U.S. flag

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

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 .

Mobile Menu Overlay

The White House 1600 Pennsylvania Ave NW Washington, DC 20500

Fact Sheet: Biden Administration Releases Additional Detail for Implementing a Safer, More Stringent International Air Travel   System

As we continue to work to protect people from COVID-19, today, the Biden Administration is releasing additional detail around implementation of the new international air travel policy requiring foreign national travelers to the United States to be fully vaccinated. This updated policy puts in place an international travel system that is stringent, consistent across the globe, and guided by public health. Starting on November 8, non-citizen, non-immigrant air travelers to the United States will be required to be fully vaccinated and to provide proof of COVID-19 vaccination status prior to boarding an airplane to fly to the U.S., with only limited exceptions. 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. Today, the Administration is releasing the following documents to implement these requirements: 1) a Presidential Proclamation to Advance the Safe Resumption of Global Travel During the COVID-19 Pandemic; 2) three Centers for Disease Control and  Prevention (CDC) Orders on vaccination, testing, and contact tracing; and 3) technical instructions to provide implementation details to the airlines and their passengers.  With science and public health as our guide, the United States has developed a new international air travel system that both enhances the safety of Americans here at home and enhances the safety of international air travel. The additional detail released today provides airlines and international air travelers with time to prepare for this new policy ahead of the November 8 implementation date. As previously announced, fully vaccinated foreign nationals will also be able to travel across the Northern and Southwest land borders for non-essential reasons, such as tourism, starting on November 8. Additional detail on amendments to restrictions with respect to land borders will be available in the coming days. Travelers can find full details about today’s air travel announcement on the CDC and Department of State websites.  A summary is below: Fully Vaccinated Status:

  • Starting on November 8, non-citizen, non-immigrant 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 fly to the U.S.

Proof of Vaccination:

  • For foreign nationals, proof of vaccination will be required – with very limited exceptions – to board the plane.
  • Match the name and date of birth to confirm the passenger is the same person reflected on the proof of vaccination;
  • Determine that the record was issued by an official source (e.g., public health agency, government agency) in the country where the vaccine was given;
  • Review the essential information for determining if the passenger meets CDC’s definition for fully vaccinated such as vaccine product, number of vaccine doses received, date(s) of administration, site (e.g., vaccination clinic, health care facility) of vaccination.
  • The Biden Administration will work closely with the airlines to ensure that these new requirements are implemented successfully.

Accepted Vaccines:

  • CDC has determined that for purposes of travel to the United States, vaccines accepted will include FDA approved or authorized and World Health Organization (WHO) emergency use listed (EUL) vaccines.
  • Individuals can be considered fully vaccinated ≥2 weeks after receipt of the last dose if they have received any single dose of an FDA approved/authorized or WHO EUL approved single-dose series (i.e., Janssen), or any combination of two doses of an FDA approved/authorized or WHO emergency use listed COVID-19 two-dose series (i.e. mixing and matching).
  • More details are available in the CDC Annex here .

Enhanced Testing:

  • Previously, all travelers were required to produce a negative viral test result within three days of travel to the United States.
  • Both nucleic acid amplification tests (NAATs), such as a PCR test, and antigen tests qualify.
  • As announced in September, the new system tightens those requirements, so that unvaccinated U.S. Citizens and LPRs will need to provide a negative test taken within one day of traveling.
  • That means that all fully vaccinated U.S. Citizens and LPRs traveling to the United States should be prepared to present documentation of their vaccination status alongside their negative test result.
  • For those Americans who can show they are fully vaccinated, the same requirement currently in place will apply – they have to produce a negative test result within three days of travel.
  • For anyone traveling to the United States who cannot demonstrate proof of full vaccination, they will have to produce documentation of a negative test within one day of departure.

Requirements for Children:

  • Children under 18 are excepted from the vaccination requirement for foreign national travelers, given both the ineligibility of some younger children for vaccination, as well as the global variability in access to vaccination for older children who are eligible to be vaccinated.
  • Children between the ages of 2 and 17 are required to take a pre-departure test.
  • If traveling with a fully vaccinated adult, an unvaccinated child can test three days prior to departure (consistent with the timeline for fully vaccinated adults). If an unvaccinated child is traveling alone or with unvaccinated adults, they will have to test within one day of departure.

Limited Exceptions from the Vaccination Requirement:

  • There are a very limited set of exceptions from the vaccination requirement for foreign nationals. These include exceptions for children under 18, certain COVID-19 vaccine clinical trial participants, those with medical contraindications to the vaccines, those who need to travel for emergency or humanitarian reasons (with a US government-issued letter affirming the urgent need to travel), those who are traveling on non-tourist visas from countries with low-vaccine availability (as determined by the CDC), and other very narrow categories.
  • Those who receive an exception will generally be required to attest they will comply with applicable public health requirements, including, with very limited exceptions, a requirement that they be vaccinated in the U.S. if they intend to stay here for more than 60 days.

Contact Tracing:

  • The CDC is also issuing a Contact Tracing Order that requires all airlines flying into the United States to keep on hand – and promptly turn over to the CDC, when needed – contact information that will allow public health officials to follow up with inbound air travelers who are potentially infected or have been exposed to someone who is infected.
  • This is a critical public health measure both to prevent the introduction, transmission, and spread of new variants of COVID-19 as well as to add a critical prevention tool to address other public health threats.

Stay Connected

We'll be in touch with the latest information on how President Biden and his administration are working for the American people, as well as ways you can get involved and help our country build back better.

Opt in to send and receive text messages from President Biden.

U.S. flag

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

  • Fact Sheets

Frequently Asked Questions: Guidance for Travelers to Enter the U.S.

Updated Date: April 21, 2022

Since January 22, 2022, DHS has required non-U.S. individuals seeking to enter the United States via land ports of entry and ferry terminals at the U.S.-Mexico and U.S.-Canada borders to be fully vaccinated for COVID-19 and provide proof of vaccination upon request.  On April 21, 2022, DHS announced that it would extend these requirements. In determining whether and when to rescind this order, DHS anticipates that it will take account of whether the vaccination requirement for non-U.S. air travelers remains in place.

These requirements apply to non-U.S. individuals who are traveling for essential or non-essential reasons. They do not apply to U.S. citizens, Lawful Permanent Residents, or U.S. nationals.

Effective November 8, 2021, new air travel requirements applied to many noncitizens who are visiting the United States temporarily. These travelers are also required to show proof of COVID-19 vaccination. All air travelers, including U.S. persons, must test negative for COVID-19 prior to departure. Limited exceptions apply. See  CDC guidance  for more details regarding air travel requirements.

Below is more information about what to know before you go, and answers to Frequently Asked Questions about cross-border travel.

Entering the U.S. Through a Land Port of Entry or Ferry Terminal

Q. what are the requirements for travelers entering the united states through land poes.

A:  Before embarking on a trip to the United States, non-U.S. travelers should be prepared for the following:

  • Possess proof of an approved COVID-19 vaccination as outlined on the  CDC  website.
  • During border inspection, verbally attest to their COVID-19 vaccination status. 
  • Bring a  Western Hemisphere Travel Initiative  compliant border crossing document, such as a valid passport (and visa if required), Trusted Traveler Program card, a Department of State-issued Border Crossing Card, Enhanced Driver’s License or Enhanced Tribal Card when entering the country. Travelers (including U.S. citizens) should be prepared to present the WHTI-compliant document and any other documents requested by the CBP officer.

 Q. What are the requirements to enter the United States for children under the age of 18 who can't be vaccinated?

A:  Children under 18 years of age are excepted from the vaccination requirement at land and ferry POEs.

Q: Which vaccines/combination of vaccines will be accepted?

A:  Per CDC guidelines, all Food and Drug Administration (FDA) approved and authorized vaccines, as well as all vaccines that have an Emergency Use Listing (EUL) from the World Health Organization (WHO), will be accepted.

Accepted Vaccines:

  • More details are available in CDC guidance  here .
  • 2 weeks (14 days) after your dose of an accepted single-dose COVID-19 vaccine;
  • 2 weeks (14 days) after your second dose of an accepted 2-dose series;
  • 2 weeks (14 days) after you received the full series of an accepted COVID-19 vaccine (not placebo) in a clinical trial;
  • 2 weeks (14 days) after you received 2 doses of any “mix-and-match” combination of accepted COVID-19 vaccines administered at least 17 days apart.

Q. Is the United States requiring travelers to have a booster dose to be considered fully vaccinated for border entry purposes?

A:  No. The CDC guidance for “full vaccination” can be found here.

Q: Do U.S. citizens or lawful permanent residents need proof of vaccination to return to the United States via land POEs and ferry terminals?

A:  No. Vaccination requirements do not apply to U.S. citizens, U.S. nationals, or Lawful Permanent Residents (LPRs). Travelers that exhibit signs or symptoms of illness will be referred to CDC for additional medical evaluation.

Q: Is pre- or at-arrival COVID testing required to enter the United States via land POEs or ferry terminals?

A: No, there is no COVID testing requirement to enter the United States via land POE or ferry terminals. In this respect, the requirement for entering by a land POE or ferry terminal differs from arrival via air, where there is a requirement to have a negative test result before departure.

Processing Changes Announced on January 22, 2022 

Q: new changes were recently announced. what changed on january 22.

A:  Since January 22, 2022, non-citizens who are not U.S. nationals or Lawful Permanent Residents have been required to be vaccinated against COVID-19 to enter the United States at land ports of entry and ferry terminals, whether for essential or nonessential purposes. Previously, DHS required that non-U.S. persons be vaccinated against COVID-19 to enter the United States for nonessential purposes.  Effective January 22, all non-U.S. individuals, to include essential travelers, must be prepared to attest to vaccination status and present proof of vaccination to a CBP officer upon request. DHS announced an extension of this policy on April 21, 2022.

Q: Who is affected by the changes announced on January 22?

A: This requirement does not apply to U.S. citizens, U.S. nationals, or U.S. Lawful Permanent Residents. It applies to other noncitizens, such as a citizen of Mexico, Canada, or any other country seeking to enter the United States through a land port of entry or ferry terminal.

Q: Do U.S. citizens need proof of vaccination to return to the United States via land port of entry or ferry terminals?

A: Vaccination requirements do not apply to U.S. Citizens, U.S. nationals or U.S. Lawful Permanent Residents. Travelers that exhibit signs or symptoms of illness will be referred to CDC for additional medical evaluation. 

Q: What is essential travel?

A:  Under the prior policy, there was an exception from temporary travel restrictions for “essential travel.” Essential travel included travel to attend educational institutions, travel to work in the United States, travel for emergency response and public health purposes, and travel for lawful cross-border trade (e.g., commercial truckers). Under current policy, there is no exception for essential travel.

Q: Will there be any exemptions? 

A: While most non-U.S. individuals seeking to enter the United States will need to be vaccinated, there is a narrow list of exemptions consistent with the Centers for Disease Control and Prevention (CDC) Order in the air travel context.

  • Certain categories of individuals on diplomatic or official foreign government travel as specified in the CDC Order
  • Children under 18 years of age;
  • Certain participants in certain COVID-19 vaccine trials as specified in the CDC Order;   
  • Individuals with medical contraindications to receiving a COVID-19 vaccine as specified in the CDC Order;
  • Individuals issued a humanitarian or emergency exception by the Secretary of Homeland Security;
  • Individuals with valid nonimmigrant visas (excluding B-1 [business] or B-2 [tourism] visas) who are citizens of a country with limited COVID-19 vaccine availability, as specified in the CDC Order
  • Members of the U.S. Armed Forces or their spouses or children (under 18 years of age) as specified in the CDC Order; and
  • Individuals whose entry would be in the U.S. national interest, as determined by the Secretary of Homeland Security.

Q: What documentation will be required to show vaccination status?

A:  Non-U.S. individuals are required to be prepared to attest to vaccination status and present proof of vaccination to a CBP officer upon request regardless of the purpose of travel.

The current documentation requirement remains the same and is available on the CDC website . Documentation requirements for entry at land ports of entry and ferry terminals mirror those for entry by air.

Q: What happens if someone doesn’t have proof of vaccine status?

A: If non-U.S. individuals cannot present proof of vaccination upon request, they will not be admitted into the United States and will either be subject to removal or be allowed to withdraw their application for entry.

Q: Will incoming travelers be required to present COVID-19 test results?

A: There is no COVID-19 testing requirement for travelers at land border ports of entry, including ferry terminals.

Q: What does this mean for those who can't be vaccinated, either due to age or other health considerations? 

A: See CDC guidance for additional information on this topic. Note that the vaccine requirement does not apply to children under 18 years of age.

Q: Does this requirement apply to amateur and professional athletes?

A: Yes, unless they qualify for one of the narrow CDC exemptions.

Q: Are commercial truckers required to be vaccinated?

A: Yes, unless they qualify for one of the narrow CDC exemptions. These requirements also apply to bus drivers as well as rail and ferry operators.

Q. Do you expect border wait times to increase?

A:  As travelers navigate these new travel requirements, wait times may increase. Travelers should account for the possibility of longer than normal wait times and lines at U.S. land border crossings when planning their trip and are kindly encouraged to exercise patience.

To help reduce wait times and long lines, travelers can take advantage of innovative technology, such as facial biometrics and the CBP OneTM mobile application, which serves as a single portal for individuals to access CBP mobile applications and services.

Q: How is Customs and Border Protection staffing the ports of entry? 

A: CBP’s current staffing levels at ports of entry throughout the United States are commensurate with pre-pandemic levels. CBP has continued to hire and train new employees throughout the pandemic. CBP expects some travelers to be non-compliant with the proof of vaccination requirements, which may at times lead to an increase in border wait times. Although trade and travel facilitation remain a priority, we cannot compromise national security, which is our primary mission. CBP Office of Field Operations will continue to dedicate its finite resources to the processing of arriving traffic with emphasis on trade facilitation to ensure economic recovery.

Q: What happens if a vaccinated individual is traveling with an unvaccinated individual?  

A:  The unvaccinated individual (if 18 or over) would not be eligible for admission.

Q: If I am traveling for an essential reason but am not vaccinated can I still enter?

A:  No, if you are a non-U.S. individual. The policy announced on January 22, 2022 applies to both essential and non-essential travel by non-U.S. individual travelers. Since January 22, DHS has required that all inbound non-U.S. individuals crossing U.S. land or ferry POEs – whether for essential or non-essential reasons – be fully vaccinated for COVID-19 and provide related proof of vaccination upon request.

Q: Are sea crew members on vessels required to have a COVID vaccine to disembark?

A:  Sea crew members traveling pursuant to a C-1 or D nonimmigrant visa are not excepted from COVID-19 vaccine requirements at the land border. This is a difference from the international air transportation context.

Entering the U.S. via Air Travel

Q: what are the covid vaccination requirements for air passengers to the united states  .

A:  According to CDC requirements [www.cdc.gov/coronavirus/2019-ncov/travelers/noncitizens-US-air-travel.html | Link no longer valid], most noncitizens who are visiting the United States temporarily must be fully vaccinated prior to boarding a flight to the United States. These travelers are required to show proof of vaccination. A list of covered individuals is available on the CDC website.  

Q: What are the COVID testing requirements for air passengers to the United States?  

A:  Effective Sunday, June 12 at 12:01 a.m. ET, CDC will no longer require pre-departure COVID-19 testing for U.S.-bound air travelers.

  • Border Security
  • Transportation Security
  • Airport Security
  • Coronavirus (COVID-19)
  • Customs and Border Protection (CBP)
  • Transportation Security Administration (TSA)

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.

The Best Beaches in Italy

Matt Ortile

Around-the-World Cruises: Everything Travelers Need to Know About These Epic Voyages

Scott Laird

The Best Things to Do in Panama: Surfing, Coffee Tastings, and Private Island Stays

Siobhan Reid

A Summer Capsule Wardrobe Will Simplify Your Packing Process

Meaghan Kenny

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.

By signing up you agree to our User Agreement (including the class action waiver and arbitration provisions ), our Privacy Policy & Cookie Statement and to receive marketing and account-related emails from Traveller. You can unsubscribe at any time. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

  • Português Br
  • Journalist Pass

9 common questions about vaccines and travel

Joel Streed

Share this:

Share to facebook

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.

  • Mayo Clinic Q and A: Thyroid nodules, cancer and treatment Mayo Clinic Minute: Dangers of late cervical cancer diagnosis in women of color

Related Articles

vaccine travel cdc

Advertisement

Supported by

What to Know About Testing and Vaccine Requirements for Travel

Do you need to be vaccinated or have a negative Covid-19 test for your next trip? Check this guide before traveling domestically or abroad.

  • Share full article

vaccine travel cdc

By Concepción de León

As vaccinations ramp up and regulations loosen for people in the United States, many are planning travel for summer and beyond, with experts predicting that July 4 will be the biggest travel weekend since the beginning of the pandemic.

But with regulations shifting, people might have questions about testing or vaccination requirements for their trips. The Centers for Disease Control and Prevention recently eased travel recommendations to more than 100 countries. On June 18, the European Union added the United States to its “safe list” of countries , meaning that both vaccinated and unvaccinated American travelers should now be able to visit the 27 member countries, but these member states are allowed to set their own requirements and restrictions for travelers.

In the United States, the C.D.C. has advised that vaccinated people no longer need to wear masks in most places and released new travel guidelines that said domestic travel is safe for them. But travelers must take note of local advice and regulations, as these can vary state by state.

Here’s everything you need to consider about testing and vaccinations before you travel within the U.S. or internationally.

Are there testing and vaccination requirements for domestic travel?

For most places, no. You do not need to be vaccinated for any domestic travel. Hawaii is the only state that requires a negative test for travel.

In Hawaii, the test must be administered within 72 hours of arrival and the results uploaded to its Safe Travel platform to avoid a mandatory quarantine when entering the state.

Alternatively in Hawaii, you can also provide proof that you’ve recovered from Covid-19 in the past 90 days, including both a positive test result and a letter from a doctor clearing you to travel.

The state’s governor, David Ige, said this month that people who received their vaccination in the state of Hawaii may bypass testing and quarantine requirements starting on June 15, and that anyone vaccinated in the U.S. will be able to enter Hawaii without testing once the state has reached a 60 percent vaccination rate.

If you are unvaccinated, you should continue to adhere to social distancing and mask-wearing protocols while traveling domestically, the C.D.C. said . You can use the C.D.C.’s Travel Planner to check guidelines by state.

What are the testing and vaccination rules for international travel?

While testing and vaccination requirements vary by destination country, everyone arriving in the U.S. — even vaccinated Americans — must present a negative test result upon entry .

Many nations are still closed to American travelers. Those that are open may require a negative test, proof of vaccination or evidence of recovery (or a combination of these) to enter.

The United Kingdom , for instance, requires that American travelers, regardless of vaccination status, provide proof of a negative test taken within 72 hours of departure, quarantine upon arrival and take two additional tests during their stay. Children under 11 are exempt from these requirements, as are some other people depending on their reason for travel.

Some European countries have been allowing in Americans who are vaccinated or who can show a negative test. Americans are on the European Union’s “safe list” of countries, but while the bloc aims to take a coordinated approach to travel this summer, member states will be allowed to set their own requirements for travelers from individual countries, which could include testing and vaccination.

The E.U. “safe list” also applies to Europe’s border-free Schengen Zone, which includes non-E.U. countries such as Norway, Switzerland, Iceland and Lichtenstein.

Canada is still closed to Americans , with few exceptions, and will remain so until at least early July, said Patty Hajdu, the country’s minister of health, in a news conference in June.

The U.S.-Mexico land border is closed for nonessential travel until at least June 21, but air travel is allowed and the country does not require a negative test for entry. Because of its high risk level, the C.D.C. recommends that travelers be fully vaccinated before traveling to Mexico.

Consult the C.D.C.’s inventory of international travel health notices for more information on regulations by country.

“Travelers should always check with their airline and the embassy of the country they are visiting to ensure they have the proper documentation required to enter the country,” said Perry Flint, a spokesman for The International Air Transport Association, a global airline industry group.

What test should I take, and where and when?

To enter the U.S., travelers must show a negative result to a nucleic acid amplification test (NAAT) — PCR is a type of NAAT test — or an antigen test, also known as a rapid test, taken in the three days before departure, according to the C.D.C .

Some airports offer on-site testing, such as Heathrow Airport in England, or Rome’s Fiumicino International Airport in Italy.

Josh Alexander, a New York-based luxury travel agent for Protravel International, said that many international hotels, including most Four Seasons hotels and resorts , are offering on-site rapid tests for free or at a nominal cost.

Testing at local clinics is also available in many places, though you should check availability at your destination ahead of time and book if you can. It may also come at a high cost. Mr. Alexander said that PCR tests abroad can range from $50 to $150.

The C.D.C. said that it allows for a three-day time frame rather than 72 hours to allow flexibility in the time of day the test can be taken. For instance, if you are flying out on a Friday, the test may be taken at any time on Tuesday.

But, when it comes to international destinations, Mr. Alexander recommends erring on the side of caution when timing your test by calculating it based on time of arrival at your destination.

“Rules are constantly changing,” he said, “so we’re just trying to always tell people they should always be as conservative as possible to eliminate any gray area.”

What are the requirements for minors?

The C.D.C. testing recommendations apply to all children 2 years and older, which means your toddler also needs to deliver a negative Covid-19 test to enter the U.S. from abroad. When traveling, children should wear masks, practice social distancing and wash hands often, the C.D.C. said .

“If the kids are age 12 and older, get ’em vaccinated,” said William Schaffner, an infectious disease expert at Vanderbilt University, in an email.

If you’re traveling to a country within the European Union that is open to travelers from the U.S., children who cannot be vaccinated should have a negative PCR test taken no more than 72 hours before arrival at your destination, and additional testing may be required upon arrival.

Travelers should check with their airline or destination country website for relevant requirements.

What if I want to go on a cruise?

Rules vary from one cruise line to another, with some planning to require that all passengers and crew be vaccinated, and others adopting a hybrid model.

But recent laws passed in Florida and Texas banning businesses from requiring proof of vaccination to use their services may complicate this plan.

Celebrity Cruises, set to be the first U.S. cruise ship to restart operations on June 26 from Fort Lauderdale, Fla., said it’s optimistic that a resolution would be reached in time . It is requiring that guests 16 years and older be vaccinated, while children will be tested at the terminal.

Carnival Cruises said on Monday that its first ship would set sail from the Port of Galveston, in Texas, on July 3 and would be available only for vaccinated passengers. Norwegian, which will begin to operate cruises from Miami in August, said it will require the same through October 31 and has threatened to skip Florida ports if the state does not allow cruise lines an exemption from the law banning vaccine requirements.

Christine Duffy, the president of Carnival Cruise Line, said in a statement on June 7 that “the current CDC requirements for cruising with a guest base that is unvaccinated will make it very difficult to deliver the experience our guests expect, especially given the large number of families with younger children who sail with us.”

“As a result, our alternative is to operate our ships from the U.S. during the month of July with vaccinated guests,” she said.

But even if you are vaccinated, you must also consider the requirements of the country where the cruise is disembarking. The Caribbean island of St. Maarten, for instance, where Celebrity Cruises started sailing on June 5, requires a negative test in addition to proof of vaccination.

What documents should I bring with me if I travel?

This will also depend on where you’re going, but a good rule of thumb is to carry your physical vaccine card, if you have it, and proof of a negative test, if it is required.

Mr. Alexander, the travel agent, recommends people bring the original documents. While a number of digital health certificates — which show vaccine status and test results — are in the works, he said, they are not yet widely accepted. You should check, also, that your document is in the correct language. The United Kingdom , for instance, requires that test results be in English, Spanish or French.

CommonPass , from the Geneva-based nonprofit the Commons Project Foundation, and the I.A.T.A. Travel Pass are two apps providing digital access to vaccine and testing records for travel. The European Union will be releasing its own digital Covid certificate for E.U. citizens by July 1, though it is unclear whether Americans will be able to use it.

You should check with your airline to see if the app you want to use will be accepted at your destination. Both the CommonPass and I.A.T.A. websites list destinations and airline partners accepting the digital health certificates.

Mr. Alexander added that some countries, such as Croatia, may also require proof of a return flight or confirmation of your hotel booking or other accommodation, though this is rare. In South Africa, which has implemented a curfew, travelers may need to show their flight ticket to law enforcement officers to show they are allowed to be in transit.

But these shifting regulations should not dissuade people from traveling, Mr. Alexander said.

“If you’re vaccinated and you’re following safe precautions, you can still have a great experience,” he said.

Concepción de León is a travel reporter based in New York. More about Concepción de León

Security Alert May 17, 2024

Worldwide caution, update may 10, 2024, information for u.s. citizens in the middle east.

  • Travel Advisories |
  • Contact Us |
  • MyTravelGov |

Find U.S. Embassies & Consulates

Travel.state.gov, congressional liaison, special issuance agency, u.s. passports, international travel, intercountry adoption, international parental child abduction, records and authentications, popular links, travel advisories, mytravelgov, stay connected, legal resources, legal information, info for u.s. law enforcement, replace or certify documents.

Travel.State.Gov Newsroom

U.S. Passports News

International Travel News

U.S. Visas News

Intercountry Adoption News and Notices

Share this page:

Update on Change to U.S. Travel Policy Requiring COVID-19 Vaccination for nonimmigrant travel

Worldwide Visa Operations: Update

Employment-Based Fourth Preference (EB-4) Announcement

Suspension of Visa Services in Sudan

Diversity Visa 2024 Update

Nonimmigrant Visa Fee Increases to Take Effect June 17, 2023

India EB-3 Retrogression

Expiration of Covid-Era Visa Application Fee Receipts

Digital Visa Authorization (DVA) Proof of Concept

Final Rule Governing Public Charge Grounds of Visa Ineligibility

Visa Waiver Travel for Israeli Citizens

Important Update on Waivers of the Interview Requirement for Certain Nonimmigrant Visa Applicants

Department of State to Process Domestic Visa Renewals in Limited Pilot Program

Visa Information for Nationals of Haiti

Department of State/AILA Liaison Committee Meeting March 20, 2024

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 an accepted COVID-19 vaccine to board a flight to the United States. CDC’s Amended Order Implementing Presidential Proclamation on Safe Resumption of Global Travel During the COVID-19 Pandemic will no longer be in effect when the Presidential Proclamation Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic is revoked .

Please see: https://www.whitehouse.gov/briefing-room/statements-releases/2023/05/01/the-biden-administration-will-end-covid-19-vaccination-requirements-for-federal-employees-contractors-international-travelers-head-start-educators-and-cms-certified-facilities/

External Link

You are about to leave travel.state.gov for an external website that is not maintained by the U.S. Department of State.

Links to external websites are provided as a convenience and should not be construed as an endorsement by the U.S. Department of State of the views or products contained therein. If you wish to remain on travel.state.gov, click the "cancel" message.

You are about to visit:

You are using an outdated browser. Upgrade your browser today or install Google Chrome Frame to better experience this site.

  • Section 2 - Vaccination & Immunoprophylaxis— General Principles
  • Section 2 - Yellow Fever Vaccine & Malaria Prevention Information, by Country

Interactions Between Travel Vaccines & Drugs

Cdc yellow book 2024.

Author(s): Ilan Youngster, Elizabeth Barnett

Vaccine–Vaccine Interactions

Travel vaccines & drugs, antimalarial drugs, drugs used for travel to high elevations, hiv medications, herbal & nutritional supplements.

During pretravel consultations, travel health providers must consider potential interactions between vaccines and medications, including those already taken by the traveler. A study by S. Steinlauf et al. identified potential drug–drug interactions with travel-related medications in 45% of travelers taking medications for chronic conditions; 3.5% of these interactions were potentially serious.

Most common vaccines can be given safely and effectively at the same visit, at separate injection sites, without impairing antibody response or increasing rates of adverse reactions. However, certain vaccines, including pneumococcal and meningococcal vaccines and live virus vaccines, require appropriate spacing; further information about vaccine–vaccine interactions is found in Sec. 2, Ch. 3, Vaccination & Immunoprophylaxis—General Principles .

Live Attenuated Oral Typhoid & Cholera Vaccines

Live attenuated vaccines generally should be avoided in immunocompromised travelers, including those taking antimetabolites, calcineurin inhibitors, cytotoxic agents, immunomodulators, and high-dose steroids (see Table 3-04 ).

Chloroquine and atovaquone-proguanil at doses used for malaria chemoprophylaxis can be given concurrently with oral typhoid vaccine. Data from an older formulation of the CVD 103-HgR oral cholera vaccine suggest that the immune response to the vaccine might be diminished when given concomitantly with chloroquine. Administer live attenuated oral cholera vaccine ≥10 days before beginning antimalarial prophylaxis with chloroquine. A study in children using oral cholera vaccine suggested no decrease in immunogenicity when given with atovaquone-proguanil.

Antimicrobial Agents

Antimicrobial agents can be active against the vaccine strains in the oral typhoid and cholera vaccines and might prevent adequate immune response to these vaccines. Therefore, delay vaccination with oral typhoid vaccine by >72 hours and delay oral cholera vaccine by >14 days after administration of antimicrobial agents. Parenteral typhoid vaccine is an alternative to the oral typhoid vaccine for travelers who have recently received antibiotics.

Rabies Vaccine

Concomitant use of chloroquine can reduce the antibody response to intradermal rabies vaccine administered as a preexposure vaccination. Use the intramuscular route for people taking chloroquine concurrently. Intradermal administration of rabies vaccine is not currently approved for use in the United States (see Sec. 5, Part 2, Ch. 19, . . . perspectives: Rabies Immunization ).

Any time a new medication is prescribed, including antimalarial drugs, check for known or possible drug interactions (see Table 2-05 ) and inform the traveler of potential risks. Online clinical decision support tools (e.g., Micromedex) provide searchable databases of drug interactions.

Atovaquone-Proguanil

Antibiotics.

Rifabutin, rifampin, and tetracycline might reduce plasma concentrations of atovaquone and should not be used concurrently with atovaquone-proguanil.

  • Anticoagulants

Patients on warfarin might need to reduce their anticoagulant dose or monitor their prothrombin time more closely while taking atovaquone-proguanil, although coadministration of these drugs is not contraindicated. The use of novel oral anticoagulants, including dabigatran, rivaroxaban, and apixaban, is not expected to cause significant interactions, and their use has been suggested as an alternative for patients in need of anticoagulation.

Antiemetics

Metoclopramide can reduce bioavailability of atovaquone; unless no other antiemetics are available, this antiemetic should not be used to treat vomiting associated with the use of atovaquone at treatment doses.

Antihistamines

Travelers taking atovaquone-proguanil for malaria prophylaxis should avoid using cimetidine (an H2 receptor antagonist) because this medication interferes with proguanil metabolism.

Atovaquone-proguanil might interact with the antiretroviral protease inhibitors atazanavir, darunavir, indinavir, lopinavir, and ritonavir, or the nonnucleoside reverse transcriptase inhibitors (NNRTIs) efavirenz, etravirine, and nevirapine, resulting in decreased levels of atovaquone-proguanil. For travelers taking any of these medications, consider alternative malaria chemoprophylaxis .

Selective Serotonin Reuptake Inhibitors

Fluvoxamine interferes with the metabolism of proguanil; consider an alternative antimalarial prophylaxis to atovaquone-proguanil for travelers taking this selective serotonin reuptake inhibitor (SSRI).

Chloroquine

Antacids & Antidiarrheals

Chloroquine absorption might be reduced by antacids or kaolin; travelers should wait ≥4 hours between doses of these medications.

Chloroquine inhibits bioavailability of ampicillin, and travelers should wait ≥2 hours between doses of these medications. Chloroquine should not be coadministered with either clarithromycin or erythromycin; azithromycin is a suggested alternative . Chloroquine also reportedly decreases the bioavailability of ciprofloxacin.

Concomitant use of cimetidine and chloroquine should be avoided because cimetidine can inhibit the metabolism of chloroquine and increase drug levels.

CYP2D6 Enzyme Substrates

Chloroquine is a CYP2D6 enzyme inhibitor. Monitor patients taking chloroquine concomitantly with other substrates of this enzyme (e.g., flecainide, fluoxetine, metoprolol, paroxetine, propranolol) for side effects.

CYP3A4 Enzyme Inhibitors

CYP3A4 inhibitors (e.g., erythromycin, ketoconazole, ritonavir) can increase chloroquine levels; concomitant use should be avoided.

Chloroquine can increase digoxin levels; additional monitoring is warranted.

Immunosuppressants

Chloroquine decreases the bioavailability of methotrexate. Chloroquine also can cause increased levels of calcineurin inhibitors; use caution when prescribing chloroquine to travelers taking these agents.

QT-Prolonging Agents

Avoid prescribing chloroquine to anyone taking other QT-prolonging agents (e.g., amiodarone, lumefantrine, sotalol); when taken in combination, chloroquine might increase the risk for prolonged QTc interval. In addition, the antiretroviral rilpivirine has also been shown to prolong QTc, and clinicians should avoid coadministration with chloroquine.

Doxycycline

Antacids, Bismuth Subsalicylate, Iron

Absorption of tetracyclines might be impaired by aluminum-, calcium-, or magnesium-containing antacids, bismuth subsalicylate, and preparations containing iron; advise patients not to take these preparations within 3 hours of taking doxycycline.

Doxycycline can interfere with the bactericidal activity of penicillin; thus, in general, clinicians should not prescribe these drugs together. Coadministration of doxycycline with rifabutin or rifampin can lower doxycycline levels; monitor doxycycline efficacy closely or consider alternative therapy.

Patients on warfarin might need to reduce their anticoagulant dose while taking doxycycline because of its ability to depress plasma prothrombin activity.

Anticonvulsants

Barbiturates, carbamazepine, and phenytoin can decrease the half-life of doxycycline.

Antiretrovirals

Doxycycline has no known interaction with antiretroviral agents.

Concurrent use of doxycycline and calcineurin inhibitors or mTOR inhibitors (sirolimus) can cause increased levels of these immunosuppressant drugs.

Mefloquine can interact with several categories of drugs, including anticonvulsants, other antimalarial drugs, and drugs that alter cardiac conduction.

Mefloquine can lower plasma levels of several anticonvulsant medications, including carbamazepine, phenobarbital, phenytoin, and valproic acid; avoid concurrent use of mefloquine with these agents.

Mefloquine is associated with increased toxicities of the antimalarial drug lumefantrine, which is available in the United States in fixed combination to treat people with uncomplicated Plasmodium falciparum malaria. The combination of mefloquine and lumefantrine can cause potentially fatal QTc interval prolongation. Lumefantrine should therefore be avoided or used with caution in patients taking mefloquine prophylaxis.

CYP3A4 Enzyme Inducers

CYP3A4 inducers include medications used to treat HIV or HIV-associated infections (e.g., efavirenz, etravirine, nevirapine, rifabutin) and tuberculosis (rifampin). St. John’s wort and glucocorticoids are also CYP3A4 inducers. All these drugs (rifabutin and rifampin, in particular) can decrease plasma concentrations of mefloquine, thereby reducing its efficacy as an antimalarial drug.

Potent CYP3A4 inhibitors (e.g., antiretroviral protease inhibitors, atazanavir, cobicistat [available in combination with elvitegravir], darunavir, lopinavir, ritonavir, saquinavir); azole antifungals (itraconazole, ketoconazole, posaconazole, voriconazole); macrolide antibiotics (azithromycin, clarithromycin, erythromycin); and SSRIs (fluoxetine, fluvoxamine, sertraline), can increase levels of mefloquine and thus increase the risk for QT prolongation.

Although no conclusive data are available regarding coadministration of mefloquine and other drugs that can affect cardiac conduction, avoid mefloquine use, or use it with caution, in patients taking antiarrhythmic or β-blocking agents, antihistamines (H1 receptor antagonists), calcium channel receptor antagonists, phenothiazines, SSRIs, or tricyclic antidepressants.

Concomitant use of mefloquine can cause increased levels of calcineurin inhibitors and mTOR inhibitors (cyclosporine A, sirolimus, tacrolimus).

Anti-Hepatitis C Virus Protease Inhibitors

Avoid concurrent use of mefloquine and direct-acting protease inhibitors (boceprevir and telaprevir) used to treat hepatitis C. Newer direct-acting protease inhibitors (grazoprevir, paritaprevir, simeprevir) are believed to be associated with fewer drug–drug interactions, but safety data are lacking; consider alternatives to mefloquine pending additional data.

Psychiatric Medications

Avoid prescribing mefloquine to travelers with a history of mood disorders or psychiatric disease; this information is included in the US Food and Drug Administration boxed warning for mefloquine.

Table 2-05 Drugs & drug classes that can interact with selected antimalarials

ANTIMALARIALS

DRUGS & DRUG CLASSES THAT CAN INTERACT

Atovaquone- proguanil

  • Fluvoxamine
  • Metoclopromide
  • Tetracycline
  • Calcineurin inhibitors
  • Ciprofloxacin
  • CYP2D6 enzyme substrates 1
  • CYP3A4 enzyme inhibitors 2
  • Methotrexate
  • QT- prolonging agents 3
  • Bismuth subsalicylate
  • Barbiturates
  • Carbamazepine
  • Iron- containing preparations
  • mTOR inhibitors
  • Antiarrhythmic agents
  • Beta blockers
  • Calcium channel receptor antagonists
  • CYP3A4 enzyme inducers 4
  • H1 receptor antagonists
  • Lumefantrine
  • Phenothiazines
  • Protease inhibitors
  • Tricyclic antidepressants

1 Examples include flecainide, fluoxetine, metoprolol, paroxetine, and propranolol.

2 Examples include antiretroviral protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir, saquinavir); azole antifungals (e.g., itraconazole, ketoconazole, posaconazole, voriconazole); macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin); selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine, fluvoxamine, sertraline); and cobicistat.

3 Examples include amiodarone, lumefantrine, and sotalol.

4 Examples include efavirenz, etravirine, nevirapine, rifabutin, rifampin, and glucocorticoids.

Drugs Used to Treat Travelers’ Diarrhea

Antimicrobials commonly prescribed as treatment for travelers’ diarrhea have the potential for interacting with several different classes of drugs ( Table 2-06 ). As mentioned previously, online clinical decision support tools provide searchable databases that can help identify interactions with medications a person may already be taking.

Azithromycin

Increased anticoagulant effects have been noted when azithromycin is used with warfarin; monitor prothrombin time for people taking these drugs concomitantly.

Because additive QTc prolongation can occur when azithromycin is used with the antimalarial artemether, avoid concomitant therapy.

Drug interactions have been reported with the macrolide antibiotics, clarithromycin and erythromycin; antiretroviral protease inhibitors; and the NNRTIs, efavirenz and nevirapine. Concomitant use of azithromycin and these drugs can increase the risk of QTc prolongation, but a short treatment course is not contraindicated for those without an underlying cardiac abnormality. When azithromycin is used with the protease inhibitor nelfinavir, advise patients about possible drug interactions.

Concurrent use of macrolides with calcineurin inhibitors can cause increased levels of drugs belonging to this class of immunosuppressants.

Fluoroquinolones

Concurrent administration of ciprofloxacin and antacids that contain magnesium or aluminum hydroxide can reduce bioavailability of ciprofloxacin.

An increase in the international normalized ratio (INR) has been reported when levofloxacin and warfarin are used concurrently.

Asthma Medication

Ciprofloxacin decreases clearance of theophylline and caffeine; clinicians should monitor theophylline levels when ciprofloxacin is used concurrently.

Immunosuppresants

Fluoroquinolones can increase levels of calcineurin inhibitors, and doses should be adjusted for renal function.

Sildenafil should not be used by patients taking ciprofloxacin; concomitant use is associated with increased rates of adverse effects. Ciprofloxacin and other fluoroquinolones should not be used in patients taking tizanidine.

Rifamycin SV

No clinical drug interactions have been studied. Because of minimal systemic rifamycin concentrations observed after the recommended dose, clinically relevant drug interactions are not expected.

Rifaximin is not absorbed in appreciable amounts by intact bowel, and no clinically significant drug interactions have been reported to date with rifaximin except for minor changes in INR when used concurrently with warfarin.

Table 2-06 Drugs & drug classes that can interact with selected antibiotics

ANTIBIOTICS

  • HIV medications
  • Antacids containing magnesium or aluminum hydroxide
  • Theophylline

No clinical drug interactions have been studied; none are expected

Before prescribing the carbonic anhydrase inhibitor, acetazolamide, to those planning high elevation travel, carefully review with them the complete list of medications they are already taking ( Table 2-07 ).

Acetazolamide

Acetaminophen & Diclofenac Sodium

Acetaminophen and diclofenac sodium form complex bonds with acetazolamide in the stomach’s acidic environment, impairing absorption. Neither agent should be taken within 30 minutes of acetazolamide. Patients taking acetazolamide also can experience decreased excretion of anticholinergics, dextroamphetamine, ephedrine, mecamylamine, mexiletine, and quinidine.

Acetazolamide should not be given to patients taking the anticonvulsant topiramate because concurrent use is associated with toxicity.

Barbiturates & Salicylates

Acetazolamide causes alkaline urine, which can increase the rate of excretion of barbiturates and salicylates and could cause salicylate toxicity, particularly in patients taking a high dose of aspirin.

  • Corticosteroids

Hypokalemia caused by corticosteroids could occur when used concurrently with acetazolamide.

Diabetes Medications

Use caution when concurrently administering metformin and acetazolamide because of increased risk for lactic acidosis.

Monitor cyclosporine, sirolimus, and tacrolimus more closely when given with acetazolamide.

Dexamethasone

Using dexamethasone to treat altitude illness can be lifesaving. Dexamethasone interacts with several classes of drugs, however, including: anticholinesterases, anticoagulants, digitalis preparations, hypoglycemic agents, isoniazid, macrolide antibiotics, oral contraceptives, and phenytoin.

Table 2-07 Drugs & drug classes that can interact with selected altitude illness drugs

ALTITUDE ILLNESS DRUG

  • Acetaminophen
  • Anticholinergics
  • Aspirin, high dose
  • Dextroamphetamine
  • Diclofenac sodium
  • Mecamylamine
  • Anticholinesterases
  • Digitalis preparations
  • Hypoglycemic agents
  • Macrolide antibiotics
  • Oral contraceptives

Patients with HIV require additional consideration in the pretravel consultation (see Sec. 3, Ch. 1, Immunocompromised Travelers ). A study from Europe showed that ≤29% of HIV-positive travelers disclose their disease and medication status when seeking pretravel advice. Antiretroviral medications have multiple drug interactions, especially through their activation or inhibition of the CYP3A4 and CYP2D6 enzymes.

Several instances of antimalarial prophylaxis and treatment failure in patients taking protease inhibitors and both nucleoside and NNRTIs have been reported. By contrast, entry and integrase inhibitors are not a common cause of drug–drug interactions with commonly administered travel-related medications. Several potential interactions are listed above, and 2 excellent resources for HIV medication interactions can be found at  HIV Drug Interactions and HIV.gov . HIV preexposure prophylaxis with emtricitabine/tenofovir is not a contraindication for any of the commonly used travel-related medications.

Up to 30% of travelers take herbal or nutritional supplements. Many travelers consider them to be of no clinical relevance and might not disclose their use unless specifically asked during the pretravel consultation. Clinicians should give special attention to supplements that activate or inhibit CYP2D6 or CYP3A4 enzymes (e.g., ginseng, grapefruit extract, hypericum, St. John’s wort). Advise patients against coadministration of herbal and nutritional supplements with medications that are substrates for CYP2D6 or 3A4 enzymes, including chloroquine, macrolides, and mefloquine.

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

Bibliography

Frenck RW Jr., Gurtman A, Rubino J, Smith W, van Cleeff M, Jayawardene D, et al. Randomized, controlled trial of a 13-valent pneumococcal conjugate vaccine administered concomitantly with an influenza vaccine in healthy adults. Clin Vaccine Immunol. 2012;19(8):1296–303.

Jabeen E, Qureshi R, Shah A. Interaction of antihypertensive acetazolamide with nonsteroidal anti-inflammatory drugs. J Photochem Photobiol B. 2013;125:155–63.

Kollaritsch H, Que JU, Kunz C, Wiedermann G, Herzog C, Cryz SJ Jr. Safety and immunogenicity of live oral cholera and typhoid vaccines administered alone or in combination with antimalarial drugs, oral polio vaccine, or yellow fever vaccine. J Infect Dis. 1997;175(4):871–5.

Nascimento Silva JR, Camacho LA, Siqueira MM, Freire Mde S, Castro YP, Maia Mde L, et al. Mutual interference on the immune response to yellow fever vaccine and a combined vaccine against measles, mumps and rubella. Vaccine. 2011;29(37):6327–34.

Nielsen US, Jensen-Fangel S, Pedersen G, Lohse N, Pedersen C, Kronborg G, et al. Travelling with HIV: a cross sectional analysis of Danish HIV-infected patients. Travel Med Infect Dis. 2014;12(1):72–8.

Ridtitid W, Wongnawa M, Mahatthanatrakul W, Raungsri N, Sunbhanich M. Ketoconazole increases plasma concentrations of antimalarial mefloquine in healthy human volunteers. J Clin Pharm Ther. 2005;30(3):285–90.

Sbaih N, Buss B, Goyal D, Rao SR, Benefield R, Walker AT, et al. Potentially serious drug interactions resulting from the pre-travel health encounter. Open Forum Infect Dis. 2018;5(11):ofy266.

Stienlauf S, Meltzer E, Kurnik D, Leshem E, Kopel E, Streltsin B, et al. Potential drug interactions in travelers with chronic illnesses: a large retrospective cohort study. Travel Med Infect Dis. 2014;12(5):499–504.

File Formats Help:

  • Adobe PDF file
  • Microsoft PowerPoint file
  • Microsoft Word file
  • Microsoft Excel file
  • Audio/Video file
  • Apple Quicktime file
  • RealPlayer file
  • Zip Archive file

Exit Notification / Disclaimer Policy

  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
  • Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
  • You will be subject to the destination website's privacy policy when you follow the link.
  • CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

Thanks for visiting! GoodRx is not available outside of the United States. If you are trying to access this site from the United States and believe you have received this message in error, please reach out to [email protected] and let us know.

U.S. flag

Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

From August 1, 2024, Onward: What Your Dog Needs to Enter the United States

At a glance.

Starting on August 1, 2024, dogs entering or returning to the United States must meet new, specific requirements depending on where they have been in the 6 months before entering the U.S. and where they received their rabies vaccines (if required).

Requirements for all dogs

Requirements for dogs with a current and valid rabies vaccination administered in the united states.

  • Requirements for foreign-vaccinated dogs that have been in a country with high risk of dog rabies within 6 months before entry

Requirements for dogs that have been ONLY in countries that are dog rabies-free or low-risk during the 6 months before entry

All dogs must:

  • Be at least 6 months of age at time of entry or return to the United States
  • This must have been implanted prior to any required rabies vaccination
  • The microchip number must be documented on all required forms and in all accompanying veterinary records
  • Dogs may not enter the United States if they are carrying a disease contagious to people.
  • Isolation of the dog, veterinary examination, and additional testing, at the importer’s expense, may be required to determine if the dog has a contagious disease and prevent spread if the dog does not appear healthy upon arrival.

black and white French bull dog

This form should be filled out online ideally 2-10 days before arrival; however, it can also be completed right before travel (even in line at the border crossing) if you have internet access. If the information on the form changes before the dog arrives, you must submit a new form and indicate you are making changes to an existing form. All information, including port of entry where the dog is arriving, must be correct at time of arrival.

  • This form requires you to upload a clear photograph of the dog showing its face and body. Dogs that will be less than one year of age at time of arrival should have the photograph taken within 10 days before arrival.
  • There is no charge to importers for submitting this form.
  • Additional requirements for dogs with a current rabies vaccination administered in the United States
  • Additional requirements for dogs that have been in a country at high-risk for dog rabies within the 6 months before entry and do NOT have appropriate documentation of current US-issued rabies vaccine
  • Additional requirements for dogs that have been ONLY in countries that are dog rabies-free or low-risk in the 6 months before entry

Dogs that do not meet all entry requirements or do not have accurate and valid forms will be denied entry to the United States and returned to the country of departure at the importer’s expense. These requirements apply to all dogs, including service dogs and dogs that were born in the United States.

Specific requirements depend on whether the dog has been in a high-risk country for dog rabies  in the past 6 months.

Dogs with a current rabies vaccination administered in the United States that have been in a high-risk country for dog rabies must:  

  • Meet all requirements in the “All Dogs” section above
  • The Certification of U.S.-issued Rabies Vaccination form is required for the importation (re-entry) of U.S.-vaccinated dogs that have been in high-risk countries for dog rabies  within the 6 months before re-entry into the United States.
  • Please note, during the transition period, the importer may instead present a copy of the USDA endorsed export health certificate that was used to ship the dog from the United States, if that export health certificate documents the dog’s age (at least 6 months), the microchip number, and valid rabies vaccination administered in the United States. The rabies vaccination must be valid (not expired) on the date of return or the form will be invalid.
  • Arrive at the location listed on the CDC Dog Import Form receipt (This can be any airport, land border crossing, or sea port but you must select this location when you complete the CDC Dog Import Form.)

Dogs with a current rabies vaccination administered in the United States that have NOT been in a high-risk country in the last 6 months must:

  • A Certification of U.S.-Issued Rabies Vaccine form that was endorsed by USDA before the dog departed the United States; or
  • Document a valid (unexpired) rabies vaccination administered in the United States (the form will be valid for the duration of the rabies vaccination (1 or 3 years)).
  • Arrive at the location listed on the CDC Dog Import Form receipt (This can be any airport, land border crossing, or sea port but you must select this location when you complete the CDC Dog Import Form .)

Important information about the Certification of U.S.-Issued Rabies Vaccination Form

The Certification of U.S.-Issued Rabies Vaccination form must be completed before the dog departs the U.S. Before asking your veterinarian to complete this form, verify the following requirements will be met:

  • Ensure your dog will be at least 6 months of age on date of return to the U.S.
  • Have your dog microchipped with an International Organization for Standardization (ISO)-compatible microchip (implanted before any required rabies vaccinations)
  • Ensure the veterinarian scans the dog for the ISO-compatible microchip and records the microchip number at the time of vaccine appointment. Rabies vaccines administered prior to microchip implantation will not be considered valid.
  • Ensure the rabies vaccination will be valid for the entire duration of your travels. If your dog’s U.S.-issued rabies vaccination lapses while overseas and your dog has been in a high-risk country in the past 6 months, your dog will need to be revaccinated overseas and meet requirements for foreign-vaccinated dogs to return to the U.S., including having a rabies serology titer, arriving at a specific port of entry, and possible quarantine requirements.
  • Your dog’s first rabies vaccination must be administered at least 28 days before travel.
  • Ensure the veterinarian submits this form to the USDA for official endorsement through the VEHCS portal
  • Your dog must travel with a printed copy of the official endorsed form upon your dog’s return to the United States if your dog has been in a high-risk country within the 6 months before returning to the U.S.

During the transition period, U.S.-vaccinated dogs that have been in a high-risk country in the past 6 months, may have either the Certification of U.S.-Issued Rabies Vaccination form or the USDA endorsed export health certificate for re-entry into the United States. Without one of these forms your dog will need to meet the requirements specific to the risk category of the countries where they have been in the 6 months before returning to the United States.

The export health certificate must document the dog’s age (at least 6 months), microchip number, and the rabies vaccination date. The rabies vaccine must be valid (not expired) on the date of return or the form will be invalid.

Requirements for foreign-vaccinated dogs that have been in a country with high risk of dog rabies within 6 months before entry

Dogs, including service dogs, that have been in a country at high-risk for dog rabies within the 6 months before entry and do not have appropriate documentation of current U.S.-issued rabies vaccine must:

  • Meet all requirements in the “All Dogs” section
  • Ensure the dog is microchipped with an International Organization for Standardization (ISO)-compatible microchip before receiving the rabies vaccination and the number is recorded on the veterinary documents or the vaccine will not be considered valid
  • Verify the dog is at least 12 weeks (84 days) of age when vaccinated against rabies
  • The dog must have a valid (i.e., non-expired) rabies vaccination. If it’s the dog’s first vaccination or if the dog’s vaccination coverage has lapsed, the vaccine must be administered at least 28 days before arrival to the United States.
  • The Certification of Foreign Rabies Vaccination and Microchip form must be completed by your veterinarian AND endorsed by an official veterinarian in the exporting country.
  • The blood sample for the rabies serology titer must have been drawn at least 30 days after the dog’s first valid rabies vaccination and at least 28 days before entry to the U.S.
  • Dogs with a history of multiple valid rabies vaccinations administered after the microchip was placed may have the sample for the rabies serology titer drawn at any time after a rabies booster vaccination as long as the dog’s first vaccine was given at least 30 days before the blood sample was drawn and there has been no lapse in vaccine coverage. If a lapse occurs, the sample must be drawn at least 30 days after the valid booster vaccination was administered.
  • The sample must be sent to a CDC-approved rabies serology laboratory . If there is no CDC-approved laboratory in your country, your veterinarian may draw the sample and send it internationally to a CDC-approved laboratory.
  • Passing results must be obtained in order for a serology to be valid.
  • Rabies serology titer results will be considered valid for the life of the dog as long as the dog’s rabies vaccination coverage does not lapse. If a lapse occurs, a new rabies serology titer will be required and that sample must be drawn at least 30 days after the new vaccination was administered.
  • If the dog does not have a valid rabies serology titer, it will be required to be quarantined at a CDC-registered animal care facility for 28 days after the dog is revaccinated by the facility’s veterinarian.
  • All foreign-vaccinated dogs that have been in a high-risk country in the previous 6 months must have a reservation for examination, verification of age, documents, and microchip number, and administration of a rabies booster vaccination at a CDC-registered animal care facility immediately upon arrival in the United States.
  • Dogs that do not have a valid rabies serology titer must also have a reservation for quarantine. Dogs will be quarantined at the facility for 28 days at the importer’s expense after being revaccinated by the facility’s veterinarian.
  • All CDC-registered animal care facility expenses, including exam, revaccination, and quarantine (if required), are the responsibility of the importer.
  • The facility will need copies of all required documents prior to confirming your reservation.
  • Ensure the dog meets any facility-specific requirements (contact facility for additional information).
  • If after arrival the CDC-registered animal care facility determines that your documents are not valid or the dog’s microchip number, age, or description does not match the paperwork provided, the dog may be denied entry and returned to the country of departure at your expense.
  • Dogs that have evidence of illness or are not healthy will be required to have testing to confirm they do not have contagious diseases before they will be eligible for release, which may extend the required quarantine period beyond 28 days. Any required testing or extended stay in quarantine will be at the importer’s expense, so please ensure dogs are healthy upon arrival (including no evidence of fleas, ticks, or skin diseases).
  • Dogs must arrive to the U.S. at the airport where the CDC-registered animal care facility is located. This must be the location where the dog has a reservation.
  • This must also be the airport listed on the CDC Dog Import Form
  • Domestic flights or other forms of travel to other locations in the U.S. are not permitted until after the dog receives required follow-up services at the CDC-registered animal care facility and is cleared for entry.
  • SERVICE DOGS ARRIVING BY SEA : Service dogs, as defined in 14 CFR 382.3, may arrive by sea if they meet the requirements in the “All Dogs” section, have a complete Certification of Foreign Rabies Vaccination and Microchip form and a valid rabies serology titer, and are traveling with their handler. Emotional support animals are not service animals under this definition.

Countries that are not on the list of countries at high risk for dog rabies  are considered to be free of or low risk for dog-mediated rabies virus variant (DMRVV) (called dog rabies-free or low-risk countries on these webpages).

Dogs, including service dogs, that have been ONLY in dog rabies-free or low-risk countries during the 6 months before entry into the United States must:

  • Certification of Foreign Rabies Vaccination and Microchip form, including the endorsement by an official veterinarian of the dog rabies-free or low-risk country where the dog has been located; AND EITHER (1) a valid rabies serology titer OR (2) veterinary records* (which list the microchip number) for the dog from the exporting country for the previous 6 months. The form must be completed within 30 days before arrival to the United States.
  • Certification of U.S.-Issued Rabies Vaccination form that was endorsed by USDA before the dog departed the United States
  • Is for the dog rabies-free or low-risk country where the dog’s return itinerary originated (the form will only be valid for 30 days if it does not contain rabies vaccination information), or
  • Documents a valid (unexpired) rabies vaccination administered in the United States (the form will be valid for the duration of the rabies vaccination (1 or 3 years)).
  • Certification of Dog Arriving from DMRVV-free or Low-Risk Country into the United States form endorsed by an official veterinarian in the exporting country; AND veterinary records* (which list the microchip number) for the dog from the exporting country for the 6 months before traveling to the U.S. The form must be completed within the 30 days before arriving to the United States.
  • Foreign export certificate that documents the dog is at least 6 months of age, lists the dog’s International Organization for Standardization (ISO)-compatible microchip number, and has been endorsed by an official veterinarian of the exporting country; AND veterinary records* (which list the microchip number) for the dog from the exporting country for the previous 6 months
  • Arrive at the location listed on the CDC Dog Import Form receipt (This can be any airport, land border crossing, or sea port but you must select it when you complete the CDC Dog Import Form .)

Any documentation that is not from the United States must be completed in the country where the dog’s travel originates. For example, if the dog’s documents were issued in France, the dog may not enter the U.S. via a land-border crossing from Mexico to the U.S.

*Examples of veterinary records that must accompany completed forms are European Union pet passports or proof of payment for veterinary services received in the exporting low-risk country for the previous 6 months. Records must include the dog’s microchip number.

For more information, see: Frequently Asked Questions on CDC Dog Importations  

If you have questions or need more information, please contact CDC-INFO at (800) 232-4636.

  • Travelers' Health
  • Healthy Pets Healthy People
  • Southern Border Health and Migration
  • Port Health
  • Division of Global Migration Health

To receive email updates about this page, enter your email address:

Exit Notification / Disclaimer Policy

  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
  • Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
  • You will be subject to the destination website's privacy policy when you follow the link.
  • CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
  • Skip to main content
  • Keyboard shortcuts for audio player

Shots - Health News

Your Health

  • Treatments & Tests
  • Health Inc.
  • Public Health

The CDC issues new rules for bringing dogs into the U.S., aimed at keeping out rabies

Rob Stein, photographed for NPR, 22 January 2020, in Washington DC.

Traveling internationally with a dog — or adopting one from abroad — just got a bit more complicated. The CDC issued new rules intended to reduce the risk of importing rabies. mauinow1/Getty Images/iStockphoto hide caption

Traveling internationally with a dog — or adopting one from abroad — just got a bit more complicated. The CDC issued new rules intended to reduce the risk of importing rabies.

The Centers for Disease Control and Prevention announced new rules Wednesday aimed at preventing dogs with rabies from coming into the United States.

Under the new regulations, all dogs entering the U.S. must appear healthy, must be at least six months old, must have received a microchip, and the owner must verify the animal either has a valid rabies vaccine or has not been in a country where rabies is endemic in the last six months.

Dogs coming from a country that is considered at high risk for rabies and who received a rabies vaccine from another country must meet additional criteria. Those include getting a blood test before they leave the other country to make sure the animal has immunity against rabies, a physical examination upon arrival and getting a U.S. rabies vaccine. If the dog doesn't have a blood test showing immunity, it must be quarantined for 28 days.

These are much stricter requirements than existing regulations for dog importation — for those who want to adopt from abroad and for those traveling internationally with their pets.

Vaccine hesitancy affects dog-owners, too, with many questioning the rabies shot

Shots - Health News

Vaccine hesitancy affects dog-owners, too, with many questioning the rabies shot.

But, U.S pet owners shouldn't panic, says Dr. Emily Pieracci , a CDC veterinary medicine officer. "This really isn't a big change," she says. "It sounds like a lot, but not when you break it down, it's really not a huge inconvenience for pet owners."

Rabies was eliminated in dogs in the United States in 2007 , but unvaccinated canines can still contract the disease from rabid wildlife such as raccoons, skunks or bats.

And rabies remains one of the deadliest diseases that can be transmitted from animals to humans around the world. Globally, about 59,000 people die from rabies each year. The illness is nearly always fatal once a person begins to experience symptoms .

Today, pet dogs in the United States are routinely vaccinated against rabies.

"This new regulation is really set to address the current challenges we're facing," Pieracci says. Those include an increased risk of disease "because of the large-scale international movement of dogs," she adds, as well as fraudulent documentation for imported dogs.

The U.S. imports an estimated 1 million dogs each year. In 2021, amid a surge of pandemic-inspired dog adoptions, the CDC suspended importations from 113 countries where rabies is still endemic because of an increase in fraudulent rabies vaccination certificates. The countries include Kenya, Uganda, Brazil, Colombia, Russia, Vietnam, North Korea, Nepal, China and Syria.

That suspension will end when the new rules go into effect Aug. 1.

"This will bring us up to speed with the rest of the international community which already has measures in place to prevent the importation of of rapid dogs," Pieracci said. "So, we're playing catch-up in a sense."

The new regulations replace rules that date back to 1956. Those rules only required that dogs be vaccinated before entering the country.

To control rabies in wildlife, the USDA drops vaccine treats from the sky

To control rabies in wildlife, the USDA drops vaccine treats from the sky

"As you can imagine a lot has changed since then," Pieracci says. "International travel has increased dramatically and people's relationships with dogs have changed since the 1950s. During that time, it really wasn't common for dogs to be considered family member. They didn't sleep in peoples' beds. They certainly didn't accompany them on international trips."

The new rules won praise from the American Veterinary Medical Association . The organization "is pleased to see the implementation of this new rule that will help protect public health and positively impact canine health and welfare," said Dr. Rena Carlson, president of the AVMA in a statement to NPR.

Dog rescue advocates also welcomed the changes.

"This updated regulation will allow us to continue bringing dogs to the U.S. safely and efficiently," Lori Kalef, director of programs for SPCA International, said in a statement.

"We have seen that dogs have been a lifeline for U.S. service members during their deployments. One of our key programs reunites these service members and their animal companions here in the U.S. once they have returned home," she said. "The CDC's commitment to improving its regulations has a profound impact on the animals and service members we support, and this new policy is an important piece of that effort."

  • importing dogs

IMAGES

  1. Travel Vaccinations: Which Ones Should You Get?

    vaccine travel cdc

  2. COVID travel: CDC says fully vaccinated people can travel at low risk

    vaccine travel cdc

  3. CDC: Fully vaccinated people can travel in US| Latest News Videos

    vaccine travel cdc

  4. Vaccine passport: How to prove you got a COVID-19 shot for travel

    vaccine travel cdc

  5. COVID-19 vaccine card: What to do if you lost it, how to laminate it

    vaccine travel cdc

  6. CDC, vaccine manufacturers increase influenza doses to prepare for

    vaccine travel cdc

COMMENTS

  1. Travelers' Health

    More. Learn about CDC's Traveler Genomic Surveillance Program that detects new COVID-19 variants entering the country. Sign up to get travel notices, clinical updates, & healthy travel tips. CDC Travelers' Health Branch provides updated travel information, notices, and vaccine requirements to inform international travelers and provide ...

  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. Travel Vaccines to Protect Your Family

    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. Before you travel, find out which vaccines you and your family will need. Plan ahead to get the shots required for all ...

  4. Need travel vaccines? Plan ahead.

    Where can I get travel vaccines? You may be able to get some travel vaccines from your primary healthcare provider. If you or your healthcare provider need help finding a location that provides certain vaccines or medicines, visit CDC's Find a Clinic page. If yellow fever vaccine is recommended or required for your destination, you'll need ...

  5. Destinations

    Destinations. Measles cases are increasing globally, including in the United States. The majority of measles cases imported into the United States occur in unvaccinated U.S. residents who become infected during international travel. A list of countries with confirmed measles outbreaks can be found on the Global Measles Travel Health Notice (THN).

  6. Vaccines for Travelers

    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 ...

  7. Routine Vaccines

    You may need to get an accelerated dose of a vaccine or a booster dose before traveling. Routine vaccinations related to travel may include the following: COVID-19. Chickenpox (Varicella) Hepatitis A. Hepatitis B. Human Papilloma Virus (HPV) Influenza. Measles, mumps, Rubella.

  8. Stay Up to Date with COVID-19 Vaccines

    CDC recommends the 2023-2024 updated COVID-19 vaccines—Pfizer-BioNTech, Moderna, or Novavax—to protect against serious illness from COVID-19. Everyone aged 5 years and older ‡ should get 1 dose of an updated COVID-19 vaccine to protect against serious illness from COVID-19. Children aged 6 months-4 years may need multiple doses of ...

  9. CDC Releases Air Travel Guidance For Fully Vaccinated People ...

    The CDC considers someone fully vaccinated two weeks after they receive the last dose of vaccine. Those individuals will no longer need to get tested before or after travel unless their ...

  10. Fact Sheet: Biden Administration Releases Additional Detail for

    Accepted Vaccines: CDC has determined that for purposes of travel to the United States, vaccines accepted will include FDA approved or authorized and World Health Organization (WHO) emergency use ...

  11. 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.

  12. CDC Travel Guidelines: What You Need to Know

    What to Know About the C.D.C. Guidelines on Vaccinated Travel. In updated recommendations, the federal health agency said both domestic and international travel was low risk for fully vaccinated ...

  13. Frequently Asked Questions: Guidance for Travelers to Enter the U.S

    Q. What are the requirements for travelers entering the United States through land POEs? A: Before embarking on a trip to the United States, non-U.S. travelers should be prepared for the following: Possess proof of an approved COVID-19 vaccination as outlined on the CDC website. During border inspection, verbally attest to their COVID-19 vaccination status.

  14. How Do I Show Proof of Vaccination When Traveling ...

    United Airlines, American Airlines, British Airways and others have all rolled out varying technologies that allow passengers to upload proof of vaccination before a flight. In July, Clear, the ...

  15. Which Vaccinations Are Required for Travel?

    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 ...

  16. Mexico

    All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6-11 months, according to CDC's measles vaccination recommendations for international travel. Measles (Rubeola) - CDC Yellow Book. Rabies: Rabid dogs are commonly found in Mexico.

  17. 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.

  18. What to Know About Testing and Vaccine Requirements for Travel

    You do not need to be vaccinated for any domestic travel. Hawaii is the only state that requires a negative test for travel. In Hawaii, the test must be administered within 72 hours of arrival and ...

  19. Plan for Travel

    You should plan to be fully vaccinated at least 2 weeks before you depart. If your trip is less than 2 weeks away and you're not protected against measles, you should still get a dose of the measles-mumps-rubella (MMR) vaccine. The MMR vaccine protects against all 3 diseases. Two doses of MMR vaccine provide 97% protection against measles.

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

    This means starting May 12, noncitizen nonimmigrant air passengers will no longer need to show proof of being fully vaccinated with an accepted COVID-19 vaccine to board a flight to the United States. CDC's Amended Order Implementing Presidential Proclamation on Safe Resumption of Global Travel During the COVID-19 Pandemic will no longer be ...

  21. Vaccines and Immunizations

    Put CDC syndicated pages on your website for free. Just add a small piece of web code to your page and the content will automatically update whenever CDC updates this page. Content Syndication. Last Reviewed: November 16, 2023. Source: National Center for Immunization and Respiratory Diseases. CDC's Vaccines and Immunizations web site HOME PAGE.

  22. Polio: For Travelers

    Polio: For Travelers. Polio, or poliomyelitis, has been eliminated from most of the world. But it still occurs in some countries. Travelers to countries where there is an increased risk of exposure to poliovirus may receive a one-time booster dose of inactivated polio vaccine (IPV) before traveling. People who plan to travel internationally ...

  23. Vaccination

    Two typhoid fever vaccines are available in the United States. Oral vaccine: Can be given to people at least 6 years old. It consists of four pills taken every other day and should be finished at least 1 week before travel. Injectable vaccine: Can be given to people at least 2 years old and should be given at least 2 weeks before travel.

  24. Interactions Between Travel Vaccines & Drugs

    CDC Yellow Book 2024. During pretravel consultations, travel health providers must consider potential interactions between vaccines and medications, including those already taken by the traveler. A study by S. Steinlauf et al. identified potential drug-drug interactions with travel-related medications in 45% of travelers taking medications ...

  25. Travel Vaccines: When to Get Them, Side Effects, and Cost

    For instance, the yellow fever vaccine offers lifelong protection for most people. But typhoid vaccine boosters are recommended every 2 to 5 years. The typical yellow fever vaccine cost is around $170 — but this can vary by clinic and location. GoodRx can help make your travel vaccines more affordable.

  26. From August 1, 2024, Onward: What Your Dog Needs to Enter the United

    Visit a veterinarian to get your dog its rabies vaccination (or booster) before travel. Rabies vaccination is not required if the dog has been only in dog rabies-free or low-risk countries for 6 months, but is strongly recommended. It may also be required by the U.S. state or territory to which the dog is traveling. 30 days before travel

  27. The CDC issues new rules for bringing dogs into the U.S., aimed at

    The CDC issued new rules intended to reduce the risk of importing rabies. The Centers for Disease Control and Prevention announced new rules Wednesday aimed at preventing dogs with rabies from ...