immunizations for travel to europe

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Vaccines for Travelers

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

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

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

Which vaccines do I need before traveling?

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

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

How far in advance should I get vaccinated before traveling?

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

Where can I go to get travel vaccines?

Start by finding a:

• Travel clinic
• Health department
• Yellow fever vaccination clinic

Learn more about where you can get vaccines .

What resources can I use to prepare for my trip?

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

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

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

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

Find out which vaccines you need

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

Take the quiz now !

Get Immunized

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

Find out how to get protected .

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A Country-by-country Guide to COVID-19 Entry Requirements in Europe

Everything you need to know for a safe and healthy trip to Europe.

When the COVID-19 pandemic first spread around the world, many countries shut their borders. In the years since, countries have opened, welcoming tourists with different vaccination or testing rules in place. 

But many countries in Europe have since dropped travel-related restrictions, reverting back to pre-pandemic times and making it easier than ever to plan a trip. 

Here, we've outlined every country in Europe and its current reopening status, including entry any requirements foreign travelers need to know.

Albania does not require U.S. travelers to show any COVID-19-related documents or tests, according to the U.S. Embassy in Albania .

To get to Andorra, visitors need to go through France or Spain, and therefore abide by the rules and regulations for those individual countries. Beyond that, there are no further entry requirements for coming to Andorra, according to the Andorra tourism site .

Austria is open to travel and there are no vaccination or testing requirements in place, according to the country’s official tourism site . In Vienna, masks must be worn on public transportation. 

Belgium welcomes travelers from the U.S. and does not require them to show proof of vaccination, recovery, or a negative test, according to the U.S. Embassy in Belgium . 

Bosnia and Herzegovina

Bosnia and Herzegovina welcomes U.S. travelers without any COVID-19-related travel restrictions, according to the U.S. Embassy in Bosnia and Herzegovina .

Bulgaria welcomes U.S. travelers without any COVID-19-related travel restrictions, according to the U.S. Embassy in Bulgaria . 

Croatia welcomes U.S. travelers without any COVID-19-related travel restrictions, according to the Croatian National Tourist Board .

Cyprus has eliminated all COVID-19-related entry restrictions, according to the Deputy Ministry of Tourism . Masks remain mandatory on public transportation. 

Czech Republic

The Czech Republic has eliminated all COVID-19-related entry restrictions, according to the Ministry of the Interior of the Czech Republic .

Denmark eliminated all of its COVID-19 entry and internal restrictions, according to the government’s COVID-19 website .

Estonia has eliminated all COVID-19-related rules, according to the government .

Finland has lifted all COVID-19-related entry rules, according to the Finnish government .

France has lifted all pandemic-related entry rules, according to the French government .

There are no longer any COVID-19-related entry rules for travel to Germany, according to the German Missions in the United States .

Greece has lifted all pandemic-era travel rules, according to the government . Greece has an optional Passenger Locator Form travelers can choose to fill out.

Hungary has lifted all COVID-19-related entry rules, according to the Hungarian Police .

Iceland welcomes travelers without any pandemic-era entry rules in place, according to Iceland’s COVID-19 website .

Ireland has removed all COVID-19-related entry rules for travel, according to the government .

Italy has lifted all COVID-19-related travel rules, according to the country's National Tourist Board .

Travelers entering Kosovo are not required to show proof of vaccination, according to the U.S. Embassy in Kosovo , but the embassy recommends travelers bring such proof. The country also doesn’t require pre-arrival testing, but the embassy said some airlines may.

Access to public institutions, malls, and indoor dining inside does require proof of vaccination or proof of a negative COVID-19 test for customers over 16.

Latvia has lifted all COVID-19-related travel rules, according to the Latvian tourism board .

Liechtenstein

Liechtenstein, a landlocked country, is accessible through Switzerland or Austria. Switzerland handles all immigration for Liechtenstein. COVID-19-related travel restrictions have been lifted in Liechtenstein, according to the European Union .

Lithuania no longer requires any pre-arrival testing or proof of vaccination to visit, according to the national tourism development agency .

Luxembourg welcomes travelers from all countries, regardless of their vaccination status, according to the U.S. Embassy in Luxembourg . Travelers do not need any pre-arrival COVID-19 tests.

Malta has eliminated all pandemic-related travel restrictions, according to the Malta Tourism Authority .

Moldova does not have any COVID-19-related entry restrictions in place for U.S. travelers, according to the U.S. Embassy in Moldova .

To get to Monaco, most visitors must travel through France. Monaco does not have any pandemic-related travel restrictions in place, according to the government .

Montenegro does not have any COVID-19-related entry rules in place, according to the U.S. Embassy in Montenegro . Face masks are required on public transportation, according to the country’s government .

Netherlands

The Netherlands has lifted COVID-19-related entry rules, according to the government .

North Macedonia

North Macedonia is open to American travelers who are not required to undergo any COVID-related entry requirements, according to the U.S. Embassy in North Macedonia .

Norway has discontinued all COVID-19-related entry restrictions, including pre-arrival testing, according to the government . 

Poland has lifted all pandemic-era entry rules, including for vaccination and testing, according to the government . 

Portugal, including the Azores and Madeira, no longer requires proof of vaccination or a negative test to enter, according to Visit Portugal .

Romania has lifted all pandemic-era entry rules, according to the government . 

San Marino is a landlocked country surrounded by Italy. The country doesn’t have any specific COVID-19-related entry rules, according to the International Air Transport Association .

Serbia has removed all COVID-19-related entry restrictions, according to the U.S. Embassy in Serbia .

Slovakia has lifted all pandemic-related entry rules, according to Slovakia Travel . Travelers no longer have to show any proof of vaccination or tests to enter hotels, restaurants, or other venues.

Slovenia has eliminated pandemic-era travel restrictions, according to the government .

Spain has dropped all COVID-19-related health controls at entry points, according to the government , becoming one of the last European countries to do so. However, the country still asks that travelers from outside the European Union travel with either proof of vaccination administered within 270 days, proof of a negative PCR test taken within 72 hours of departure, proof of a negative rapid antigen test taken within 24 hours of departure, or proof they contracted COVID-19 and recovered within 180 days.

Sweden no longer has any COVID-19-related entry restrictions, according to the Public Health Agency of Sweden .

Switzerland

Switzerland has lifted all COVID-19-related entry rules, according to the Federal Office of Public Health .

Turkey is open to foreign travelers and does not have any COVID-19-related entry rules in place, according to the U.S. Embassy and Consulates in Turkey .

Visitors to Ukraine must show proof of either vaccination or proof of a negative COVID-19 test taken within 72 hours, according to the U.S. Embassy in Ukraine . Travelers must also have a health insurance policy to cover the potential costs of COVID-19 treatment.

The U.S. Department of State has currently issued a Level 4: Do Not Travel warning against visiting Ukraine due to the ongoing war and Russian invasion.

United Kingdom

The United Kingdom has dropped all COVID-19-related entry rules, according to the government .

Vatican City

Vatican City is the world's smallest country and is encircled by the Italian city of Rome. It is open to travelers who are able to enter Italy .

The information in this article reflects that of the publishing time above. However, as statistics and information regarding coronavirus rapidly change, some figures may be different from when this story was originally posted. While we strive to keep our content as up to date as possible, we also recommend visiting sites like the CDC or websites of local health departments.

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Get Vaccinated Before You Travel

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

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

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

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

Vaccinate at least a month before you travel

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

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

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

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

Last-minute travelers

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

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

• Discover and learn about specific diseases that can affect you while traveling
• What to do if you get sick after traveling
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Travel Vaccines and Advice for Western Europe

Western Europe is one of the most popular destinations for travelers throughout the world. The cuisine of Paris, history of Rome and beaches of Barcelona are just some of the draws. But, many travelers don’t realize the health risks that can occur as part of European travel.

Passport Health offers immunizations, medication and personalized healthcare for your trip to Western Europe and beyond. See our What Vaccines… section to learn more.

Countries in this region include:

What Vaccines Do I Need for Western Europe?

The CDC and WHO recommend the following vaccinations for travelers to Western Europe: hepatitis A , hepatitis B , typhoid and rabies .

Some routine vaccinations are also recommended, this includes: measles, mumps and rubella (MMR) , tetanus, diphtheria and pertussis (Tdap) , influenza , chickenpox , shingles , pneumonia , meningitis and polio .

COVID-19 vaccination is recommended for travel to all regions, both foreign and domestic. Check with your local Passport Health clinic if immunization is offered in your area.

Vaccine-preventable diseases like measles, mumps and pertussis have become increasingly more common in Western Europe. Make sure your vaccinations are up to date before travel.

See the table below for more vaccination information:

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Currently, tourist visas are not required for any country in Western Europe. But, passport validity can vary by country. Make sure your passport has at least six months before expiring before leaving for your trip.

Embassy information for each country is available on its own destination advice page.

Traveling to Another Destination?

Traveling outside of Western Europe? Learn more about your destination with our full compliment of destination advice pages!

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On This Page: What Vaccines Do I Need for Western Europe? What Are the Entry Requirements in Western Europe? Traveling to Another Destination?

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European countries will soon accept vaccinated US travelers. Here are the documents you'll need and how to know when it's safe.

• EU representatives voted Wednesday to allow fully vaccinated US travelers to visit soon.
• Americans will need to prove they've had their shots, but the specific rules may vary by country.
• Greece and Iceland, among the few countries already open to US tourists, are accepting CDC cards. 

Hold on to your vaccination cards: European Union representatives agreed on Wednesday that Americans who have been fully immunized should be allowed to visit the EU's 27 member nations. They won't have to show a negative COVID-19 test result or quarantine upon arrival, NBC News reported . Children may also be able to accompany their vaccinated parents abroad, regardless of their own vaccination status — provided that they have a negative coronavirus test.

The new travel guidelines are expected to be formally approved by the European Council later this week, meaning travel from the US to Europe could be possible this summer.

It's likely that Americans will need to show government-issued vaccine certificates to visit most European countries. For now, neither EU nor US officials have specified whether people will need to show the white vaccination card issued by the Centers for Disease Control and Prevention or other documentation.

Lisa Lee, a public-health expert at Virginia Tech, said European countries will probably have patchwork of different rules for US travelers.

"Some have said they're only going to accept electronic [vaccine records] so it can be verified," Lee told Insider. "Other people are afraid that the CDC cards are too prone to fraud and they won't accept the paper cards."

In an interview with Ouest France, French President Emmanuel Macron said foreign tourists could visit France with a "health pass" starting June 9. Macron didn't expand on what that pass would look like, though.

Spain's tourism secretary, meanwhile, has said the country is prepared to let travelers return in June — as long as visitors show proof they've been vaccinated, recently tested negative for the coronavirus, or recently recovered from COVID-19.

"One thing is clear: All 27 member states will accept, unconditionally, all those who are vaccinated with vaccines that are approved by EMA," Ursula von der Leyen, the European Commission president, told The New York Times in April , referring to the European Medicines Agency. The EMA has authorized all three vaccines used in the US: Pfizer, Moderna, and Johnson & Johnson.

Already, a few European countries — including Greece and Iceland — are allowing visitors from the US. Their policies could offer a hint at what to expect from other nations moving forward.

The US still doesn't recommend travel to Europe 

The CDC currently recommends avoiding all international travel to European countries, with the exception of Iceland and the UK. (The agency says Americans can travel there for essential visits only.) Similarly, the US is denying entry to visitors from the EU or UK unless they're US citizens.

The Biden administration hasn't said whether it will remove these restrictions in the near future, but travel and aviation groups are pushing the US government to open its borders to more countries , with testing requirements in place.

For now, the US also requires fully vaccinated Americans to test negative before reentering the country.

Lee said this policy helps protect the population from highly transmissible variants that are more prevalent in other countries and might evade protection from vaccines.

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"These vaccines are incredibly effective, but they're not 100% —  and they're certainly not 100% or as effective against strains that we don't know about yet that might be developing through transmission, so it's still a good time to be somewhat cautious," she said.

Greece and Iceland are accepting CDC cards as proof of vaccination

As of April 19, Greece is welcoming US travelers with a few stipulations: Visitors are asked to fill out a locator form at least one day before entering or leaving the country. Americans must also provide proof that they've been fully vaccinated — a CDC card is sufficient — or present a negative PCR test.

US travelers don't need to quarantine under this policy, a change that came with the new rule. Previously, Americans entering Greece had to isolate for a week. If a person tests positive upon arrival, however, they'll be transported to a hotel, where Greek authorities will confirm the test results and ask them to stay inside for 10 days. 

US travelers to Iceland can also avoid the nation's mandatory quarantine by presenting a CDC card that shows they are fully vaccinated. Alternatively, a person can provide proof that they've had COVID-19 already — either through a positive PCR or antibody test result.

But those going to Iceland still need to take another COVID-19 test upon arrival, then wait at their accommodation until the results are back (which can take up to 24 hours). Hotels in Iceland may ask to see your CDC vaccination card  as well.

Bulgaria, Croatia, Cyprus, Georgia, Montenegro aren't requiring US travelers to quarantine, either, if they show proof of vaccination. Italy is similarly allowing American visitors to bypass quarantine requirements with a negative COVID-19 test.

UK residents have been able to travel internationally since May 17 — but Americans who want to visit the UK must still present a negative COVID-19 test, quarantine for 10 days upon arrival, and get tested twice during their visit.

Travel requirements aside, an international trip brings risks

Just because a country is accepting US travelers doesn't mean a visit is low-risk. For Americans trying to decide whether to travel or where to go, Lee recommended that fully vaccinated people look at two key metrics: low levels of transmission and case numbers that are declining day over day.

"If you look at Portugal, for example, the incidence is a lot lower than Spain and they're right next to each other," Lee said.

On average, Spain is recording nearly 102 daily cases per 1 million people, while Portugal is recording around 39 daily cases per 1 million people. The CDC defines low transmission as fewer than 5 cumulative new cases per 100,000 people over the prior 28 days, and moderate transmission as fewer than 50 cumulative new cases per 100,000 people over 28 days.

If you're looking to lower your risk of infection, choose less crowded locales where you're unlikely to bump into people who haven't been vaccinated. Opt out of large events like concerts or soccer matches, too. 

"If you're planning a trip to the countryside, that's a very different calculus than if you're planning a trip to the middle of a bustling city," Lee said. 

Of course, outbreaks can also change course quickly, so a country that looks safe now may have high levels of transmission in three months. 

"Check the requirements frequently, right up until the departure date, as every country's policies are going to be changing in response to the way the epidemic evolves," Lee said.

The website Skyscanner offers real-time updates on countries' travel restrictions and quarantine requirements. Make sure to prepare the necessary documentation for each country you plan to visit.

"You don't want to get from one place to another and discover, 'Oh, whoops, they need this piece of paper or that piece of software and I don't have that,'" Lee said.

This story has been updated. It was originally published on May 2, 2021.

Watch: We followed a Delta cleaning crew to see how the airline is sanitizing planes as travel ramps back up

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What are the vaccine requirements for European travel?

Traveling to the European Union (EU) or Schengen Area is a dream for many global tourists, workers, and students alike. However, health and safety measures have become crucial considerations, significantly reshaped by the COVID-19 pandemic. At the time of writing this article, there is no European country that still requires Covid-19 testing or vaccination before allowing entry. That is because. from the beginning of January 2023, the EU COVID vaccine requirements have been lifted by all the countries in the region.

EU nations have now reverted to the same entry measures that applied before the arrival of Covid-19.

Pre-COVID-19 Vaccination Requirements

Before the COVID-19 pandemic, the EU and Schengen Area did not require mandatory vaccinations for travellers, except for certain circumstances. These exceptions usually applied to individuals traveling from countries with high risks of particular infectious diseases.

• Yellow Fever: For travellers from or transiting through countries where yellow fever is endemic, a yellow fever vaccination certificate is required.
• Tuberculosis, Polio, and Other Diseases: Specific vaccines might be recommended depending on the health situation in the travellers’ home country or the EU/Schengen Area member state they intend to visit.

The pre-COVID-19 vaccination recommendations mostly cantered around individual health protection rather than public health security at large.

COVID-19 Impact: From Crisis to Vaccination Rollout

The COVID-19 pandemic drastically changed global travel, and the EU/Schengen Area has been no exception. As the pandemic unfolded, the EU adopted temporary travel restrictions, and stringent health checks became a common feature at borders.

Eventually, as vaccines against COVID-19 became available, they emerged as a key tool in facilitating safer travel. The EU and Schengen countries implemented new vaccination requirements, making COVID-19 vaccinations crucial for traveling to these regions.

Post-COVID-19 Vaccination Requirements

Current vaccine requirements.

Currently, there are no vaccine requirements to enter the Schengen Area for travellers entering the block without a visa. If a Schengen Visa is required, travellers will be advised of any possible vaccine requirements at the time of their consulate interview.

Previous COVID-19 Vaccination Certificates

As part of its response to the pandemic, the EU launched the EU Digital COVID Certificate (previously known as the Digital Green Certificate). The certificate functioned as verification that an individual was inoculated against COVID-19, had a negative test outcome, or had recuperated from COVID-19. Only vaccines approved by the European Medicines Agency (EMA) or a comparable national body were deemed acceptable. They primarily include Pfizer-BioNTech, Moderna, AstraZeneca, and Johnson & Johnson vaccines.

Previous Traveller Health Declarations

Some EU/Schengen Area member states required health declarations or additional health checks from arriving passengers. These measures were put into place to monitor potential COVID-19 symptoms among travellers.

Impacts and Considerations

• Impact on Travel: The COVID-19 vaccine requirement had significantly impacted international travel, with a marked increase in vaccination rates among frequent travellers.
• Equity Concerns: The disparity in global vaccine distribution raised equity concerns. Travellers from countries with slower vaccine rollouts faced greater difficulties in meeting the EU's vaccine requirements.
• Recognition of Vaccines: The EU's acceptance of only certain vaccines posed challenges. Travellers inoculated with vaccines not recognized by the EMA faced restrictions. To make matters confusing, individual member states sometimes had their own regulations and accepted other vaccines.
• Validity and Booster Shots: With ongoing research about vaccine effectiveness and duration, new guidelines concerning booster shots and certificate validity emerged, affecting future travel requirements.

The road ahead

As the global community continues to grapple with the aftermath of COVID-19, the vaccine requirements for entering the EU/Schengen Area will likely remain dynamic. Governments, health authorities, and travellers will need to stay informed and adaptable.

Despite the challenges, these measures underscore the EU's commitment to protecting public health while enabling international travel. As we navigate this new era, the hope remains for a return to normal travel circumstances bolstered by a robust understanding of global health security.

What kinds of vaccinations should I get if I plan to visit Western Europe?

The WHO and CDC recommend that travellers get the following types of vaccinations before they visit Western Europe: rabies, typhoid, hepatitis B, and hepatitis A.

They also recommend the following routine vaccinations: mumps, measles, rubella, diphtheria, tetanus, pertussis, chickenpox, influenza, pneumonia, shingles, polio, and meningitis.

Although these are no longer mandatory, Covid-19 vaccinations are still recommended for all foreigners who want to travel to Europe and for locals who want to travel to a different part of the continent.

Diseases that could be prevented by vaccination, such as mumps and measles, are starting to become increasingly common in parts of Western Europe. We recommend that you double-check your immunization status and get any necessary vaccines before you go.

The COVID-19 pandemic has significantly altered the landscape of travel to the EU and Schengen Area, with vaccinations now playing a central role in travel protocols. These changes underscore the ongoing commitment to safeguarding both public health and the freedom of movement. As we continue to adapt to this evolving situation, vaccines will remain a key factor in navigating international travel and fostering global connectivity in a post-pandemic world. 

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Help! I’m Traveling to Europe. All the Requirements Are a Dizzying Mess.

For three confused but vaccinated travelers, our columnist tries to make sense of the new rules of entry into the European Union.

By Sarah Firshein

Dear Tripped Up,

I know that vaccinated Americans are not required to quarantine when visiting France , but are they required to take a Covid test — either going there or returning home? And although I updated my Clear app to show that I have been vaccinated, I don’t know who is responsible for looking at it: Is it the airline when you check in, an officer when you go through security or someone on the ground when you land? Bob

Once upon a time, the requirements for international travel weren’t all that complicated: always a passport, sometimes a visa.

Today, to leave one country and enter another is to contend with confusing rules and restrictions that continue to change as borders reopen and travel resumes.

Americans will encounter varying health protocols while traveling abroad. France is allowing vaccinated visitors from a short list of “green” countries — which includes the United States — to enter without restrictions. Greece and Lebanon are, too. But since January, everyone traveling to the United States has been required to take a Covid test within three days of their flight. That applies to residents and visitors, vaccinated and unvaccinated, alike.

Although vaccination requirements are set by countries, not airlines, airlines are not allowing passengers to check in for international flights without first verifying whatever documents are required, including vaccination records and virus tests.

What that means logistically depends on the airline — and sometimes the airport. Passengers on Delta Air Lines flights, for example, will have their documents verified in-person by a check-in agent and again by a gate agent before boarding. United Airlines passengers are cleared for check-in after the necessary documents are verified in person or online at United’s Travel-Ready Center , an online hub that tells confirmed ticket-holders what’s required, based on their destination. (The digital option allows carry-on die-hards to get a boarding pass without an in-person check at the airport.)

Depending on a multitude of factors, including where you’re going and how airports are set up, you should also expect to produce proof of vaccination at other touch points along the “getting there” part of the trip, including at customs and immigration after landing.

There are a bunch of new digital health pass initiatives that verify and store vaccination records and test results, including one from Clear, the biometrics company. Digital passes provide another layer of safeguard and allow you to easily show proof of vaccination when asked, whether it’s by a check-in agent at an airport or a host at a restaurant where indoor dining is reserved for vaccinated patrons. But because digital passes are nonstandardized at this point, and are accepted at a venue’s discretion, it’s important to always have your physical card when traveling, as well. Treat it like a passport or driver’s license; as in, something you would never leave home without and something you’re asked to routinely pull out on command while traveling.

In addition to vaccination records and test results, many international destinations are also requiring that health declaration forms be filled out before arrival. The Delta Discover Map is a handy online tool for keeping the dizzying mess of what’s required, and where, straight.

My husband and I purchased plane tickets to the U.K. and Copenhagen for late September. In the fine print of Denmark’s updated policies, “fully vaccinated” is defined as: “You must have received your final dose of vaccination at least 14 days, but no more than 180 days, before traveling.” But because my husband was vaccinated in early February, he will be outside the 180 days when we visit. What gives? Alanna

Dear Alanna,

Denmark has reopened for fully vaccinated American travelers and those from several other countries. But as if to underscore the ragtag, in flux nature of the nitty-gritty of travel in the Covid era, the rules have evolved further in the few weeks since. To boot: When I emailed Visit Denmark, the country’s tourism organization, a spokeswoman directed me to the press office for the Danish Health Authority, where a spokesman steered me to the Ministry of Foreign Affairs, where a spokeswoman sent me to the Ministry of Justice.

A few days later, a spokesman from the Danish Ministry of Health emailed with news: As of July 2 , vaccinations are now “valid” for 12 months.

Long story short: Wherever their desired destination, travelers should expect country-by-country requirements to shift, so it’s important to continue to check for updates and book tickets that can be changed or canceled without penalty.

This winter, while living in Barbados, I received two properly spaced doses of Covishield, the version of the AstraZeneca vaccine that was manufactured in India, as well as a temporary vaccination certificate that includes my United States passport number and other essential information. I’m planning a trip to Germany and Italy in September, and I’m wondering if the European Union will recognize my Barbados vaccination certificate. Tom

The Barbadian Ministry of Health and Wellness is in the process of issuing electronic certificates to everyone who’s been vaccinated in the country, including those who initially received temporary certificates. The new certificates will feature a barcode and security seal, and can be requested by phone or email.

Although Covishield was approved for emergency use by the World Health Organization in February, it has not yet been formally authorized by the European Medicines Agency, the branch of the European Union that oversees the scientific evaluation of medicines and vaccines. By contrast, vaccines manufactured by Pfizer, Moderna and Johnson & Johnson, plus the version of the AstraZeneca vaccine that was manufactured in Europe, have all been authorized by the E.M.A. Those are also the four that have been approved by the European Commission for the EU Digital COVID Certificate , which is designed to ease travel within Europe.

In considering who’s allowed to enter for nonessential travel, some European countries are still taking their cues directly from that list. But because individual countries can also choose whether or not to accept other vaccinations as proof of immunity, Germany, Iceland, Belgium and a growing list of others , including France, are now accepting Covishield. Italy isn’t yet, but travelers coming from elsewhere in Europe can also take a virus test to enter, even if they don’t possess the needed proof of vaccination.

In an email, a spokeswoman from the E.M.A. said the agency “has not received a marketing authorization application for Covishield. Should there be any change we would communicate about it.”

“The decision on entry in the E.U. is a Member State competence,” a European Commission spokesman said in an email. “However, in order to ensure a coordinated approach across the E.U., the Commission is discussing these vaccines — those that correspond to E.M.A. authorized vaccines, and vaccines listed by the W.H.O. — with the Member States in the Health Security Committee.”

In short, keep a close eye on Italy and other E.U. countries, because they may add Covishield to their lists of vaccines that prove immunity and exempt travelers from testing and quarantine.

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We asked readers to tell us about the spots that have delighted, inspired and comforted them in a dark year. Here, 52 of the more than 2,000 suggestions we received, to remind us that the world still awaits.

If you need advice about a best-laid travel plan that went awry, send an email to [email protected] .

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Travel vaccination advice

If you're planning to travel outside the UK, you may need to be vaccinated against some of the serious diseases found in other parts of the world.

Vaccinations are available to protect you against infections such as yellow fever , typhoid and hepatitis A .

In the UK, the  NHS routine immunisation (vaccination) schedule protects you against a number of diseases, but does not cover all of the infectious diseases found overseas.

When should I start thinking about the vaccines I need?

If possible, see the GP or a private travel clinic at least 6 to 8 weeks before you're due to travel.

Some vaccines need to be given well in advance to allow your body to develop immunity.

And some vaccines involve a number of doses spread over several weeks or months.

You may be more at risk of some diseases, for example, if you're:

• travelling in rural areas
• backpacking
• staying in hostels or camping
• on a long trip rather than a package holiday

If you have a pre-existing health problem, this may make you more at risk of infection or complications from a travel-related illness.

Which travel vaccines do I need?

You can find out which vaccinations are necessary or recommended for the areas you'll be visiting on these websites:

• Travel Health Pro
• NHS Fit for Travel

Some countries require proof of vaccination (for example, for polio or yellow fever vaccination), which must be documented on an International Certificate of Vaccination or Prophylaxis (ICVP) before you enter or when you leave a country.

Saudi Arabia requires proof of vaccination against certain types of meningitis for visitors arriving for the Hajj and Umrah pilgrimages.

Even if an ICVP is not required, it's still a good idea to take a record of the vaccinations you have had with you.

Find out more about the vaccines available for travellers abroad

Where do I get my travel vaccines?

First, phone or visit the GP practice or practice nurse to find out whether your existing UK vaccinations are up-to-date.

If you have any records of your vaccinations, let the GP know what you have had previously.

The GP or practice nurse may be able to give you general advice about travel vaccinations and travel health, such as protecting yourself from malaria.

They can give you any missing doses of your UK vaccines if you need them.

Not all travel vaccinations are available free on the NHS, even if they're recommended for travel to a certain area.

If the GP practice can give you the travel vaccines you need but they are not available on the NHS, ask for:

• written information on what vaccines are needed
• the cost of each dose or course
• any other charges you may have to pay, such as for some certificates of vaccination

You can also get travel vaccines from:

• private travel vaccination clinics
• pharmacies offering travel healthcare services

Which travel vaccines are free?

The following travel vaccines are available free on the NHS from your GP surgery:

• polio (given as a combined diphtheria/tetanus/polio jab )
• hepatitis A

These vaccines are free because they protect against diseases thought to represent the greatest risk to public health if they were brought into the country.

Which travel vaccines will I have to pay for?

You'll have to pay for travel vaccinations against:

• hepatitis B
• Japanese encephalitis
• tick-borne encephalitis
• tuberculosis (TB)
• yellow fever

Yellow fever vaccines are only available from designated centres .

The cost of travel vaccines that are not available on the NHS will vary, depending on the vaccine and number of doses you need.

It's worth considering this when budgeting for your trip.

Other things to consider

There are other things to consider when planning your travel vaccinations, including:

• your age and health – you may be more vulnerable to infection than others; some vaccines cannot be given to people with certain medical conditions
• working as an aid worker – you may come into contact with more diseases in a refugee camp or helping after a natural disaster
• working in a medical setting – a doctor, nurse or another healthcare worker may require additional vaccinations
• contact with animals – you may be more at risk of getting diseases spread by animals, such as rabies

If you're only travelling to countries in northern and central Europe, North America or Australia, you're unlikely to need any vaccinations.

But it's important to check that you're up-to-date with routine vaccinations available on the NHS.

Pregnancy and breastfeeding

Speak to a GP before having any vaccinations if:

• you're pregnant
• you think you might be pregnant
• you're breastfeeding

In many cases, it's unlikely a vaccine given while you're pregnant or breastfeeding will cause problems for the baby.

But the GP will be able to give you further advice about this.

People with immune deficiencies

For some people travelling overseas, vaccination against certain diseases may not be advised.

This may be the case if:

• you have a condition that affects your body's immune system, such as HIV or AIDS
• you're receiving treatment that affects your immune system, such as chemotherapy
• you have recently had a bone marrow or organ transplant

A GP can give you further advice about this.

Non-travel vaccines

As well as getting any travel vaccinations you need, it's also a good opportunity to make sure your other vaccinations are up-to-date and have booster vaccines if necessary.

Although many routine NHS vaccinations are given during childhood, you can have some of them (such as the MMR vaccine ) as an adult if you missed getting vaccinated as a child.

There are also some extra NHS vaccinations for people at higher risk of certain illnesses, such as the flu vaccine , the hepatitis B vaccine and the BCG vaccine for tuberculosis (TB) .

Your GP can advise you about any NHS vaccinations you might need.

Find out about NHS vaccinations and when to have them

Page last reviewed: 16 March 2023 Next review due: 16 March 2026

Important Immunizations For Traveling To Italy

• Last updated May 31, 2024
• Difficulty Intemediate

• Category Travel

Italy is a true gem of Europe, offering a rich history, stunning architecture, delicious cuisine, and picturesque landscapes. If you’re planning a trip to this beautiful country, it’s important to make sure you’re prepared and protected against potential health risks. One way to safeguard your health while traveling to Italy is by getting the necessary immunizations. From hepatitis A and B to typhoid fever and influenza, these vaccinations will give you peace of mind and ensure a safe and enjoyable journey through la bella Italia. So, before you indulge in mouth-watering pasta, explore ancient ruins, or wander through charming Italian streets, take the necessary steps to protect your health and make the most of your Italian adventure.

What You'll Learn

Required immunizations for travel to italy, recommended vaccines for traveling to italy, common infectious diseases in italy and how to prevent them, health and safety precautions for travelers in italy.

If you are planning a trip to Italy, it is important to make sure you are up to date on your immunizations. Vaccines can help protect you from getting sick and they may be required for entry into the country. Here is a list of the required immunizations for travel to Italy:

• Routine Vaccines: Make sure you are up to date on your routine vaccinations, which include measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and your yearly flu shot.
• Hepatitis A: This vaccine is recommended for all travelers to Italy, regardless of the length of stay. Hepatitis A is a viral infection that can be transmitted through contaminated food or water. Getting vaccinated can help prevent this infection.
• Hepatitis B: It is also recommended to get vaccinated against hepatitis B, particularly if you may have sexual contact with a new partner, get a tattoo or piercing, or have any medical procedures during your trip. Hepatitis B is transmitted through infected blood and bodily fluids.
• Typhoid: Typhoid fever is a bacterial infection that can be contracted through contaminated food or water. If you are planning to eat or drink outside of major restaurants and hotels in Italy, it is recommended to get a typhoid vaccine.
• Rabies: Rabies is a deadly viral infection that can be transmitted through animal bites or scratches. If you plan to be involved in outdoor activities or visit rural areas where you may have contact with animals, it is recommended to get a rabies vaccine.
• Meningococcal: This vaccine is recommended for travelers who plan to have close contact with the local population in Italy or attend large gatherings (such as festivals or sporting events). Meningitis is a serious infection that can be life-threatening, and getting vaccinated can help protect you.

It is important to consult with a healthcare professional or travel medicine specialist before your trip to Italy. They can assess your vaccination history and provide personalized recommendations based on your specific health needs and travel itinerary. Remember to get your vaccines well in advance of your trip, as some vaccines may require multiple doses or take time to become effective. By staying up to date on your immunizations, you can help ensure a safe and enjoyable trip to Italy.

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Italy is a popular travel destination, but it's important to make sure you are up-to-date on your immunizations before you go. While there are no specific immunization requirements for traveling to Italy, there are a few recommended vaccines that you should consider getting to help protect yourself from preventable diseases.

Routine Vaccinations:

Before traveling to Italy, it's important to make sure you are up-to-date on your routine vaccinations. These typically include vaccines such as the measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, and the annual influenza vaccine. These vaccines help protect you from common illnesses that can be easily spread, especially in crowded travel environments.

Hepatitis A:

Hepatitis A is a viral infection that can be transmitted through contaminated food and water. Italy has a high standard of hygiene, but it's still possible to come into contact with the virus, especially if you eat street food or in rural areas. Getting the hepatitis A vaccine is recommended for travelers visiting Italy, especially if you plan to stay for an extended period or have a weakened immune system.

Hepatitis B:

Hepatitis B is a viral infection that can be transmitted through contact with infected blood or bodily fluids. It can be spread through sexual contact, sharing needles, or getting a tattoo or piercing with unsterile equipment. If you plan on participating in activities that can put you at risk for hepatitis B transmission, such as getting a tattoo or piercing, it's recommended to get the hepatitis B vaccine before traveling to Italy.

Typhoid fever is a bacterial infection that can be contracted through contaminated food and water. While the risk of typhoid in Italy is generally low, it's still a good idea to consider the vaccine, especially if you plan on traveling to more remote areas or will be visiting friends or relatives who live there. The typhoid vaccine can be administered as an injection or as an oral medication, so discuss with your healthcare provider which option is best for you.

Rabies is a viral infection that is transmitted through the bite or scratch of an infected animal. While the risk of rabies in Italy is very low, it's always important to be cautious. If you plan on participating in outdoor activities or will be in close contact with animals, it may be a good idea to get the rabies vaccine before you travel. It's a series of three injections, so it's important to plan ahead and get the vaccine well in advance of your trip.

While these are the recommended vaccines for traveling to Italy, it's always best to consult with a healthcare professional who specializes in travel medicine. They will be able to evaluate your specific health needs and recommend any additional vaccines or precautions based on your travel itinerary and medical history. Remember, prevention is key, so it's always better to be safe than sorry when it comes to protecting your health while traveling.

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Italy is a beautiful country known for its rich history, delicious cuisine, and stunning landscapes. If you are planning a trip to Italy, it is important to take certain precautions to prevent common infectious diseases that you may encounter while traveling. In this blog post, we will discuss some of the most common infectious diseases in Italy and provide tips on how to stay healthy during your trip.

• Influenza: Influenza, or the flu, is a common viral infection that can be easily spread from person to person. It is especially prevalent during the winter months. To protect yourself from the flu, it is recommended to get a flu shot before your trip. The flu shot is usually given annually and provides protection against the most common strains of the virus.
• Hepatitis A: Hepatitis A is a highly contagious viral infection that affects the liver. It is commonly spread through contaminated food and water. To prevent hepatitis A, it is important to practice good hygiene and avoid consuming raw or undercooked seafood, fruits, and vegetables. Additionally, getting vaccinated against hepatitis A is recommended, especially if you are planning to visit rural areas or small towns where sanitation may be compromised.
• Typhoid fever: Typhoid fever is a bacterial infection that spreads through contaminated food and water. It is more common in areas with poor sanitation. To prevent typhoid fever, it is important to practice good hygiene and avoid consuming food and drinks from street vendors or establishments with questionable hygiene practices. Vaccination against typhoid fever is also recommended, especially if you are traveling to rural areas or staying for an extended period of time.
• Measles: Measles is a highly contagious viral infection that spreads through respiratory droplets. It causes a rash, fever, and other flu-like symptoms. If you have not been vaccinated against measles or have not had the disease before, it is recommended to get vaccinated before your trip. Measles outbreaks can occur in any country, including Italy, so being vaccinated is important to protect yourself and others.
• Tick-borne encephalitis: Tick-borne encephalitis is a viral infection that is transmitted through tick bites. It is more common in rural areas and woodlands. If you are planning outdoor activities, such as hiking or camping, in tick-infested areas, it is important to take precautions to prevent tick bites. Wearing long sleeves, using insect repellent, and checking your body for ticks after outdoor activities can help reduce the risk of infection. Vaccination against tick-borne encephalitis is also available and recommended, especially if you will be spending a lot of time in tick-infested areas.

In addition to these specific diseases, it is important to maintain general hygiene practices to prevent the spread of infectious diseases. Wash your hands frequently with soap and water, or use hand sanitizer when soap and water are not available. Avoid close contact with sick individuals, and cover your mouth and nose with a tissue or your elbow when sneezing or coughing.

It is always a good idea to consult with a healthcare professional or travel clinic before your trip to Italy. They can provide personalized advice based on your specific needs and medical history. By taking these preventive measures, you can enjoy a healthy and safe trip to Italy.

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Italy is a stunning destination that offers a rich history, vibrant culture, and delicious cuisine. However, it is important to prioritize your health and safety while traveling in Italy. To ensure a worry-free trip, here are some essential health and safety precautions you should consider:

• Consult with a healthcare professional: Before traveling to Italy, it is wise to consult with your healthcare provider or a travel medicine specialist. They can provide you with up-to-date information on any required or recommended immunizations for your trip. While Italy does not have any mandatory immunizations for travelers, it is still important to ensure that your routine immunizations, such as measles, mumps, and rubella (MMR), diphtheria, tetanus, and pertussis (DTaP), and influenza, are up to date.
• Purchase travel health insurance: It is highly recommended to purchase travel health insurance before your trip to Italy. This will provide you with financial protection in case you require medical treatment during your stay. Take the time to review the terms and coverage of your insurance policy to ensure it suits your needs.
• Stay hydrated and protect yourself from the sun: Italy's summers can be scorching, so it is crucial to stay hydrated and protect yourself from the sun. Carry a refillable water bottle with you at all times and drink plenty of fluids. Apply sunscreen with a high sun protection factor (SPF) and wear a hat, sunglasses, and lightweight, breathable clothing to shield yourself from harmful UV rays.
• Practice good hygiene: To prevent illnesses, it is essential to practice good hygiene habits while traveling in Italy. Wash your hands thoroughly with soap and water or use hand sanitizer regularly, especially before eating or touching your face. Carry hand sanitizer with you for situations where soap and water are not available.
• Be cautious with food and water: Italy is renowned for its delicious cuisine, but it is important to be cautious with your food and water choices. Opt for bottled water or use a water filter to ensure its safety. Avoid consuming raw or undercooked food, street food, or food from questionable establishments. Stick to well-cooked, hot meals and fruits that you can peel yourself.
• Stay vigilant against pickpocketing: Like many popular tourist destinations, Italy has its share of pickpocketing incidents. Stay vigilant and keep your personal belongings secure at all times. Use a money belt or a hidden wallet to carry your passport, cash, and important documents. Avoid displaying wealth or carrying large amounts of cash.
• Stay up to date with travel advisories: Keep an eye on travel advisories issued by your government or international organizations. These advisories provide important information on safety and security concerns in specific regions, cities, or countries. It is wise to avoid areas with high crime rates or political unrest.
• Practice road safety: If you plan to rent a car or use public transportation in Italy, practice road safety. Italy's road infrastructure can be challenging, and driving styles can be aggressive. Familiarize yourself with local traffic laws, wear seatbelts, and avoid driving under the influence of alcohol or drugs.
• Know emergency numbers: Before your trip, make sure you know the emergency numbers in Italy. The general emergency number is 112, which can connect you to police, fire, and medical services. Keep important contacts saved in your phone or written down for easy access in case of an emergency.

Remember, it is always better to be prepared and take necessary precautions to safeguard your health and safety while traveling. By following these tips, you can enjoy a memorable and worry-free trip to Italy.

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Travel vaccinations

Measles cases are increasing worldwide.

Before travelling, check that you and your family have received the recommended measles vaccinations.

Do not travel if you have symptoms of measles or have been in contact with someone with measles.

If you develop symptoms of measles after your return to Canada, call a health care provider right away.

Global Measles Notice

When travelling outside Canada, you may be at risk for a number of vaccine preventable illnesses.

You should consult a health care provider or visit a travel health clinic preferably six weeks before you travel. This is an opportunity to:

• review your immunization history
• make sure your provincial/territorial vaccination schedule is up-to-date
• discuss any trip-related health concerns you may have
• assess your needs based on where you plan to travel and what you plan to do

You may need additional vaccinations depending on your age, planned travel activities and local conditions. Preventing disease through vaccination is a lifelong process.

Use the reference below to determine which vaccinations may be recommended or required for your destination.

Vaccination recommendations by destination

Yellow fever vaccination.

Some countries require proof that you have received a yellow fever vaccination before allowing you to enter the country. Consult an embassy or consulate of your destination country in Canada for up-to-date information on its entry and exit requirements before you travel abroad.

Other countries may require you to have been vaccinated for yellow fever if you have passed through an area where yellow fever may occur .

Proof of vaccination must be documented on an International Certificate of Vaccination or Prophylaxis . You must carry the original certificate with you.

In Canada, the vaccination is only given at designated yellow fever vaccination centres .

Immunization records

• Download the free CANImmunize app from the iOS App Store or Google Play, and manage your family’s vaccination records on the go.
• Carry copies of your family’s immunization records while you travel and leave the originals at home.
• Sickness or injury
• Travel Advice and Advisories
• If you get sick after travelling
• Receiving medical care in other countries
• Travel health kit
• Travel insurance
• Well on Your Way - A Canadian’s Guide to Healthy Travel Abroad
• Tips for healthy travel
• Yellow Fever Vaccination Centres in Canada , Public Health Agency of Canada (PHAC)
• Recommended Immunization Schedules , PHAC

European vaccine requirements and recommendations for travellers

This website does not belong to, nor is it affiliated with, the EU. The official website of the European Union is europa.eu.

• You are advised to get some vaccinations before travelling to countries in the EU
• COVID-19 vaccination is no longer mandatory for Europe, but it remains recommended

Health and safety is top priority when travelling overseas. Although European countries are considered safe destinations, there are some preventative measures visitors can take to promote well-being.

This article explains:

• Recommended vaccines to travel to EU destinations
• COVID-19 vaccine information for travelling to Europe
• Other health advice for your trip to Europe

You should consider speaking with a medical professional before your trip to Europe. They may have specific recommendations depending on your health circumstances.

Recommended vaccines for travelling to the EU

As mentioned above, there are no mandatory vaccinations for Europe. However, visitors may take into consideration the following recommendations.

Vaccines recommended for all travellers to Europe

You can use your trip to Europe as an opportunity to get up-to-date with routine vaccinations .

According to the US Centers for Disease Control and Prevention CDC), routine vaccinations trips to Spain, France, and other European countries include:

• Diphtheria-Tetanus-Pertussis
• Seasonal flu
• Measles-Mumps-Rubella

Being up-to-date with primary and booster doses of these vaccines is recommended for all travellers, regardless of health situation and travel plans.

European vaccines that depend on travel plans and health condition

A medical professional may recommend that travellers get vaccinated against Hepatitis A and/or Hepatitis B before travelling to Europe.

Hepatitis A

• How is it spread?

Hepatitis A is spread through consuming contaminated food or water

• Should I get vaccinated?

Recommended if you are visiting rural areas or planning to eat street food. Risk is highest where sanitation is poor.

• Other considerations

If you have a medical condition which increases your chances of disease, consider getting this vaccine for Europe. Men who have sex with men and people who inject drugs are also at higher risk.

Hepatitis B

Hepatitis B is spread through infected blood, contaminated needles, and sexual intercourse.

If you are staying in Europe for a long period or visiting frequently, this is recommended. It is also an advisable vaccine for children who are more prone to cuts.

The risk of contracting this disease is highest for people who have an underlying medical condition, people who change sexual partners often, men who have sex with men, and people who inject drugs.

Do I need a COVID-19 vaccine to travel to Europe?

COVID-19 vaccines are no longer mandatory to travel to countries in the EU. You will not be asked to present proof of your vaccination status.

Nevertheless, travellers are advised to get vaccinated against COVID-19 before any overseas trips, including to Europe.

Other health recommendations for your trip to Europe

Aside from EU travel vaccines, there are some other things to take into consideration when preparing for your trip:

• Travel insurance : comprehensive travel insurance covering healthcare in Europe is highly recommended for all travellers and obligatory for Schengen visa applicants .
• Medication : if you are travelling to Europe with medication, check whether there are any restrictions for your destination
• Avoid travel if unwell : postpone travel plans if you feel unwell in the days leading up to your trip

If you do need medical treatment whilst travelling in Europe, care is of a high standard . Locate your nearest hospital or medical centre when you arrive in case of an emergency.

Most travellers enjoy a safe stay in Europe. By following vaccination recommendations and speaking to a healthcare professional, you can further increase your chances of good health throughout your trip.

• About the Handbook

Vaccination for international travellers

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

Recently added

This page was added on  09 June 2018 .

Updates made

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

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

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

See also Infographic. Vaccination for international travellers .

Health risks of overseas travel

Health risks associated with international travel include exposure to:

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

The level of health risks depends on factors such as:

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

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

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

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

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

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

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

Common infections acquired by travellers

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

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

Foodborne and waterborne infections

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

Vaccines are available against hepatitis A, typhoid and cholera.

Vector-borne infections

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

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

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

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

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

Aerosol-borne infections

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

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

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

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

Vaccines are available against all of these diseases.

Bloodborne and sexually transmitted infections

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

Vaccines are available against hepatitis B.

Exotic infectious agents

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

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

Of these diseases, vaccines are available only against rabies.

Recommending travel vaccines

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

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

There are 3 categories of travel vaccines:

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

Questions for a pre-travel medical consultation

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

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

Also ask about their itinerary in detail, including:

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

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

Organisational requirements for vaccination

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

Routinely recommended vaccines (not specific to travelling overseas)

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

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

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

Diphtheria, tetanus and pertussis

Vaccinate adult travellers against tetanus before departure, particularly if:

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

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

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

Hepatitis B

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

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

• Central and South America

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

See also Hepatitis B .

Influenza and pneumococcal disease

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

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

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

See also Influenza. 

Measles, mumps and rubella

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

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

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

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

See also Measles . 

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

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

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

See also Varicella .

Meningococcal disease

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

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

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

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

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

See also Meningococcal disease .

Poliomyelitis

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

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

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

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

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

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

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

See also COVID-19 .

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

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

Prioritise vaccines for diseases that are:

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

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

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

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

See also Cholera .

Hepatitis A

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

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

See also Hepatitis A .

Japanese encephalitis

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

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

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

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

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

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

See also Japanese encephalitis .

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

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

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

Recommendations for rabies vaccination as pre-exposure prophylaxis

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

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

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

Benefits of vaccination as pre-exposure prophylaxis

Pre-travel rabies vaccination:

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

Tick-borne encephalitis

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

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

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

Tuberculosis

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

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

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

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

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

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

See also Tuberculosis .

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

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

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

Inactivated parenteral and live oral typhoid vaccine formulations are available.

See also Typhoid fever .

Yellow fever

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

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

When assessing the need for yellow fever vaccination, consider:

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

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

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

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

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

See also Yellow fever .

Booster doses

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

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

Yellow fever requirements.

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

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

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

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

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

Requirements for travellers to Mecca

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

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

Temporary requirements

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

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

Planning and documenting vaccines

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

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

Requirements for multiple vaccines

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

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

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

Documentation and certificates

It is important to document travel vaccines: 

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

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

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

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

See also Accessing up-to-date travel information .

Vaccinating travellers with special risk factors

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

Accessing up-to-date travel information

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

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

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

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

Page history

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

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

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

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Acknowledgement

The Department of Health and Aged Care acknowledges First Nations peoples as the Traditional Owners of Country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to all Elders both past and present.

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Immunisation for travel

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

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

Vaccines needed for travel

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

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

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

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

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

When to get vaccinated

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

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

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

How to check your vaccination record

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

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

The AIR includes vaccines given:

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

You can check your immunisation record :

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

Cost of vaccines

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

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

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

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

Check with your provider when you book your appointment.

How to stay safe overseas

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

Find more information:

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

Keep routine vaccinations up to date

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

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

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

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

Get more about information about routine vaccinations:

• National Immunisation Program Schedule
• When to get vaccinated

Diseases to be aware of

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

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

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

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

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

Hepatitis A

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

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

Japanese encephalitis

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

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

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

Meningococcal

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

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

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

Tuberculosis

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

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

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

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

Yellow fever

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

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

Find more information: Yellow fever fact sheet

• Immunisation
• Travel health

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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) . Measles spreads rapidly in communities that are not fully vaccinated and may pose a risk to international travelers in places not included in the THN. CDC recommends all travelers get fully vaccinated against measles before traveling to any international destination.

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Complete List of Destinations

• Afghanistan
• American Samoa
• Anegada (see Virgin Islands, British )
• Anguilla (U.K.)
• Antigua and Barbuda
• Austral Islands (see French Polynesia (France) )

⇧ Top

• Bahamas, The
• Barbuda (see Antigua and Barbuda )
• Bermuda (U.K.)
• Bora-Bora (see French Polynesia (France) )
• Bosnia and Herzegovina
• British Indian Ocean Territory (U.K.)
• Burkina Faso
• Burma (Myanmar)
• Caicos Islands (see Turks and Caicos Islands (U.K.) )
• Canary Islands (Spain)
• Cayman Islands (U.K.)
• Central African Republic
• Christmas Island (Australia)
• Cocos (Keeling) Islands (Australia)
• Congo, Republic of the
• Cook Islands (New Zealand)
• Côte d'Ivoire
• Curaçao
• Democratic Republic of the Congo
• Dominican Republic
• Dubai (see United Arab Emirates )
• Easter Island (Chile)
• El Salvador
• England (see United Kingdom )
• Equatorial Guinea
• Eswatini (Swaziland)
• Falkland Islands (Islas Malvinas)
• Faroe Islands (Denmark)
• French Guiana (France)
• French Polynesia (France)
• Galápagos Islands (see Ecuador )
• Gambia, The
• Gibraltar (U.K.)
• Greenland (Denmark)
• Grenadines (see Saint Vincent and the Grenadines )
• Guam (U.S.)
• Guernsey (see United Kingdom )
• Guinea-Bissau
• Holy See (see Italy )
• Hong Kong SAR (China)
• Isle of Man (see United Kingdom )
• Israel, including the West Bank and Gaza
• Ivory Coast (see Côte d'Ivoire )
• Jersey (see United Kingdom )
• Jost Van Dyke (see Virgin Islands, British )
• Liechtenstein
• Macau SAR (China)
• Madeira Islands (Portugal)
• Marquesas Islands (see French Polynesia (France) )
• Marshall Islands
• Martinique (France)
• Mayotte (France)
• Micronesia, Federated States of
• Montserrat (U.K.)
• Moorea (see French Polynesia (France) )
• Myanmar (Burma) (see Burma (Myanmar) )
• Netherlands, The
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Us, europe weighing vaccinating poultry, dairy workers exposed to bird flu.

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CHICAGO/LONDON – The United States and Europe are taking steps to acquire or manufacture H5N1 bird flu vaccines that could be used to protect at-risk poultry and dairy workers , veterinarians and lab technicians, government officials said, moves influenza experts say could curb the threat of a pandemic.

U.S officials last week said they were moving bulk vaccine from CSL Seqirus (CSL.AX), opens new tab that closely matches the current virus into finished shots that could provide 4.8 million doses of vaccine. European health officials told Reuters they were in talks to acquire CSL’s prepandemic vaccine.

Canadian health officials said they have met with GSK (GSK.L), opens new tab, maker of Canada’s seasonal flu shots, to discuss acquiring and manufacturing a prepandemic bird flu vaccine once its seasonal flu production capacity is freed up.

Other countries, including the UK, are discussing how to proceed on prepandemic vaccines, scientists said.

The actions follow the explosive spread of a new strain of bird flu that emerged in late 2020 and has caused unprecedented numbers of deaths among wild birds and domestic poultry and has begun infecting many mammal species.

In March, U.S. officials reported the first outbreak of the virus in dairy cattle, which has infected dozens of herds in nine states and two dairy workers. The U.S. Food and Drug Administration has estimated that 20% of the U.S. milk supply shows signs of the virus , indicating a wider spread is likely.

Human exposures to the virus in poultry and dairy operations could increase the risk that the virus will mutate and gain the ability to spread easily in people.

“All of our efforts need to be focused on preventing those events from happening,” said Matthew Miller, co-director of the Canadian Pandemic Preparedness Hub at McMaster University. “Once we have widespread infections of humans, we’re in big trouble.”

Dr. Angela Rasmussen, a virologist at the University of Saskatchewan, said she has been in discussions with U.S. and Canadian officials about using vaccines to protect workers following the virus’ spread into new mammal species.

Dawn O’Connell of the U.S. Administration for Strategic Preparedness and Response said the government is “looking closely” at the possibility of vaccinating farm workers and others in close contact with the virus.

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The U.S. has contracts with CSL and GSK to test prepandemic vaccines that more closely match the circulating virus than older H5N1 vaccines in the stockpile. The U.S. is moving forward with the CSL vaccine, a Department of Health and Human Services official confirmed.

Discussions about prepandemic vaccine use are going on at government levels and among scientists in a number of places, including in the UK, said Wendy Barclay, chair in influenza virology at University College London, who also researches avian flu for the UK Health Security Agency.

If deployed strategically to dairy farmers, healthcare workers and those in close contact with infected animals, “it would put a pin in the virus,” she said, although she said it was not clear if this step was necessary yet.

The UK government did not comment but said it is monitoring the situation in the U.S.

In Europe, the European Commission’s Health Emergency Preparedness and Response Authority is working on a joint procurement of CSL Seqirus’s vaccine to “potentially prevent a pandemic” sparked by individuals exposed to infected birds and animals, spokesman Stefan De Keersmaecker told Reuters.

A spokeswoman for CSL, which has contracts for pandemic influenza vaccines with 30 governments, said the company has been in talks with several governments about procuring vaccines since 2022. Those requests have accelerated with the U.S. outbreak, she said.

PREPANDEMIC STOCKPILE

The U.S. maintains a stockpile of prepandemic vaccine candidates and bulk vaccine against an array of influenza strains and conducts clinical trials to support an Emergency Use Authorization or FDA license in the event of pandemic.

Seasonal flu vaccine makers, including Sanofi (SASY.PA), opens new tab, could also be asked to shift to producing pandemic flu vaccines.

The U.S. is in talks with mRNA vaccine makers Pfizer (PFE.N), opens new tab and Moderna (MRNA.O), opens new tab about potential pandemic vaccines.

Dr. Richard Webby, a St. Jude Children’s Research Hospital virologist who studies flu in animals and birds for the World Health Organization, said the situation in dairy cattle merits vaccine use.

“If we look at the exposure levels that some of these farmers are getting, it’s high,” Webby said.

The decision on how and when to use the vaccine will hinge on evidence of increased transmission, severity of disease, cases in people with no link to a dairy farm and mutations in the virus, U.S. Centers for Disease Control and Prevention Principal Deputy Director Nirav Shah said.

Dutch flu virologist Ron Fouchier of the Erasmus MC in Rotterdam, who has conducted experiments mapping the changes necessary for bird flu to spark a pandemic, said Europe’s plan is to procure the CSL vaccine for people occupationally exposed to the virus.

His lab could well be eligible if a vaccine becomes available, he said, adding, “I would certainly take it.”

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