vaccine (unless serological evidence indicates that they are not immune). This is because circulating measles virus and disease were prevalent before 1966, so most people would have acquired immunity from natural infection .

However, confirmed cases of measles have occurred in people born before 1966. 14 If in doubt about a person’s immunity, it may be faster and easier to vaccinate the person than conduct serological testing . See Serological testing for immunity to measles . 

See also Measles . 

Unvaccinated travellers are recommended to receive varicella vaccine if they either:

  • have not had clinical disease, or
  • have an uncertain history of clinical disease and serology shows a lack of immunity 

The exception is for pregnant women, because varicella vaccine is a live vaccine and is contraindicated in pregnancy.

See also Varicella .

Meningococcal disease

Vaccination against meningococcal serogroups A, C, W-135, Y and B is recommended for certain age and population groups who are at increased risk of meningococcal disease.

In addition, MenACWY (quadrivalent meningococcal) vaccine is recommended for people who are:

  • planning travel to, or living in, parts of the world where epidemics of serogroup A, C, W-135 or Y meningococcal disease occur, particularly the ‘meningitis belt’ of sub-Saharan Africa 15
  • planning travel to mass gatherings, such as pilgrims travelling to the Hajj in Saudi Arabia

Seek up-to-date epidemiological information to determine whether a traveller needs meningococcal vaccination. See Accessing up-to-date travel information.

The Saudi Arabian authorities require that all pilgrims travelling to Mecca (for the Hajj or Umra) have evidence of recent vaccination with the quadrivalent meningococcal vaccine. 16  See Requirements for travellers to Mecca and Accessing up-to-date travel information .

See also Meningococcal disease .

Poliomyelitis

Ensure that all travellers are age-appropriately vaccinated against polio (see Poliomyelitis ).

If the person is travelling to a country where wild poliovirus is still circulating, they should receive inactivated poliovirus ( IPV ) vaccine if they have not completed a 3-dose primary course of any polio vaccine. Travellers who have completed the primary course should receive a single booster dose.

The World Health Organization (WHO) Global Polio Eradication Initiative website website has an up-to-date list of polio-affected countries.

Documented evidence of polio vaccination is not routinely required for travellers under the International Health Regulations. However, documented evidence of vaccination may be temporarily required according to WHO recommendations in response to new evidence of the spread of wild poliovirus (see Vaccines required by the International Health Regulations or for entry into specific countries and Documentation and certificates ).

International polio epidemiology and associated travel requirements can change. Check the Australian Government Department of Health website for current recommendations for Australian travellers .

Ensure that all travellers are age-appropriately vaccinated against COVID-19. Foreign governments may require evidence of COVID-19 vaccination before a traveller is allowed to enter. The Australian-issued International COVID-19 Vaccination Certificate is a secure way to prove COVID-19 vaccination history that has been developed to meet agreed international travel standards. Parents and carers of children <14 years of age, adolescents ≥14 years of age and adults can get a copy of their COVID-19 vaccination certificate at any time:

  • using their Medicare online account through myGov
  • through the Medicare Express Plus mobile app
  • by calling 1800 653 809 (free call)

See also COVID-19 .

Vaccines based on travel itinerary, activities and likely risk of disease exposure

Use a risk assessment approach when recommending travel vaccines. Weigh the potential risks of disease exposure and protective benefits from vaccination against potential adverse effects, and the non-financial and financial costs of vaccination.

Prioritise vaccines for diseases that are:

  • common and of significant impact, such as influenza and hepatitis A
  • less common, but have severe potential adverse outcomes, such as Japanese encephalitis and rabies

Consider booster doses, where appropriate (see disease-specific chapters in this Handbook for recommendations). If the person is departing for travel soon, consider an accelerated schedule, if appropriate, such as for hepatitis B vaccine or the combination hepatitis A-hepatitis B vaccine (see Hepatitis A and Hepatitis B ). Although immunity may be established sooner with the accelerated schedule, people who receive an accelerated schedule need another dose about a year later to complete the course and ensure long-term protection.

Most travellers do not need cholera vaccine. 16,17  The risk of a traveller acquiring cholera is very low if they avoid contaminated food and water.

No country requires travellers to have certification of cholera vaccination. No country has official entry requirements for cholera vaccination

See also Cholera .

Hepatitis A

Hepatitis A vaccine is recommended for all travellers ≥1 year of age travelling to moderately or highly endemic countries (including all developing countries). The exceptions are people who have evidence of natural immunity after previous infection .

Normal human immunoglobulin is no longer used to protect travellers against hepatitis A.

See also Hepatitis A .

Japanese encephalitis

While now considered an emerging disease in Australia, Japanese Encephalitis is more likely in travellers to endemic regions overseas. 18 Japanese encephalitis ( JE ) vaccine is recommended for travellers spending a month or more in endemic areas in Asia, Papua New Guinea or the outer islands of Torres Strait during the JE virus transmission season.

Consider JE vaccination for shorter-term travellers, particularly if:

  • travel is during the wet season 
  • travel may be repeated
  • the person will spend a lot of time outdoors 
  • the person’s accommodation has no air-conditioning, screens or bed nets

Check a reputable source before travel for information about JE virus activity — for example, Health Information for International Travel (the ‘Yellow Book’) . 19

A traveller’s overall risk of acquiring JE in these JE - endemic countries is likely to be low (<1 case per 1 million travellers). Determine the specific risk according to the: 17

  • season of travel
  • regions visited 
  • duration of travel
  • extent of outdoor activity
  • extent to which the person avoids mosquito bites 

See also Japanese encephalitis .

Before travel to rabies- endemic regions, advise people about:

  • the risk of rabies infection
  • avoiding close contact with wild, stray and domestic animals — especially dogs, cats, monkeys and bats 
  • the importance of appropriate immediate wound care of all animal bites and scratches 

See also Rabies and other lyssaviruses, including Australian bat lyssavirus .

Recommendations for rabies vaccination as pre-exposure prophylaxis

When deciding whether to give a pre-travel prophylactic rabies vaccination, assess the:

  • likelihood of exposure to potentially rabid animals
  • access to appropriate health care and availability of post-exposure prophylaxis , including rabies immunoglobulin , should there be an at-risk exposure
  • timeliness of access to health care after exposure

Use a lower threshold for recommending rabies pre-exposure prophylaxis for children travelling to endemic areas.

Benefits of vaccination as pre-exposure prophylaxis

Pre-travel rabies vaccination:

  • ensures that the traveller has received a safe and efficacious vaccine
  • simplifies the management of a subsequent exposure because the person will need fewer doses of vaccine
  • means that rabies immunoglobulin — which is often extremely expensive, and difficult or even impossible to obtain in many developing countries — is not needed
  • reduces the urgency of post-exposure prophylaxis

Tick-borne encephalitis

Tick-borne encephalitis (TBE) is caused by a tick-borne RNA flavivirus. The disease may involve the central nervous system. TBE is prevalent in parts of central and northern European temperate regions, and across northern Asia. Travellers are at risk when hiking or camping in forested areas in endemic regions during the summer months.

Safe and effective vaccines are available. Vaccination is recommended only for people with a high risk of exposure.

TBE vaccine is not registered in Australia, but a small stock of vaccine may be available for use under the Special Access Scheme .

Tuberculosis

Vaccination with BCG (bacille Calmette–Guérin) vaccine is generally recommended for tuberculin-negative children <5 years of age who will be staying in high-risk countries for an extended period (3 months or longer).

Vaccinating older children and adults appears to be less beneficial. However, consider vaccinating tuberculin-negative children aged ≥5 years but <16 years who may be living or travelling for long periods in high-risk countries.

A high-risk country is one that has a tuberculosis incidence of >40 per 100,000 population.

For travellers who need BCG vaccine, consider the following precautions when scheduling their vaccination visits:

  • If possible, give BCG vaccine at least 3 months before the person will arrive in an endemic area.
  • Give other live viral vaccines (for example, MMR , varicella, yellow fever) at the same time or with a minimum 4-week interval after BCG vaccination.
  • A tuberculin skin test (TST; Mantoux), performed by trained and accredited healthcare practitioners, is recommended before receiving BCG vaccine for all individuals (except infants aged <6 months).
  • People may suppress reactions to tuberculin for 4–6 weeks after viral infections or live viral vaccines, particularly measles infection and measles-containing vaccines.

State and territory tuberculosis services can provide tuberculin skin tests and BCG vaccine.

See also Tuberculosis .

Typhoid vaccine may be recommended for travellers ≥2 years of age travelling to endemic regions, including: 

  • the Indian subcontinent
  • most Southeast Asian countries 
  • several South Pacific nations, including Papua New Guinea 

This advice is also relevant for those travelling to endemic regions to visit friends and relatives.

Inactivated parenteral and live oral typhoid vaccine formulations are available.

See also Typhoid fever .

Yellow fever

Yellow fever vaccine is recommended for all people ≥9 months of age travelling to, or living in, an area with a risk of yellow fever virus transmission. 20

To minimise the risk of introducing yellow fever, some countries require documented evidence of yellow fever vaccination for entry, in line with the International Health Regulations (see Vaccines required by the International Health Regulations or for entry into specific countries ).

When assessing the need for yellow fever vaccination, consider:

  • the risk of the person being infected with yellow fever virus
  • country entry requirements
  • individual factors such as age, pregnancy and underlying medical conditions 

Vaccination is generally not recommended for travel to areas with a low probability of yellow fever virus exposure — that is: 

  • where human yellow fever cases have never been reported 
  • where evidence suggests only low levels of yellow fever virus transmission in the past 

However, consider vaccination for a small subset of travellers to lower-risk areas who are at increased risk of exposure to mosquitoes or who are unable to avoid mosquito bites. 20

People aged ≥60 years are at increased risk of severe adverse events after primary yellow fever vaccination. Weigh the adverse effects of vaccinating people in this age group against the potential for yellow fever virus exposure and, in turn, the benefits of vaccination. 17

See also Yellow fever .

Booster doses

Most people do not need a booster dose of yellow fever vaccine. A single dose induces protective antibody levels that last for many decades. However, certain people are recommended to receive a booster if their last dose was more than 10 years ago and they are at ongoing risk of yellow fever virus infection . See Yellow fever .

Vaccines required by the International Health Regulations or for entry into specific countries

Yellow fever requirements.

The International Health Regulations require yellow fever vaccination for travelling in certain circumstances. This is to:

  • protect travellers who are likely to be exposed to yellow fever 
  • stop importation of the virus into countries that have the relevant vectors (see Yellow fever ).

Some countries may require documented evidence of yellow fever vaccination as a condition of entry or exit (see Planning and documenting vaccines ). This includes countries that do not currently have yellow fever circulating.

Australia’s yellow fever travel requirements are detailed in the Australian Government Department of Health’s yellow fever fact sheet .

Contact the relevant embassies or consulates in Australia to confirm the entry requirements for yellow fever vaccination for the countries a traveller intends to enter or transit through. 

Requirements for travellers to Mecca

Each year, Saudi Arabia’s Ministry of Health publishes the requirements and recommendations for entry visas for travellers on pilgrimage to Mecca (Hajj and Umra). 16

For pilgrims travelling directly from Australia, only evidence of MenACWY vaccination is currently mandatory. However, check the current requirements when advising prospective Hajj and Umra pilgrims (see Meningococcal disease and Accessing up-to-date travel information ).

Temporary requirements

The International Health Regulations may temporarily introduce requirements for other vaccine-preventable diseases in response to changes in disease epidemiology that are of international health concern. An example is for polio vaccination.

Because country vaccination requirements are subject to change at any time, confirm all current vaccination requirements for the countries a traveller intends to enter or transit through before travel. See Poliomyelitis and Accessing up-to-date travel information .

Planning and documenting vaccines

Ideally, start vaccination courses early enough before departure to allow:

  • monitoring of any possible adverse events 
  • time for adequate immunity to develop

Requirements for multiple vaccines

A traveller may need multiple vaccines before they depart. Apply the standard recommendations and precautions when giving multiple vaccines (see Administration of vaccines ).

A traveller may need more than 1 clinic visit if they need multiple vaccines or doses (for example, rabies pre-exposure prophylaxis or hepatitis B vaccine). Pay special attention to scheduling of these visits, and consider:

  • dose interval precautions (for example, for multiple live vaccines)
  • requirements for pre-vaccination tests (for example, tuberculin skin test)
  • potential interference by some antimalarials, if relevant (for example, rabies vaccine)

Documentation and certificates

It is important to document travel vaccines: 

  • in the clinic’s record
  • in the traveller’s record that they can carry with them 
  • on the Australian Immunisation Register

The record should also include all the other routinely recommended vaccines that the traveller has ever received. 

For yellow fever vaccination, a traveller needs to have an International Certificate of Vaccination or Prophylaxis (ICVP), which only Yellow Fever Vaccination Centres can provide under the International Health Regulations (see Yellow fever ). 

Travellers may also need an ICVP for other vaccine-preventable diseases, such as polio, based on temporary recommendations.

See also Accessing up-to-date travel information .

Vaccinating travellers with special risk factors

See Vaccination for women who are planning pregnancy, pregnant or breastfeeding , Vaccination for people who are immunocompromised and the disease-specific chapters in this Handbook for recommendations for travellers who are pregnant or immunocompromised.

Accessing up-to-date travel information

International travellers’ health risks constantly change. Up-to-date information, and knowledge of the changing epidemiology and current outbreaks of infectious and emerging diseases are essential. Reliable online information sources include:

  • World Health Organization (WHO) for disease outbreak news, and its Travel and health section for specific advice on travel and health, including travel vaccination recommendations
  • Travelers’ health , United States Centers for Disease Control and Prevention (CDC)
  • Travel health information , Australian Government Department of Health
  • Smartraveller , the Australian Government’s travel advisory and consular information service, which provides up-to-date advice about health, safety and other risks of specific destinations for Australian travellers

The following resources have comprehensive technical advice on international travel and health, including vaccination:

  • the latest edition of WHO’s International travel and health
  • the CDC’s Health Information for International Travel (the ‘Yellow Book’)
  • Australian Bureau of Statistics. 3401.0 – Overseas arrivals and departures, Australia, Mar 2018 (accessed May 2018). 
  • Paudel P, Raina C, Zwar N, et al. Risk activities and pre-travel health seeking practices of notified cases of imported infectious diseases in Australia. Journal of Travel Medicine 2017;24(5):tax044.
  • Heywood AE, Watkins RE, Iamsirithaworn S, Nilvarangkul K, MacIntyre CR. A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports. BMC Public Health 2012;12:321.
  • Chen LH, Leder K, Barbre KA, et al. Business travel-associated illness: a GeoSentinel analysis. Journal of Travel Medicine 2018;25.
  • Angelo KM, Kozarsky PE, Ryan ET, Chen LH, Sotir MJ. What proportion of international travellers acquire a travel-related illness? A review of the literature. Journal of Travel Medicine 2017;24.
  • Freedman DO, Weld LH, Kozarsky PE, et al. Spectrum of disease and relation to place of exposure among ill returned travelers. New England Journal of Medicine 2006;354:119-30.
  • Halstead SB, Hills SL, Dubischar K. Japanese encephalitis vaccines. In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Plotkin's vaccines. 7th ed. Philadelphia, PA: Elsevier; 2018.
  • Staples JE , Monath TP, Gershman MD, Barrett AD. Yellow fever vaccines. In: Plotkin SA, Orenstein WA, Offit PA, Edwards KM, eds. Plotkin's vaccines. 7th ed. Philadelphia, PA: Elsevier; 2018.
  • World Health Organization (WHO). Chapter 6: Vaccine-preventable diseases and vaccines . In: International travel and health. Geneva: WHO; 2017. 
  • Steffen R. Travel vaccine preventable diseases-updated logarithmic scale with monthly incidence rates. Journal of Travel Medicine 2018;25.
  • Denholm JT, Thevarajan I. Tuberculosis and the traveller: evaluating and reducing risk through travel consultation. Journal of Travel Medicine 2016;23.
  • Lachish T, Tenenboim S, Schwartz E. 35 - Humanitarian Aid Workers. In: Keystone JS, Kozarsky PE, Connor BA, et al., eds. Travel Medicine (Fourth Edition). London: Elsevier; 2019. (Accessed 6 July 2023). https://www.sciencedirect.com/science/article/pii/B9780323546966000355
  • Leggat PA, Zwar NA, Hudson BJ. Hepatitis B risks and immunisation coverage amongst Australians travelling to Southeast Asia and East Asia. Travel Medicine and Infectious Disease 2009;7:344-9.
  • Winkler NE, Dey A, Quinn HE, et al. Australian vaccine preventable disease epidemiological review series: measles, 2012-2019. Commun Dis Intell (2018) 2022;46.
  • World Health Organization (WHO). Epidemic meningitis control in countries of the African meningitis belt, 2017. Weekly Epidemiological Record 2018;93:173-84.
  • World Health Organization (WHO). International travel and health: health conditions for travellers to Saudi Arabia for the pilgrimage to Mecca (Hajj) . 2017 (accessed May 2018). 
  • Freedman DO, Chen LH. Vaccines for International Travel. Mayo Clinic Proceedings 2019;94:2314-39.
  • Furuya-Kanamori L, Gyawali N, Mills DJ, et al. The Emergence of Japanese Encephalitis in Australia and the Implications for a Vaccination Strategy. Trop Med Infect Dis 2022;7.
  • Hills SL, Rabe IB, Fischer M. Infectious diseases related to travel: Japanese encephalitis . In: CDC yellow book 2018: health information for international travel. New York: Oxford University Press; 2017. 
  • World Health Organization (WHO). International travel and health (accessed Apr 2018). 

Page history

Minor updates to clinical guidance around routinely recommended vaccines (not specific to travelling overseas), including the addition of advice regarding COVID-19.

Editorial update to reflect changes to pneumococcal vaccine recommendations for older adults and people with medical risk factors.

Guidance on vaccination of travellers against measles, mumps and rubella updated to reflect advice in the Measles chapter.

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Immunisation for travel

It’s important to protect your health when travelling overseas. You can avoid diseases and other health conditions by planning ahead for any vaccinations you may need.

If you are looking for information COVID-19 vaccines, please visit the  COVID-19 digital certificate page.

Vaccines needed for travel

If you travel outside Australia, you may get sick from a number of diseases that vaccination can prevent. Travellers can bring these diseases into Australia when they return and cause disease outbreaks.

You should always ask your doctor or travel health clinic about vaccinations before you travel.

Your immunity to some diseases may have changed or reduced with time – you may need a booster.

Different countries have different vaccination requirements. The recommended vaccines for travelling depend on a number of factors, including:

  • pregnancy or planning pregnancy
  • underlying medical conditions
  • vaccination history
  • season of travel.

When to get vaccinated

You should consult your doctor or visit a travel health clinic 6 to 12 weeks before you leave Australia.

It is important to see your doctor early. If you do need vaccinations:

  • your body needs time to develop full immunity
  • you may need several doses of a vaccine to achieve full immunity. 

How to check your vaccination record

You may have already received recommended vaccines from previous travel or routine vaccinations. These may be recorded in the Australian Immunisation Register.

The Australian Immunisation Register (AIR) is a national register that records vaccines given to all people in Australia.

The AIR includes vaccines given:

  • Under the National Immunisation Program
  • through school programs
  • privately, such as for flu or travel.

You can check your immunisation record :

  •  online on MyGov through Medicare
  •  via the Express Plus Medicare mobile app
  •  by calling 1800 653 809 (Monday to Friday 8 am to 5 pm).

Cost of vaccines

The vaccines you need for travel may not be covered by the National Immunisation Program. In this case, you will need to buy them. This may involve:

  • getting a prescription for the vaccine
  • buying it from a pharmacy
  • returning to your doctor to give you the vaccination.

The cost of vaccines varies depending on the type, the formula and where you buy them.

Some doctors might have these vaccines available in their clinics. Some pharmacies also offer vaccination services.

Check with your provider when you book your appointment.

How to stay safe overseas

The vaccine information you find on various websites is only a guide. You should not rely on such information. Talk to your doctor or travel health clinic for advice on travel vaccines and how to stay safe while you are overseas.

Find more information:

  • Travel Health Information  for things to consider before you leave, while you are away and when you return.
  • Smartraveller (Department of Foreign Affairs and Trade)
  • Travellers’ health  (US Center for Disease Control & Prevention)

Keep routine vaccinations up to date

Travel is an important time to check whether you and your children are up to date with your vaccinations. This includes routine childhood vaccinations and boosters. Some of these include:

  • measles-mumps-rubella (MMR)
  • diphtheria-tetanus-whooping cough (pertussis)
  • chickenpox (varicella)

Influenza is the most common vaccine-preventable disease caught by travellers.

The chance of getting these diseases may be greater while travelling overseas. Travellers can bring these diseases into Australia. This can lead to disease outbreaks.

Get more about information about routine vaccinations:

  • National Immunisation Program Schedule
  • When to get vaccinated

Diseases to be aware of

Some countries require proof of immunisation for certain infectious diseases before you can legally enter that country. Ask your doctor or travel health clinic if you need proof of immunisation before you travel.

Read about some of the common vaccine-preventable diseases found in other areas of the world.

Cholera is found in places with poor water and waste facilities. It spreads through contaminated food and water and causes severe diarrhoea and dehydration.

Humanitarian disaster workers should get vaccinated for cholera because they are more likely to get infected. Most travellers do not need a cholera vaccination because the risk of getting cholera is very low. 

Your doctor may recommend the cholera vaccine if you have a condition that puts you at greater risk of travellers’ diarrhoea.

Hepatitis A

Hepatitis A is one of the most common vaccine-preventable diseases caught by travellers. It is a liver disease spread by contaminated food and water. It is common in parts of India, Africa, Asia, South and Central America and the Middle East where there is poor sanitation and limited access to clean water.

You and your children over 1 year of age should get a Hepatitis A vaccination if you are travelling to an area where Hepatitis A is common.

Japanese encephalitis

Japanese encephalitis is a serious disease spread by mosquitoes in Asia and the Torres Strait region of Australia. We recommend vaccination against this disease if you are travelling to these parts and will be:

  • travelling in rural areas
  • undertaking certain activities with increased risk of exposure
  • spending a month or more in the region.

You should avoid mosquito bites when you are in these areas.

Meningococcal

Meningococcal disease is a serious disease spread by close contact with an infected person. It is commonly found in sub-Saharan Africa.

Rabies is common to Central and South America, Eastern Europe, Africa and Asia. It is spread from infected animals to humans through bites, scratches and licks to open wounds. It is fatal when left untreated. The animal does not have to appear ill to have rabies. Infected animals can include dogs, monkeys, cats, rats, bats, foxes and chipmunks.

Ask your doctor if you need the rabies vaccine before you travel.

Tuberculosis

Tuberculosis (TB) is a serious disease spread by close contact with an infected person. It is common in developing countries.

We recommend the TB vaccine called BCG for children aged 5 years or under who are:

  • travelling a lot
  • spending a long time in countries where TB is common .

Typhoid is a disease spread through contaminated food and water. It causes diarrhoea and other symptoms. It is common in parts of India, Africa, Asia, South and Central America and the Middle East where there is poor sanitation and limited access to clean water.

Yellow fever

Yellow fever can be a serious disease. It causes fever, yellowing of the skin (jaundice) and damages the liver and kidneys. Mosquitoes spread yellow fever. It is found in Africa, the Caribbean and Central and South America.

You must be immunised for yellow fever before you can legally enter some countries. Only authorised yellow fever vaccination centres can give yellow fever vaccinations and certification. Ask your doctor about this.

Find more information: Yellow fever fact sheet

  • Immunisation
  • Travel health

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  • Clinical Trials

Yellow Fever Vaccine Boosters Needed for Some Travelers

immunizations for overseas travel

According to the U.S. CDC Yellow Book 2024, an international traveler's risk for acquiring Yellow Fever virus is determined by their immunization status and destination-specific and travel-associated factors. 

Since about thirty countries require proof of a pre-arrival yellow fever vaccination, many travelers have questions about the vaccine's long-term efficacy.

On January 22, 2024, the Lancet Global Health recently published results from a systematic review aimed at assessing the necessity of a booster vaccination based on the long-term (10+ years) immunogenicity of primary yellow fever vaccination in travelers and in residents of yellow fever-endemic areas, as well as in specific populations, including children and immunocompromised individuals.

The gathered evidence suggested that a single dose of yellow fever vaccine  provides lifelong protection (overall seroprotection rate 94%) in travelers.

However, in people living with HIV and young children (<2 years), booster doses might still be required because lower proportions of vaccinees were seroprotected ten or more years post-vaccination.

The pooled seroprotection rate was 47% in children and 61% in people living with HIV. 

Lower observed seroprotection rates among residents of yellow fever endemic areas were partly explained by the use of a higher cutoff for seroprotection that was applied in Brazil. No conclusions could be drawn for the sub-Saharan Africa region.

The CDC says most people infected with yellow fever do not get sick or have only mild symptoms. People who get sick will start having symptoms 3–6 days after infection.

According to the CDC, about 12% of people with symptoms develop serious illnesses.

The study was registered with PROSPERO, CRD42023384087. No industry conflicts of interest were disclosed.

Our Trust Standards:  Medical Advisory Committee

Yellow fever cases 2023

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  • Section 2 - Complementary & Integrative Health Approaches to Travel Wellness
  • Section 2 - Telemedicine

Prioritizing Care for Resource-Limited Travelers

Cdc yellow book 2024.

Author(s): Zoon Wangu, Elizabeth Barnett

Malaria Prophylaxis

Travelers’ diarrhea, preventive behaviors.

Travelers seen in pretravel clinic consultations often have financial constraints and must pay out of pocket for pretravel care, because many health insurance plans provide no or limited coverage for travel immunizations and prophylactic medications. Optimizing care for travelers without adequate insurance coverage or with only modest means can challenge the abilities of even the savviest travel medicine clinician. As an example, the estimated cost of a pretravel consultation for a backpacker from the United States planning a 4-week trip to West Africa could easily exceed $1,000 for the initial consultation and vaccinations, excluding malaria prophylaxis.

Travelers on a limited budget might be at increased risk for travel-associated infections because they are more likely to visit remote areas, stay in more modest accommodations, and eat in restaurants with lower hygiene standards. However, the total cost of hospitalization, treatment, and lost wages after becoming ill with a vaccine- or prophylaxis-preventable disease can easily exceed the upfront cost of vaccination and prophylaxis, making the pretravel consultation particularly important. Travelers also must consider the cost and benefit of purchasing travel health insurance and medical evacuation insurance before travel (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ). Use the pretravel consult as an opportunity to help guide travel health recommendations for travelers with financial constraints.

Required Travel Vaccines

Only meningococcal and yellow fever vaccines are required categorically, and then only for some travelers: meningococcal vaccine for pilgrims traveling to Mecca during the Hajj, and yellow fever vaccine for travelers to certain countries in Africa and South America (see Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country ). Prioritize administration and documentation of these vaccines; travelers without them could be denied entry to their destination. Be aware that even travelers staying only briefly in a yellow fever-endemic country (e.g., during an airport layover) might still need evidence of vaccination to be permitted entry to other countries on their itinerary.

In a few specific circumstances, travelers to polio-affected countries might be asked to show proof of polio vaccination before departure if their stay is >4 weeks (see Sec. 5, Part 2, Ch. 17, Poliomyelitis ). Travelers and clinicians should check the Centers for Disease Control and Prevention (CDC) Travelers’ Health website for the latest recommendations for their destinations .

Routine Vaccines

All travelers should be current with routine vaccines before international travel, regardless of destination. The benefits of routine vaccines extend beyond the travel period, and many provide lifelong immunity. Because these vaccines are mass-produced as part of scheduled national childhood and adult vaccination programs, associated costs generally are low, and many insurance companies reimburse the patient for the cost of administration. Travelers also can obtain these vaccines in a health department or primary care setting, where costs might be lower than at a travel clinic.

For travelers not up to date with routine vaccines, prioritize administration of those that protect against diseases for which the traveler is most likely to be at general risk (e.g., hepatitis A, influenza, and measles). Children in the United States routinely receive hepatitis A vaccine, but it is not included in the adult immunization schedule. Some travelers might be immune to diseases for which travel medicine providers would consider immunization; pretravel antibody testing might be covered by insurance when vaccines are not. Assess the time to departure to decide whether to test rather than vaccinate.

Recommended Travel Vaccines

When prioritizing recommended vaccines, consider time until departure (see Last-Minute Travelers , Sec. 2, Ch. 11), risk for disease at the destination, effectiveness and safety of the vaccine, and likelihood of future benefit because of repeat travel. As previously noted, hepatitis A vaccine is not currently listed as a routine vaccine for US adults; however, this vaccine can provide lifelong immunity and clinicians should consider administering it to any traveler not previously vaccinated. Hepatitis B vaccine is recommended for all US adults under age 60; since hepatitis B acquisition is not frequently associated with travel, however, vaccination against hepatitis B might be a lower priority for travelers with limited resources, unless their destinations are areas of high disease incidence or they plan to engage in activities that place them at increased risk of exposure to bloodborne pathogens (see Sec. 5, Part 2, Ch. 8, Hepatitis B ). Typhoid vaccine is ≈50%–80% effective in preventing disease, and protection is not long-lasting. Thus, typhoid vaccine is more critical for travelers to higher-risk destinations where acquiring typhoid is more likely, and to areas where typhoid is harder to treat because of multidrug resistance (e.g., Southeast Asia and the Indian subcontinent).

Coronavirus Disease 2019

Clinicians should discuss and recommend vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), regardless of destination (see Sec. 5, Part 2, Ch. 3, COVID-19 ).

Japanese Encephalitis

Review the traveler’s itinerary in detail to determine the need for Japanese encephalitis (JE) vaccine (see Sec. 5, Part 2, Ch. 13, Japanese Encephalitis ). Some travelers might be able to obtain the single-dose JE vaccine, which is much less expensive and is available outside the United States, but bear in mind (and educate travelers about) issues surrounding quality of vaccines in many countries (see Sec. 6, Ch. 3, . . . perspectives: Avoiding Poorly Regulated Medicines & Medical Products During Travel ). Whether or not travelers accept the JE vaccine, provide instructions for when and how to use insect repellents and other measures to prevent mosquito bites (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ).

When considering rabies vaccine for resource-limited travelers, factor in the risk for animal exposure, access to local health care, and availability of rabies immune globulin and rabies vaccine at the traveler’s destination (see Sec. 5, Part 2, Ch. 18, Rabies ). Advise travelers who decline preexposure immunization to devise a plan of action in case an exposure occurs. In many areas, rabies vaccine or rabies immune globulin are difficult or impossible to obtain, and travelers might need to be medically evacuated to receive full and proper postexposure prophylaxis.

Every pretravel consultation should include detailed advice about preventing mosquito bites (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ). Malaria risk varies widely depending on destination, accommodations, and activities during travel. Costs associated with the different regimens vary widely. Providers should stay up to date on the cost of antimalarial medications in their region and at pharmacies, so they can recommend the most cost-effective drug based on the traveler’s planned itinerary. If travelers ask whether they can purchase antimalarial drugs at their destination, advise them about the risk of inappropriate, substandard, and counterfeit medications and discourage them from this practice (see Sec. 6, Ch. 3, . . . perspectives: Avoiding Poorly Regulated Medicines & Medical Products During Travel ).

Travelers’ diarrhea (TD) is among the most common travel-related illnesses. Consider prescribing antibiotics to travelers to treat incapacitating diarrhea. Prophylaxis is indicated only in select patients at high risk for complications from TD (Sec. 2, Ch. 6, Travelers’ Diarrhea ). As with antimalarial drugs purchased at the destination, advise travelers about the risk of purchasing counterfeit antibiotics overseas.

For each traveler, weigh the potential severity of illness against the affordability and availability of immunization or prophylaxis, as well as the level of protection provided. In cases where a disease is potentially deadly but where affordable, effective chemoprophylaxis options exist (e.g., malaria), work with the traveler to identify an acceptable prescribed chemoprophylaxis regimen and emphasize the importance of not eschewing medication due to cost.

In addition, educate all travelers about the importance of employing preventive behaviors that can serve to reduce their exposure risks: avoiding animals, using insect bite precautions, following safe sex practices, washing their hands or using alcohol-based hand sanitizer frequently, and observing food and water precautions to the best of their ability. Strongly advise all travelers, and especially those unable to afford some of the more costly immunizations or prophylactic medications, to practice these behaviors. In the era of the COVID-19 pandemic, offer advice about mask use, encourage travelers to take note of the level of SARS-CoV-2 infection at their destination, and to be mindful about avoiding large gatherings. Reassure travelers that the actions they take to avoid preventable health risks also can protect against travel-associated conditions that are more prevalent than certain vaccine-preventable diseases.

The following authors contributed to the previous version of this chapter: Zoon Wangu, Elizabeth D. Barnett

Bibliography

Adachi K, Coleman MS, Khan N, Jentes ES, Arguin P, Rao SR, et al. Economics of malaria prevention in US travelers to West Africa. Clin Infect Dis. 2014;58(1):11–21.

IBM Micromedex. RED BOOK System. Truven Health Analytics, Greenwood Village, Colorado, USA. Available from: www.ibm.com/watson/health/provider-client-training/micromedex-red-book.

Jentes ES, Blanton JD, Johnson KJ, Petersen BW, Lamias MJ, Robertson K, et al. The global availability of rabies immune globulin and rabies vaccine in clinics providing indirect care to travelers. J Travel Med. 2014;21(1):62–6.

Johnson DF, Leder K, Torresi J. Hepatitis B and C infection in international travelers. J Travel Med. 2013;20(3):194–202.

Mangtani P, Roberts JA. Economic evaluations of travelers’ vaccinations. In: Zuckerman JN, Jong EC, editors. Travelers’ vaccines, 2nd edition. Shelton, CT: People’s Medical Publishing House; 2010. pp. 553–67.

Riddle MS, Connor BA, Beeching NJ, DuPont HL, Hamer DH, Kozarsky P, et al. Guidelines for the prevention and treatment of travelers’ diarrhea: a graded expert panel report. J Travel Med. 2017;24(1):S63–80.

Wu D, Guo CY. Epidemiology and prevention of hepatitis A in travelers. J Travel Med. 2013;20(6):394–9.

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IMAGES

  1. Preparing for International Travel

    immunizations for overseas travel

  2. Prepare for Overseas Travel With This Checklist

    immunizations for overseas travel

  3. 9 Travel Immunizations You Need Before Going Overseas

    immunizations for overseas travel

  4. Preparing for International Travel

    immunizations for overseas travel

  5. Overseas Immunizations

    immunizations for overseas travel

  6. Immunizations for Travel to Keep You Healthy Overseas

    immunizations for overseas travel

COMMENTS

  1. Need travel vaccines? Plan ahead.

    International travel increases your chances of getting and spreading diseases that are rare or not found in United States. Find out which travel vaccines you may need to help you stay healthy on your trip. Before Travel. Make sure you are up-to-date on all of your routine vaccines.

  2. Think Travel Vaccine Guide

    Prevention modalities: vaccination, medication, consultation. Hepatitis A. Contaminated food & water. Vaccination (2-dose vaccine): Recommended for most travelers. --Administer 2 doses, at least 6 months apart. --At least 1 dose should be given before travel. Consultation: Advise patient to wash hands frequently and avoid unsafe food and water.

  3. Vaccines for Travelers

    The White House. USA.gov. Vulnerability Disclosure Policy. Receive the latest updates from the Secretary, Blogs, and News Releases. 200 Independence Avenue, S.W. Washington, D.C. 20201 Toll Free Call Center: 1-877-696-6775 . Vaccines protect travelers from serious diseases. Some vaccines may also be required for you to travel to certain places.

  4. Travel Vaccines to Protect Your Family

    Protect your child and family when traveling in the United States or abroad by: Getting the shots required for all countries you and your family plan to visit during your trip. Making sure you and your family are up-to-date on all routine U.S. vaccines. Staying informed about travel notices and alerts and how they can affect your family's ...

  5. What Vaccines Do I Need for Travel?

    Before you embark on your journey, he suggests making sure you're up to date with routine vaccinations, including vaccines for: COVID-19. Flu. Hepatitis A. Hepatitis B. Tetanus. "People don ...

  6. Travelers' Health

    CDC Travelers' Health Branch provides updated travel information, notices, and vaccine requirements to inform international travelers and provide guidance to the clinicians who serve them. ... Routine Vaccines. It's important to be up to date on recommended routine vaccines prior to travel, including Flu, RSV and COVID-19. ...

  7. Your Travel Vaccine Checklist

    Below is a list of vaccine-preventable travel-related diseases that are not covered by routine adult vaccinations: Hepatitis A. Hepatitis B. Typhoid and paratyphoid fever. Meningococcal disease ...

  8. Which Vaccinations Are Required for Travel?

    A trip abroad requires you to be up-to-date on a whole checklist of things these days: travel insurance, airline policies, visas, passports, and, as far as your health is concerned, vaccines.Yet ...

  9. International Travel Vaccine Requirement

    U.S. travelers need to be prepared to show proof of a negative test before they travel to the United States and should make arrangements for testing in advance of travel if possible. Vaccinated U.S. travelers will need to carry and provide proof of vaccination to the airlines to qualify for the three-day testing window; otherwise one-day tests ...

  10. 9 common questions about vaccines and travel

    Pneumococcal. Measles, mumps and rubella (MMR) Polio. Shingles. Additional vaccines may be recommended depending on your travel itinerary. For example, hepatitis A vaccination is recommended if you are traveling to Southeast Asia. During your appointment, we can discuss which vaccines are appropriate for your itinerary. 3.

  11. Travel Immunizations and Vaccinations for International Tourism

    The vaccines you should get depend on where you're going. No matter where you're going, check to make sure you're up to date on all routine vaccines: measles-mumps-rubella, diphtheria-tetanus ...

  12. Updates on U.S. Travel Policy Requiring Vaccination

    Ned Price, Department Spokesperson. October 25, 2021. Today, the White House and CDC announced details of the new vaccination policy that will go into effect for international travelers on November 8. As of that date, foreign national air travelers to the United States will be required to be fully vaccinated and to provide proof of vaccination ...

  13. Vaccines

    Vaccines. Vaccination is the administration of agent-specific, but safe, antigenic components that in vaccinated individuals can induce protective immunity against the corresponding infectious agent. Before departure, travelers should have a medical consultation to learn about the risk of disease in the country or countries they plan to visit ...

  14. Vaccination requirements for international travel

    Vaccination requirements for international travel are the aspect of vaccination policy that concerns the movement of people across borders.Countries around the world require travellers departing to other countries, or arriving from other countries, to be vaccinated against certain infectious diseases in order to prevent epidemics.At border checks, these travellers are required to show proof of ...

  15. COVID-19 international travel advisories

    COVID-19 testing and vaccine rules for entering the U.S. As of May 12, 2023, noncitizen nonimmigrant visitors to the U.S. arriving by air or arriving by land or sea no longer need to show proof of being fully vaccinated against COVID-19. As of June 12, 2022, people entering the U.S. no longer need to show proof of a negative COVID-19 test .

  16. Travelers' Health Most Frequently Asked Questions

    If you need to contact a US embassy or consulate, call 1-888-407-4747 (from the US or Canada) OR 00-1-202-501-4444 (from other countries). Travel healthy, from CDC's Travelers' Health! CDC Travelers' Health Branch provides health advice to international travelers, including advice about medications and vaccines.

  17. 9 Travel Immunizations You Need Before Going Overseas

    That is why, since 1944, international travelers have needed immunizations for travel. The goal then and now is to promote public health and reduce the spread of diseases. After 2021, many countries updated their visa and visitor requirements to require immunization against COVID-19, though many of these have since been lifted.

  18. Update on Change to U.S. Travel Policy Requiring COVID-19 Vaccination

    Last Updated: May 4, 2023. The Administration will end the COVID-19 vaccine requirements for international air travelers at the end of the day on May 11, the same day that the COVID-19 public health emergency ends. This means starting May 12, noncitizen nonimmigrant air passengers will no longer need to show proof of being fully vaccinated with ...

  19. What You Need to Know About Proof of Vaccination for Travel in 2023

    One exception is Viking: "For departures on or before October 31, 2023, Viking will continue to require that all guests be vaccinated against COVID-19 at least 14 days prior to travel. You may be required to show proof of vaccination to board a Viking ship and along your journey. We strongly suggest carrying your physical vaccine records at ...

  20. Vaccination for international travellers

    Travel vaccines — those relevant for travelling — include all relevant vaccines, not just the ones that prevent diseases that most commonly occur overseas. Do not recommend a vaccine based only on the destination country, because there is no single 'correct' list of vaccines for travel to any particular country.

  21. Immunisation for travel

    When to get vaccinated. You should consult your doctor or visit a travel health clinic 6 to 12 weeks before you leave Australia. It is important to see your doctor early. If you do need vaccinations: your body needs time to develop full immunity. you may need several doses of a vaccine to achieve full immunity.

  22. Yellow Fever Vaccine Boosters Needed for Some Travelers

    According to the U.S. CDC Yellow Book 2024, an international traveler's risk for acquiring Yellow Fever virus is determined by their immunization status and destination-specific and travel-associated factors. Since about thirty countries require proof of a pre-arrival yellow fever vaccination, many travelers have questions about the vaccine's long-term efficacy.

  23. Destinations

    CDC is monitoring respiratory illness around the world. Some countries have reported elevated levels of respiratory illness activity. Respiratory illnesses that are circulating include influenza, COVID-19, respiratory syncytial virus (RSV) infection, and Mycoplasma pneumoniae infection. Actions you can take to help protect yourself and others ...

  24. Find a Clinic

    Find a COVID-19 testing clinic. CDC provides these links as a convenience to international travelers. CDC does not endorse, recommend, or favor any clinics on these lists, nor does the appearance of a clinic on these lists imply a guarantee of service quality. Page last reviewed: August 11, 2022.

  25. Official Trusted Traveler Program Website

    This is the official U.S. Customs and Border Protection (CBP) website where international travelers can apply for Trusted Traveler Programs (TTP) to expedite admittance into the United States (for pre-approved, low-risk travelers).

  26. Prioritizing Care for Resource-Limited Travelers

    For travelers not up to date with routine vaccines, prioritize administration of those that protect against diseases for which the traveler is most likely to be at general risk (e.g., hepatitis A, influenza, and measles). Children in the United States routinely receive hepatitis A vaccine, but it is not included in the adult immunization schedule.