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What to Know About the C.D.C. Guidelines on Vaccinated Travel

In updated recommendations, the federal health agency said both domestic and international travel was low risk for fully vaccinated Americans. But travel remains far from simple.

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By Ceylan Yeginsu

The Centers for Disease Control and Prevention updated its guidance for fully vaccinated Americans in April, saying that traveling both domestically and internationally was low risk.

The long-awaited recommendations were issued by federal health officials after a series of studies found that vaccines administered in the United States were robustly effective in preventing infections in real-life conditions.

One is considered fully vaccinated two weeks after receiving the single dose of the Johnson & Johnson vaccine, or two weeks after receiving the second dose of the Pfizer-BioNTech or Moderna shots.

If you decide to travel, you might still have some questions. Here are the answers.

Will I still need to wear a mask and socially distance while traveling?

Yes. Under federal law, masks must be worn at airports in the United States, onboard domestic flights and in all transport hubs. The C.D.C. says that as long as coronavirus measures are taken in these scenarios, including mask wearing, fully vaccinated Americans can travel domestically without having to take a test or quarantine, although the agency warns that some states and territories may keep their local travel restrictions and recommendations in place.

For those wishing to travel internationally, a coronavirus test will not be required before departure from the United States unless mandated by the government of their destination. Vaccinated travelers are still required to get tested three days before travel by air into the United States, and are advised to take a test three to five days after their return, but will not need to self-quarantine.

Can I go abroad?

Yes, but only to countries that will have you.

More than half the world’s countries have reopened to tourists from the United States, including the countries of the European Union , which on June 18 added the United States to its “safe list” of countries, meaning that American travelers can now visit. While the European Union aims to take a coordinated approach to travel this summer, member states will be allowed to set their own requirements for travelers from individual countries based on their own epidemiological criteria, which means they may require testing or vaccination.

Some places like Turkey, Croatia and Montenegro had already been welcoming Americans with negative test results. Greece joined that growing list in May, ahead of most European countries, opening to fully vaccinated tourists and other foreigners with a negative test.

Many Caribbean nations have reopened to American tourists, but each has its own coronavirus protocols and entry requirements.

Here’s a full list of countries Americans can currently travel to.

What about domestic travel? Is it free and clear to cross state borders?

If you are fully vaccinated, the C.D.C. says you can travel freely within the United States and that you do not need to get tested, or self-quarantine, before or after traveling. But some states and local governments may choose to keep travel restrictions in place, including testing, quarantine and stay-at-home orders. Hawaii , for instance, still has travel restrictions in place.

Before you travel across state lines, check the current rules at your destination.

How are they going to check that I’m fully vaccinated?

Right now, the best way to prove that you have been vaccinated is to show your vaccine card .

Digital vaccine and health certificates showing that people have been vaccinated or tested are in various stages of development around the world and are expected, eventually, to be widely used to speed up travel.

The subject of “ vaccine passports ” is currently one of the most hotly debated topics within the travel industry, with questions over the equity of their use and concerns over health and data privacy.

In early April, Gov. Ron DeSantis of Florida issued an executive order that would ban local governments and state businesses from requiring proof of vaccination for services.

And in March, the European Union endorsed its own vaccine certificate , which some countries are already using, with more expected to adopt it by July 1.

But what about my kids? What’s the guidance on traveling with unvaccinated people?

The C.D.C. advises people against travel unless they have been vaccinated. If you must travel, the agency recommends testing one to three days before a trip and following all coronavirus guidance at your destination.

In May, the F.D.A. expanded its emergency use authorization of the Pfizer-BioNTech coronavirus vaccine to include adolescents between 12 and 15 years of age.

All air passengers aged two and older coming into the United States, including fully vaccinated people, are required to have a negative Covid-19 test result taken no more than three days before they board their flight.

What is my moral obligation to the places I visit where most people are not vaccinated?

The United States inoculation rollout has been among the fastest in the world, but there is a stark gap between its rapid rollout and the vaccination programs in different countries. Some nations have yet to report a single dose being administered.

Many countries are currently seeing a surge in new cases and are implementing strict coronavirus protocols, including mask mandates in public spaces, capacity limits at restaurants and tourist sites and other lockdown restrictions.

It is important to check coronavirus case rates, measures and medical infrastructure before traveling to your destination and not to let your guard down when you get there. Even though you are fully vaccinated, you may still be able to transmit the disease to local communities who have not yet been inoculated.

You can track coronavirus vaccination rollouts around the world here.

Follow New York Times Travel on Instagram , Twitter and Facebook . And sign up for our weekly Travel Dispatch newsletter to receive expert tips on traveling smarter and inspiration for your next vacation.

Ceylan Yeginsu is a London-based reporter. She joined The Times in 2013, and was previously a correspondent in Turkey covering politics, the migrant crisis, the Kurdish conflict, and the rise of Islamic State extremism in Syria and the region. More about Ceylan Yeginsu

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The White House 1600 Pennsylvania Ave NW Washington, DC 20500

Executive Order on Promoting COVID- ⁠ 19 Safety in Domestic and International   Travel

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows: 

Section 1.  Policy.  Science-based public health measures are critical to preventing the spread of coronavirus disease 2019 (COVID-19) by travelers within the United States and those who enter the country from abroad.  The Centers for Disease Control and Prevention (CDC), the Surgeon General, and the National Institutes of Health have concluded that mask-wearing, physical distancing, appropriate ventilation, and timely testing can mitigate the risk of travelers spreading COVID-19.  Accordingly, to save lives and allow all Americans, including the millions of people employed in the transportation industry, to travel and work safely, it is the policy of my Administration to implement these public health measures consistent with CDC guidelines on public modes of transportation and at ports of entry to the United States.   

Sec. 2.  Immediate Action to Require Mask-Wearing on Certain Domestic Modes of Transportation.

(a)  Mask Requirement.   The Secretary of Labor, the Secretary of Health and Human Services (HHS), the Secretary of Transportation (including through the Administrator of the Federal Aviation Administration (FAA)), the Secretary of Homeland Security (including through the Administrator of the Transportation Security Administration (TSA) and the Commandant of the United States Coast Guard), and the heads of any other executive departments and agencies (agencies) that have relevant regulatory authority (heads of agencies) shall immediately take action, to the extent appropriate and consistent with applicable law, to require masks to be worn in compliance with CDC guidelines in or on: 

(i)    airports; 

(ii)   commercial aircraft; 

(iii)  trains; 

(iv)   public maritime vessels, including ferries; 

(v)    intercity bus services; and

(vi)   all forms of public transportation as defined in section 5302 of title 49, United States Code.

(b)  Consultation.   In implementing this section, the heads of agencies shall consult, as appropriate, with interested parties, including State, local, Tribal, and territorial officials; industry and union representatives from the transportation sector; and consumer representatives.

(c)  Exceptions.   The heads of agencies may make categorical or case-by-case exceptions to policies developed under this section, consistent with applicable law, to the extent that doing so is necessary or required by law.  If the heads of agencies do make exceptions, they shall require alternative and appropriate safeguards, and shall document all exceptions in writing.

(d)  Preemption.  To the extent permitted by applicable law, the heads of agencies shall ensure that any action taken to implement this section does not preempt State, local, Tribal, and territorial laws or rules imposing public health measures that are more protective of public health than those required by the heads of agencies. 

(e)  Coordination.  The Coordinator of the COVID-19 Response and Counselor to the President (COVID-19 Response Coordinator) shall coordinate the implementation of this section.  The heads of agencies shall update the COVID-19 Response Coordinator on their progress in implementing this section, including any categorical exceptions established under subsection (c) of this section, within 7 days of the date of this order and regularly thereafter.  The heads of agencies are encouraged to bring to the attention of the COVID-19 Response Coordinator any questions regarding the scope or implementation of this section.

Sec. 3.  Action to Implement Additional Public Health Measures for Domestic Travel. 

(a)  Recommendations.   The Secretary of Transportation (including through the Administrator of the FAA) and the Secretary of Homeland Security (including through the Administrator of the TSA and the Commandant of the Coast Guard), in consultation with the Director of CDC, shall promptly provide to the COVID-19 Response Coordinator recommendations concerning how their respective agencies may impose additional public health measures for domestic travel.

(b)  Consultation.   In implementing this section, the Secretary of Transportation and the Secretary of Homeland Security shall engage with interested parties, including State, local, Tribal, and territorial officials; industry and union representatives from the transportation sector; and consumer representatives.  

Sec. 4.  Support for State, Local, Tribal, and Territorial Authorities.  The COVID-19 Response Coordinator, in coordination with the Secretary of Transportation and the heads of any other relevant agencies, shall promptly identify and inform agencies of options to incentivize, support, and encourage widespread mask-wearing and physical distancing on public modes of transportation, consistent with CDC guidelines and applicable law.

Sec. 5.  International Travel. 

(a)  Policy.   It is the policy of my Administration that, to the extent feasible, travelers seeking to enter the United States from a foreign country shall be: 

(i)   required to produce proof of a recent negative COVID-19 test prior to entry; and 

(ii)  required to comply with other applicable CDC guidelines concerning international travel, including recommended periods of self-quarantine or self-isolation after entry into the United States.

(b)  Air Travel.  

(i)    The Secretary of HHS, including through the Director of CDC, and in coordination with the Secretary of Transportation (including through the Administrator of the FAA) and the Secretary of Homeland Security (including through the Administrator of the TSA), shall, within 14 days of the date of this order, assess the CDC order of January 12, 2021, regarding the requirement of a negative COVID-19 test result for airline passengers traveling into the United States, in light of subsection (a) of this section.  Based on such assessment, the Secretary of HHS and the Secretary of Homeland Security shall take any further appropriate regulatory action, to the extent feasible and consistent with CDC guidelines and applicable law.  Such assessment and regulatory action shall include consideration of: 

(A)  the timing and types of COVID-19 tests that should satisfy the negative test requirement, including consideration of additional testing immediately prior to departure; (B)  the proof of test results that travelers should be required to provide; (C)  the feasibility of implementing alternative and sufficiently protective public health measures, such as testing, self-quarantine, and self-isolation on arrival, for travelers entering the United States from countries where COVID-19 tests are inaccessible, particularly where such inaccessibility of tests would affect the ability of United States citizens and lawful permanent residents to return to the United States; and (D)  measures to prevent fraud.

(ii)   The Secretary of HHS, in coordination with the Secretary of Transportation (including through the Administrator of the FAA) and the Secretary of Homeland Security (including through the Administrator of the TSA), shall promptly provide to the President, through the COVID-19 Response Coordinator, a plan for how the Secretary and other Federal Government actors could implement the policy stated in subsection (a) of this section with respect to CDC-recommended periods of self-quarantine or self-isolation after a flight to the United States from a foreign country, as he deems appropriate and consistent with applicable law.  The plan shall identify agencies’ tools and mechanisms to assist travelers in complying with such policy.

(iii)  The Secretary of State, in consultation with the Secretary of HHS (including through the Director of CDC), the Secretary of Transportation (including through the Administrator of the FAA), and the Secretary of Homeland Security, shall seek to consult with foreign governments, the World Health Organization, the International Civil Aviation Organization, the International Air Transport Association, and any other relevant stakeholders to establish guidelines for public health measures associated with safe international travel, including on aircraft and at ports of entry.  Any such guidelines should address quarantine, testing, COVID-19 vaccination, follow-up testing and symptom-monitoring, air filtration requirements, environmental decontamination standards, and contact tracing.  

(c)  Land Travel.  The Secretary of State, in consultation with the Secretary of HHS, the Secretary of Transportation, the Secretary of Homeland Security, and the Director of CDC, shall immediately commence diplomatic outreach to the governments of Canada and Mexico regarding public health protocols for land ports of entry.  Based on this diplomatic engagement, within 14 days of the date of this order, the Secretary of HHS (including through the Director of CDC), the Secretary of Transportation, and the Secretary of Homeland Security shall submit to the President a plan to implement appropriate public health measures at land ports of entry.  The plan should implement CDC guidelines, consistent with applicable law, and take into account the operational considerations relevant to the different populations who enter the United States by land.

(d)  Sea Travel.  The Secretary of Homeland Security, through the Commandant of the Coast Guard and in consultation with the Secretary of HHS and the Director of CDC, shall, within 14 days of the date of this order, submit to the President a plan to implement appropriate public health measures at sea ports.  The plan should implement CDC guidelines, consistent with applicable law, and take into account operational considerations.  

(e)  International Certificates of Vaccination or Prophylaxis.  Consistent with applicable law, the Secretary of State, the Secretary of HHS, and the Secretary of Homeland Security (including through the Administrator of the TSA), in coordination with any relevant international organizations, shall assess the feasibility of linking COVID-19 vaccination to International Certificates of Vaccination or Prophylaxis (ICVP) and producing electronic versions of ICVPs.  

(f)  Coordination.  The COVID-19 Response Coordinator, in consultation with the Assistant to the President for National Security Affairs and the Assistant to the President for Domestic Policy, shall coordinate the implementation of this section.  The Secretary of State, the Secretary of HHS, the Secretary of Transportation, and the Secretary of Homeland Security shall update the COVID-19 Response Coordinator on their progress in implementing this section within 7 days of the date of this order and regularly thereafter.  The heads of all agencies are encouraged to bring to the attention of the COVID-19 Response Coordinator any questions regarding the scope or implementation of this section.

Sec. 6.  General Provisions.   (a)  Nothing in this order shall be construed to impair or otherwise affect:

(i)   the authority granted by law to an executive department or agency, or the head thereof; or

(ii)  the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b)  This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c)  This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

JOSEPH R. BIDEN JR.

THE WHITE HOUSE, January 21, 2021.

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COVID-19 international travel advisories

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

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

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

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

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

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

LAST UPDATED: December 6, 2023

Have a question?

Ask a real person any government-related question for free. They will get you the answer or let you know where to find it.

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CDC Updates Criteria for International Travel COVID Risks

petovarga / Getty Images

Key Takeaways

• The CDC recently updated their Travel Health Notice system to reserve level four for special circumstances.
• Individuals can check the COVID-19 risk level of their destination to know the precautions they need to take before, during, and after their planned overseas travel.
• It’s important to establish a plan in case the traveler tests positive in another country, experts said.

To inform travelers about the pressing COVID-19 treat around the world, the Centers for Disease Control and Prevention (CDC) established a Travel Health Notice system for international destinations. Now, the system has been reconfigured to help travelers understand when the level of concern is most urgent.

The highest risk category, level four, is now reserved for special circumstances, which include:

• Rapidly escalating or an extremely high number of COVID-19 cases
• The emergence of a new variant of concern
• Healthcare infrastructure collapse

Meanwhile, levels three, two, and one are still determined by 28-day incidence or case counts. Experts said the new system continues to help travelers weigh the risks of their travel.

Benefits of the Travel Health Notice System

The Travel Health Notice system established by the CDC is intended to help travelers gauge the risk of their destination and plan accordingly to protect themselves before, during, and after their travel.  

“The new system makes sense from a public health perspective,” Pia MacDonald, PhD, MPH , an infectious disease epidemiologist at RTI International, told Verywell. “It will help people think through the risks they could face traveling to certain countries.”

For instance, travelers often consider their individual health and the health system of their destination to assess whether they can get the necessary care if they needed to, she added. The updated CDC system reserves level four for destinations that travelers are not recommended to travel to, regardless of vaccination status.

“It is a way to simplify community transmission rates within a particular country,” Christopher Scuderi, DO , a family physician at the University of Florida Health in Jacksonville, told Verywell. “If a country is rated as a higher level three, and especially as a four, it helps travelers make an informed decision based on their personal risks whether they should continue to travel or postpone their trip.”

There is a continuum of how people approached traveling during the pandemic, especially during the past year. For those with high-risk medical issues, CDC’s recommendations have been helpful in guiding whether they should travel, Scuderi said.

Meanwhile, those who have accepted the risks of the pandemic—and are traveling as planned despite higher levels of transmission—might not be deterred by the travel health notice, but it may encourage them to choose different activities if they do travel to a high-risk country. They can choose to go hiking or eat outdoors instead of going to indoor places, he added.

What This Means For You

Before traveling internationally, make sure to check the CDC’s COVID-19 Travel Recommendations page to check the COVID-19 risk of your destination.

How to Remain Safe While Traveling

MacDonald and Scuderi recommend that people who intend to travel consult a healthcare provider prior beforehand to discuss the risk, especially for those who are more likely to have complications with COVID-19.

“We know being vaccinated and boosted is the most important precaution a person can take to avoid severe COVID-19 and possible death,” MacDonald said. “This is true at home and when traveling internationally.”

Since a federal judge in Florida declared the mask mandate for public transportation unconstitutional, many travel authorities have stopped requiring masks. The Department of Justice recently appealed the ruling, but the travel mask mandate has yet to be put back in effect.

Nonetheless, wearing high-quality and well-fitting masks in airports or airplanes where many people from different places are sitting in close proximity can reduce the risk of getting infected with the virus, MacDonald said. It’s also important to understand the quickly-changing rules around testing, quarantine, and isolation, she added.

“Learn the guidelines for entry for the country you’re traveling to as well as testing options upon returning to the U.S.,” Scuderi said. “There is often a lot of paperwork to do once you arrive and it can take some time. Each country will also have certain time constraints on when to fill them out. It may be helpful to set an alarm on your phone for when each documentation is due.”

Travelers must also think through a plan if they test positive in another country, which would require them to extend their stay before being able to return home, MacDonald noted. This is even more important for families with children.

“It’s also important to prepare for the unexpected,” Scuderi said. “Educate your children on any current surges and how to best approach your travels as a team. Set a contingency plan for what would happen if you got sick while you were away.”

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page .

Centers for Disease Control and Prevention. CDC mask order remains in effect and CDC realigns travel health notice system .

By Carla Delgado Delgado is a health and culture writer specializing in health, science, and environmental sustainability.

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Starting on Sunday, you won't have to test for COVID-19 to fly into the U.S.

Ximena Bustillo

In this file photo, travelers pass a sign for COVID-19 testing at Logan Airport in Boston. The Biden administration is lifting its requirement for COVID testing before flying to the U.S. Charles Krupa/AP hide caption

In this file photo, travelers pass a sign for COVID-19 testing at Logan Airport in Boston. The Biden administration is lifting its requirement for COVID testing before flying to the U.S.

The Biden administration is planning to drop the requirement for air travelers coming to the United States to test negative for COVID-19 before departure, starting on Sunday, according to a senior administration official.

The official said the Centers for Disease Control and Prevention had determined the requirement was no longer needed. The requirement will lift effective Sunday, June 12th at 12:01 a.m. ET.

The CDC will reassess the decision in 90 days and could reinstate it if there were a new COVID variant of concern, the official said.

Since December, travelers have had to present a negative COVID-19 test result taken no more than a day before departure​, or proof of recovery from the virus within the last 90 days.

Coronavirus Updates

Cdc drops its covid-19 risk advisory for cruise ship travel.

The administration official said the new step was possible because of vaccines and treatments that are now available — and said the CDC will continue to recommend that people get tested for COVID before flying, even though it's not mandatory.

CDC Health Information for International Travel: Yellow Book

As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, actionable information about the health challenges posed by this mass movement has never been greater. For both international travelers and the health professionals who care for them, CDC Health Information for International Travel (more commonly known as the Yellow Book ) is the definitive guide to staying healthy and safe anywhere in the world. The Yellow Book is produced biennially with input from hundreds of travel medicine experts and is published through a unique collaboration between CDC, the CDC Foundation and Oxford University Press. 

The 2018 edition codifies the U.S. government’s most current health guidelines and information for international travelers, including pretravel vaccine recommendations, destination-specific advice, and easy-to-reference maps , tables and charts . The book also offers updated guidance for specific types of travel and travelers, including:

• Precautions for pregnant travelers, immunocompromised travelers and travelers with disabilities
• Special considerations for newly arrived adoptees , immigrants and refugees
• Practical tips for last-minute or resource-limited travelers
• Advice for air crews , humanitarian workers , missionaries and others who provide care and support overseas

The 2018 Yellow Book includes important travel medicine updates:

• The latest information about emerging infectious disease threats such as Zika , Ebola  and MERS
• New cholera vaccine recommendations
• Updated guidance on the use of antibiotics in the treatment of travelers' diarrhea
• Special considerations for unique types of travel, such as wilderness expeditions , work-related travel  and study abroad
• Destination-specific recommendations for popular itineraries, including new sections for travelers to Cuba and Burma

Written by a team of CDC experts on the forefront of travel medicine, the Yellow Book provides a user-friendly, vital resource for those in the business of keeping travelers healthy abroad. Order the 2018 edition online .

©David Snyder/CDC Foundation

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Mexico Traveler View

Travel health notices, vaccines and medicines, non-vaccine-preventable diseases, stay healthy and safe.

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After Your Trip

Be aware of current health issues in Mexico. Learn how to protect yourself.

Level 1 Practice Usual Precautions

• Dengue in the Americas April 18, 2024 Dengue is a risk in many parts of Central and South America, Mexico, and the Caribbean. Some countries are reporting increased numbers of cases of the disease. Travelers to the Americas can protect themselves by preventing mosquito bites. Destination List: Argentina, Brazil, Colombia, Costa Rica, Ecuador, including the Galápagos Islands, French Guiana (France), Guadeloupe, Guatemala, Martinique (France), Mexico, Nicaragua, Panama, Paraguay, Peru, Turks and Caicos Islands (U.K.), Uruguay
• Rocky Mountain Spotted Fever in Mexico March 12, 2024 There have been reports of Rocky Mountain spotted fever (RMSF) in people traveling to the United States from Tecate, in the state of Baja California, Mexico.
• Salmonella Newport in Mexico March 29, 2023 Some travelers who have spent time in Mexico have been infected with multidrug-resistant (MDR) Salmonella Newport.

⇧ Top

Check the vaccines and medicines list and visit your doctor at least a month before your trip to get vaccines or medicines you may need. If you or your doctor need help finding a location that provides certain vaccines or medicines, visit the Find a Clinic page.

Routine vaccines

Recommendations.

Make sure you are up-to-date on all routine vaccines before every trip. Some of these vaccines include

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Flu (influenza)
• Measles-Mumps-Rubella (MMR)

Immunization schedules

All eligible travelers should be up to date with their COVID-19 vaccines. Please see  Your COVID-19 Vaccination  for more information. 

COVID-19 vaccine

Hepatitis A

Recommended for unvaccinated travelers one year old or older going to Mexico.

Infants 6 to 11 months old should also be vaccinated against Hepatitis A. The dose does not count toward the routine 2-dose series.

Travelers allergic to a vaccine component or who are younger than 6 months should receive a single dose of immune globulin, which provides effective protection for up to 2 months depending on dosage given.

Unvaccinated travelers who are over 40 years old, immunocompromised, or have chronic medical conditions planning to depart to a risk area in less than 2 weeks should get the initial dose of vaccine and at the same appointment receive immune globulin.

Hepatitis A - CDC Yellow Book

Dosing info - Hep A

Hepatitis B

Recommended for unvaccinated travelers younger than 60 years old traveling to Mexico. Unvaccinated travelers 60 years and older may get vaccinated before traveling to Mexico.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

CDC recommends that travelers going to certain areas of Mexico take prescription medicine to prevent malaria. Depending on the medicine you take, you will need to start taking this medicine multiple days before your trip, as well as during and after your trip. Talk to your doctor about which malaria medication you should take.

Find  country-specific information  about malaria.

Malaria - CDC Yellow Book

Considerations when choosing a drug for malaria prophylaxis (CDC Yellow Book)

Malaria information for Mexico.

Cases of measles are on the rise worldwide. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks prior to departure, or have not had measles in the past, and travel internationally to areas where measles is spreading.

All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, according to  CDC’s measles vaccination recommendations for international travel .

Measles (Rubeola) - CDC Yellow Book

Rabid dogs are commonly found in Mexico. However, if you are bitten or scratched by a dog or other mammal while in Mexico, rabies treatment is often available. 

Consider rabies vaccination before your trip if your activities mean you will be around dogs or wildlife.

Travelers more likely to encounter rabid animals include

• Campers, adventure travelers, or cave explorers (spelunkers)
• Veterinarians, animal handlers, field biologists, or laboratory workers handling animal specimens
• Visitors to rural areas

Since children are more likely to be bitten or scratched by a dog or other animals, consider rabies vaccination for children traveling to Mexico. 

Rabies - CDC Yellow Book

Recommended for most travelers, especially those staying with friends or relatives or visiting smaller cities or rural areas.

Typhoid - CDC Yellow Book

Dosing info - Typhoid

Avoid contaminated water

Leptospirosis

How most people get sick (most common modes of transmission)

• Touching urine or other body fluids from an animal infected with leptospirosis
• Swimming or wading in urine-contaminated fresh water, or contact with urine-contaminated mud
• Drinking water or eating food contaminated with animal urine
• Avoid contaminated water and soil

Clinical Guidance

Avoid bug bites, chagas disease (american trypanosomiasis).

• Accidentally rub feces (poop) of the triatomine bug into the bug bite, other breaks in the skin, your eyes, or mouth
• From pregnant woman to her baby, contaminated blood products (transfusions), or contaminated food or drink.
• Avoid Bug Bites

Chagas disease

• Mosquito bite

Leishmaniasis

• Sand fly bite
• An infected pregnant woman can spread it to her unborn baby

Airborne & droplet

Avian/bird flu.

• Being around, touching, or working with infected poultry, such as visiting poultry farms or live-animal markets
• Avoid domestic and wild poultry
• Breathing in air or accidentally eating food contaminated with the urine, droppings, or saliva of infected rodents
• Bite from an infected rodent
• Less commonly, being around someone sick with hantavirus (only occurs with Andes virus)
• Avoid rodents and areas where they live
• Avoid sick people

Tuberculosis (TB)

• Breathe in TB bacteria that is in the air from an infected and contagious person coughing, speaking, or singing.

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in Mexico, so your behaviors are important.

Eat and drink safely

Food and water standards around the world vary based on the destination. Standards may also differ within a country and risk may change depending on activity type (e.g., hiking versus business trip). You can learn more about safe food and drink choices when traveling by accessing the resources below.

• Choose Safe Food and Drinks When Traveling
• Water Treatment Options When Hiking, Camping or Traveling
• Global Water, Sanitation and Hygiene | Healthy Water
• Avoid Contaminated Water During Travel

You can also visit the Department of State Country Information Pages for additional information about food and water safety.

Prevent bug bites

Bugs (like mosquitoes, ticks, and fleas) can spread a number of diseases in Mexico. Many of these diseases cannot be prevented with a vaccine or medicine. You can reduce your risk by taking steps to prevent bug bites.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). Do not use permethrin directly on skin.
• Stay and sleep in air-conditioned or screened rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
• Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
• 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs .

For more detailed information on avoiding bug bites, see Avoid Bug Bites .

Some diseases in Mexico—such as dengue, Zika, leishmaniasis, and Chagas disease—are spread by bugs and cannot be prevented with a vaccine. Follow the insect avoidance measures described above to prevent these and other illnesses.

Stay safe outdoors

If your travel plans in Mexico include outdoor activities, take these steps to stay safe and healthy during your trip.

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• If you are outside for many hours in heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation : use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if driving a boat, and always wear a life jacket.
• Do not dive into shallow water.
• Do not swim in freshwater in developing areas or where sanitation is poor.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• To prevent infections, wear shoes on beaches where there may be animal waste.

Leptospirosis, a bacterial infection that can be spread in fresh water, is found in Mexico. Avoid swimming in fresh, unchlorinated water, such as lakes, ponds, or rivers.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately. Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Consider buying medical evacuation insurance. Rabies is a deadly disease that must be treated quickly, and treatment may not be available in some countries.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medications you take.
• Some prescription drugs may be illegal in other countries. Call Mexico’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website ( www.jointcommissioninternational.org ).

In some countries, medicine (prescription and over-the-counter) may be substandard or counterfeit. Bring the medicines you will need from the United States to avoid having to buy them at your destination.

Malaria is a risk in some parts of Mexico. If you are going to a risk area, fill your malaria prescription before you leave, and take enough with you for the entire length of your trip. Follow your doctor’s instructions for taking the pills; some need to be started before you leave.

Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

In many places cars, buses, large trucks, rickshaws, bikes, people on foot, and even animals share the same lanes of traffic, increasing the risk for crashes.

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Ride only in cars that have seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Avoid driving at night; street lighting in certain parts of Mexico may be poor.
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in Mexico, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.
• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Medical Evacuation Insurance

If you are seriously injured, emergency care may not be available or may not meet US standards. Trauma care centers are uncommon outside urban areas. Having medical evacuation insurance can be helpful for these reasons.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

For information traffic safety and road conditions in Mexico, see Travel and Transportation on US Department of State's country-specific information for Mexico .

Maintain personal security

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel advisories and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP) .
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate .
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

To call for emergency services while in Mexico, dial 066, 060, or 080. Write these numbers down to carry with you during your trip.

Learn as much as you can about Mexico before you travel there. A good place to start is the country-specific information on Mexico from the US Department of State.

Americans in Mexico have been arrested for purchasing souvenirs that were, or looked like, antiques and that local customs authorities believed were national treasures. Familiarize yourself with any local regulations for antiques and follow these tips:

• When you are considering purchasing an authentic antique or a reproduction, ask if you are allowed to export these items before you purchase them.
• If you buy a reproduction, document on the customs form that it is a reproduction.
• If you buy an authentic antique, obtain the necessary export permit (often from the national museum).

Healthy Travel Packing List

Use the Healthy Travel Packing List for Mexico for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.

Why does CDC recommend packing these health-related items?

It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.

If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic . Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.

If your doctor prescribed antimalarial medicine for your trip, keep taking the rest of your pills after you return home. If you stop taking your medicine too soon, you could still get sick.

Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the doctor about your travel history.

For more information on what to do if you are sick after your trip, see Getting Sick after Travel .

Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.

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CDC updates and simplifies respiratory virus recommendations

Recommendations are easier to follow and help protect those most at risk

For Immediate Release: Friday, March 1, 2024 Contact: Media Relations (404) 639-3286

CDC released today updated recommendations  for how people can protect themselves and their communities from respiratory viruses, including COVID-19. The new guidance brings a unified approach to addressing risks from a range of common respiratory viral illnesses, such as COVID-19, flu, and RSV, which can cause significant health impacts and strain on hospitals and health care workers. CDC is making updates to the recommendations now because the U.S. is seeing far fewer hospitalizations and deaths associated with COVID-19 and because we have more tools than ever to combat flu, COVID, and RSV.

“Today’s announcement reflects the progress we have made in protecting against severe illness from COVID-19,” said CDC Director Dr. Mandy Cohen. “However, we still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses—this includes vaccination, treatment, and staying home when we get sick.”

As part of the guidance, CDC provides active recommendations on core prevention steps and strategies:

• Staying  up to date with vaccination   to protect people against serious illness, hospitalization, and death. This includes flu, COVID-19, and RSV if eligible.
• Practicing good hygiene by covering coughs and sneezes, washing or sanitizing hands often, and cleaning frequently touched surfaces.
• Taking steps for cleaner air , such as bringing in more fresh outside air, purifying indoor air, or gathering outdoors.

When people get sick with a respiratory virus, the updated guidance recommends that they stay home and away from others. For people with COVID-19 and influenza, treatment is available and can lessen symptoms and lower the risk of severe illness. The recommendations suggest returning to normal activities when, for at least 24 hours, symptoms are improving overall, and if a fever was present, it has been gone without use of a fever-reducing medication.

Once people resume normal activities, they are encouraged to take additional prevention strategies for the next 5 days to curb disease spread, such as taking more steps for cleaner air, enhancing hygiene practices, wearing a well-fitting mask, keeping a distance from others, and/or getting tested for respiratory viruses. Enhanced precautions are especially important to protect those most at risk for severe illness, including those over 65 and people with weakened immune systems. CDC’s updated guidance reflects how the circumstances around COVID-19 in particular have changed.  While it remains a threat, today it is far less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.  Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19.

While every respiratory virus does not act the same, adopting a unified approach to limiting disease spread makes recommendations easier to follow and thus more likely to be adopted and does not rely on individuals to test for illness, a practice that data indicates is uneven.

“The bottom line is that when people follow these actionable recommendations to avoid getting sick, and to protect themselves and others if they do get sick, it will help limit the spread of respiratory viruses, and that will mean fewer people who experience severe illness,” National Center for Immunization and Respiratory Diseases Director Dr. Demetre Daskalakis said. “That includes taking enhanced precautions that can help protect people who are at higher risk for getting seriously ill.”

The updated guidance also includes specific sections with additional considerations for people who are at higher risk of severe illness from respiratory viruses, including people who are immunocompromised, people with disabilities, people who are or were recently pregnant, young children, and older adults. Respiratory viruses remain a public health threat. CDC will continue to focus efforts on ensuring the public has the information and tools to lower their risk or respiratory illness by protecting themselves, families, and communities.

This updated guidance is intended for community settings. There are no changes to respiratory virus guidance for healthcare settings.

### U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC’s world-leading experts protect lives and livelihoods, national security and the U.S. economy by providing timely, commonsense information, and rapidly identifying and responding to diseases, including outbreaks and illnesses. CDC drives science, public health research, and data innovation in communities across the country by investing in local initiatives to protect everyone’s health.

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CDC updates measles vaccine guidance for international travelers

March 13 (UPI) -- The Centers for Disease Control and Prevention is warning Americans traveling abroad to make sure they are up-to-date on their measles vaccines at least six weeks before their trip, in new guidelines announced Wednesday, as the number of cases rise around the world.

The CDC is now recommending travelers consult with their doctors sooner than previous guidance , which had called for vaccinations one month before travel.

"Traveling for spring break? Make sure you and your family are up-to-date on measles vaccine, especially before international travel," the CDC wrote in a post on X. "The measles vaccine is safe and effective. Two doses of MMR vaccine are about 97% effective at preventing measles."

Traveling for spring break? Make sure you & your family are up-to-date on measles vaccine, esp. before international travel. The measles (MMR) vaccine is safe & effective. Two doses of MMR vaccine are about 97% effective at preventing measles. https://t.co/UaSXjqlA4Y pic.twitter.com/UqMT7Zr1DC — CDC (@CDCgov) March 12, 2024

The CDC also added Russia and Malaysia on Wednesday to its map of 46 countries dealing with measles outbreaks.

"Measles spreads rapidly and may become a risk to travelers in places not included on the list," the agency warned. "CDC recommends all travelers are fully vaccinated against measles when traveling to any international destination."

The CDC recommends, and school enrollment requires, two doses of the measles, mumps and rubella vaccine by the age of six. For any adults born after 1957, who are not sure if they have had the vaccine, the CDC recommends at least one dose of MMR.

Measles, which can cause rash, high fever, cough, runny nose or red and watery eyes, is highly contagious and is also on the rise in the United States.

On Tuesday, the Chicago Department of Public Health confirmed four new cases of measles at a migrant shelter, bringing the number of cases in the past four days up to five.

The CDPH said it provided measles vaccines for 900 people at the shelter, while trying to determine the immunization status of 700 residents.

"Because some Chicagoans on the whole are unvaccinated, there remains an opportunity for the virus to spread," CDPH warned in a statement.

According to the CDC, 45 recent measles cases have been detected across 17 states.

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