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Don't Forget These Vaccines When You Travel

Planning an international winter getaway know which shots—from measles to yellow fever—you may need to protect yourself., sharing is nice.

We respect your privacy . All email addresses you provide will be used just for sending this story.

If you're planning a winter trip to another country, you may be preoccupied with booking airfare and finding lodging, but certain destinations require an extra step of planning: travel vaccines.

You might be tempted to skip the extra doctor's visit, but don't. Last year saw a record number of measles cases in Europe, and the highly contagious illness has continued to spread across the continent throughout 2019. Yellow fever remains a significant concern in South America, and hepatitis A has doctors everywhere—including in the U.S.—on alert. 

You can protect yourself from all three of these illnesses (and more) if you get your shots in time. Here's a quick rundown on the travel vaccines recommended by the Centers for Disease Control and Prevention . 

According to the CDC , most cases of measles in the U.S. result from international travel, when unvaccinated Americans become infected during visits to other countries, then carry the disease back home.

Measles, one of the most contagious of all infectious diseases, is spread through the cough or sneeze of an infected person. Symptoms include rash, high fever, cough, runny nose, and red, watery eyes. In rare cases, the disease can cause brain swelling and be fatal.

Measles outbreaks have become increasingly common in the past couple of years in the U.S. and other countries.

Europe is of particular concern for travelers. As CDC researchers noted in a  report published in Pediatrics  earlier this year, Europe had a record number of cases—more than 41,000, including 37 deaths—between January and June 2018. According to the Pediatrics report, the Ukraine reported the largest number of cases, but France, Georgia, Greece, Italy, Serbia, and the Russian Federation also had a high number. 

But because Europe, a popular travel destination, isn't one that visitors usually think of as having significant risks of infectious disease, they may not consider the need for vaccinations.

In fact, a recent study in JAMA Pediatrics found that not all children are adequately vaccinated against measles before international travel. (The CDC has special recommendations for measles vaccinations for children going overseas.)

In this study, only about 41 percent of infants and preschool-age children who were eligible for pre-travel measles vaccination actually received it. 

And  a study by researchers at Massachusetts General Hospital in Boston, published in 2017 in the Annals of Internal Medicine, found that more than half of all U.S. travelers—not just young kids—who were eligible for the measles, mumps, and rubella (MMR) vaccine weren't getting it before leaving the country. 

The CDC advises anyone who isn't protected against measles, either through vaccination or past infection, to get vaccinated before traveling anywhere overseas.

You'll need to see your doctor at least four to six weeks before you leave. That's because it may take that much time to complete a full course of the vaccine and to give your body time to build up immunity in response to the shot. See the CDC's recommendations for travelers of different ages  and Consumer Reports' coverage of when a measles booster is warranted . 

Other Routine Shots

Before any international trip, you should make sure you're up to date on all of your routine vaccines, not only  measles-mumps-rubella (MMR)  but also diphtheria-tetanus-pertussis (DTP), varicella (chickenpox), polio, and your yearly flu shot.

Some of these diseases are quite rare in the U.S., thanks to good vaccine coverage of children here. But the CDC says these same diseases can be much more common in other countries, including areas where you wouldn't usually worry about travel-related illnesses. Being current with your routine vaccines will give you the best protection.

Yellow Fever

Yellow fever is spread by the Aedes aegypti mosquito (the same one that spreads  Zika , dengue, and chikungunya). Although the virus was eradicated from much of the world in the mid-1900s, it has re-emerged in recent years in parts of Africa and South America, including, most recently, Brazil .

Brazil has been suffering through a yellow fever outbreak that's one of the largest the world has seen in decades.

"Since early 2018, a number of unvaccinated travelers to Brazil contracted yellow fever," the CDC notes. "Several have died."

According to the  CDC , the vaccine that's typically used to prevent the yellow fever virus, known as YF-Vax, is currently unavailable due to production delays . To cover the shortage, the CDC and the Food and Drug Administration have turned to a different yellow fever vaccine known as Stamaril.

This other shot is already approved in more than 70 other countries around the world and is thought to be just as safe and effective as the YF-Vax shot. It's been okayed by the FDA under a special program , but its availability in the U.S. is limited. 

If you're traveling to  a country where yellow fever is spreading  or one that requires all visitors to have a yellow fever shot, be sure to plan ahead. Unlike other travel shots, the yellow fever vaccine is available only at  specially designated clinics . Because of the shortage, there will be far fewer clinics than usual.

You definitely don't want to skip this shot. Yellow fever is a serious disease. The CDC estimates that it can be fatal in 15 to 20 percent of cases. Find out where the nearest clinic is ( you can search online here ) and make sure you budget enough time to go.

You should also be sure to apply plenty of insect repellent , which can help protect you from the mosquitoes that spread yellow fever, Zika, and other diseases .

Hepatitis A and B

Hepatitis A is a virus that causes liver disease. It spreads through contaminated food and through physical contact with an infected person, especially if that person doesn't wash his or her hands properly after using the bathroom. It's common among people who travel to developing countries, particularly those who visit rural areas, though it can also be spread in more modern tourist accommodations.

The vaccine to prevent this virus—given in two doses, six months apart—is 100 percent effective, according to the CDC. 

Hepatitis B is a different but related virus that passes through blood, semen, and other body fluids. It can disappear after just a few weeks or it can linger for a lifetime, potentially causing liver disease and cancer.

This virus occurs in nearly every part of the world, but it's most common in Asia, Africa, South America, and the Caribbean. Travel-related cases are generally rare but can result from unprotected sex, intravenous drug use, and blood transfusions.

The vaccine for hepatitis B is more than 90 percent effective. It's usually given in three doses spread across six months, but ask your doctor for an accelerated schedule if your travel plans require it. 

Typhoid fever is a serious disease caused by the bacteria salmonella typhi and is spread through contaminated food and water. In rare cases, it can be fatal. Typhoid is rare in developed countries like the U.S. but common in most of the rest of the world, especially South Asia. The U.S. sees about 300 travel-related cases of typhoid fever every year. 

The vaccine for typhoid fever is available as a pill and an injectable. The pill contains live but weakened bacteria and is given in four doses: One capsule is taken every other day for a week. The injectable contains killed bacteria and is given in one dose. Get the injectable at least two weeks before traveling and complete the oral vaccine at least 10 days before. 

The CDC concedes that the typhoid vaccine in any form is only about 50 to 80 percent effective. You should still get it before traveling to an endemic region. But you should also take basic precautions with the food you eat while traveling, sticking to bottled water in places where the tap water is questionable, for example.

Rabies is a disease caused by a virus that spreads through the saliva of infected animals. The most common sources of human infection are licks, bites, and scratches from infected dogs. But bats, foxes, raccoons, and mongooses have also been known to pass the disease to humans. Prevention of this disease is especially important because once contracted, it's almost always fatal. 

Rabies is found all over the world except in Antarctica. In most developed countries, including the U.S., the risk of human infection is low because the virus is rare in domestic animals. But in much of Africa, Asia, and Latin America, rabies in dogs is still a problem. 

If you're traveling to a country where the virus is prevalent in dogs, or if your itinerary will bring you into contact with wild animals like bats and other carnivores, you should consider getting a rabies shot before you travel. It's given in three doses over three weeks. 

It's important to note that even if you've had your rabies shots, you should still seek immediate medical treatment if you're bitten or scratched by an animal while traveling. You can't be too careful when it comes to rabies prevention. 

There's no vaccine available against malaria, but it's still crucial to plan ahead if you're going to a region where malaria is common. You can take prophylactic medications that will reduce your risk of developing malaria if you're bitten by an infected mosquito.

The recommendations vary depending on what country you're visiting, what time of year you're going, and whether the mosquitoes in your destination have developed resistance to certain antimalarial drugs.

The CDC offers this chart of every country and specific recommendations for preventing malaria in different destinations.

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Brazil Travel Requirements & Vaccinations

Brazil is the fifth largest country in the world and the third largest in the Americas. Because of its vast expanse and varied topography – including hills, mountains and plains — the climate is widely varied but most of the country is categorized as either tropical or subtropical. Portuguese is the official language of Brazil.

Brazil offers tourists a wide range of attractions and geographical variety, including:

• The Amazon Rainforest and River Basin
• Diverse wildlife
• Picturesque beaches and dunes
• Cultural attractions

Recommended Vaccinations for Brazil Travel

• Hepatitis A
• Yellow Fever

*Rabies vaccination is typically only recommended for very high risk travelers given that it is completely preventable if medical attention is received within 7 – 10 days of an animal bite.

Travelers may also be advised to ensure they have received the routine vaccinations listed below. Some adults may need to receive a booster for some of these diseases:

• Measles, mumps and rubella (MMR)
• Tdap (tetanus, diphtheria and pertussis)

Older adults or those with certain medical conditions may also want to ask about being vaccinated for shingles and/or pneumonia.

This information is not intended to replace the advice of a travel medicine professional. Not all of the vaccines listed here will be necessary for every individual.

Talk to the experts at UH Roe Green Center for Travel Medicine & Global Health to determine how each member of your family can obtain maximum protection against illness, disease and injury while traveling, based on age, health, medical history and travel itinerary.

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I did this trip two years ago. Looks like you're already in good shape re vaccinations. Hepatitis B isn't necessary unless you plan to be intimate with some of the locals. Malaria is not much of a problem because the waters of the Amazon are highly acidic, which kills most mosquito larvae.

http://www.travelhealth.ie/countries/Brazil.php

U. S. Centers for Disease Control and Prevention health information for travelers to Brazil:

http://1.usa.gov/1dyOhS0

Public Health Agency of Canada: Brazil:

http://bit.ly/20iEp20

Hepatitis A is definitely one you should take. It is widespread.

i would add tetanus, if your last tetanus shot was more than 10 years ago (even for those who are not traveling; never know when that rusty nail injury can cause serious problems).

dont know how it works in the UK, but when I got Hep A shots, it was a combo Hep A+B. it required two shots one month apart; followed by a blood test six months later to see if enough protection had been acquired. if not, a third shot would be given.

when I traveled to malaria areas, I also skipped medication, because of the controversies you mentioned.

if you decide to get malaria prevention, make sure you mention it is for Brazil; malaria varies around the world and recommended prophlaxis can vary too.

Hepatitis A is usually a single shot.

Hepatitis B is a three shot thing, usually the second one being taken one month after the first one and then the third one six months after the second one.

I had Hepatitis A because I had not been vaccinated. Terrible. Got it here in Brazil.

I then took the Hepatitis B shots.

We had the Hep A & B done for Africa....tetnus is up to date....my DH had YF vaccine years ago but I will need to do that.

Again, while on board our ship I am not concerned, however I have heard from locals both here on TA as well as Cruise Critic that it is when you go into the ports or into the country that the concern is there......

1wanaka: No need to take Malarone. A good way to avoid mosquito bites in the Amazon is to wear protective clothing and to use insect repellent.

Definitely planning on that. Thanks much.

I am not worried while on board ship. I have read of the issues with mosquitoes in port towns and on excursions (private mostly) - particularly Manaus. The recommendation I received about taking something for Malaria was for those areas. So it's all a bit confusing. I have to think that if there is concern for Yellow Fever, that Malaria should be as well?

thanks everyone for the tips, and links which i have had a look at. hepatitis A i think is a must, and also recommended by the Brazilian Dr. Hep B, possibly not, as we are very unlikely to be participating in the kind of behaviour that puts you at risk, or getting involved with any health care. as I used to be a health care worker, i have been covered by a full course plus booster. We are going to be well armed with deet at full strength, covered up with clothing, and repellent for said clothing, and for the room/cabin. malaria is still at issue, which we will have to discuss further. there is one type i am totally unwilling to take, and another which is still problematic. one i would consider, especially as is also gives a little bit of protection against intestinal infections. cannot get a definitive answer about this, some people say side effects are too bad, others say they never had any and would not think of going without it.

I've used Malarone on at least a half dozen trips to various countries and never had a problem with it.

I had a real rough time with Malarone - my stomach on a couple days violently and on every day I was nauseous for a few hours following taking it even with food.

I would be interested in knowing experience with other Malaria medication options. Thank you in advance

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COVID-19: CDC Says Fully Vaccinated People Can Travel

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The Centers for Disease Control and Prevention (CDC) has updated its travel guidance for people who are fully vaccinated. A person is considered fully vaccinated two weeks after receiving the last recommended dose of vaccine.

According to the CDC, fully vaccinated people can travel at low risk to themselves within the United States and do not need COVID-19 testing or self-quarantine after their trip as long as they continue to take COVID-19 precautions while traveling — wearing a mask, avoiding crowds, socially distancing and washing hands frequently.

Non-essential travel is still discouraged for people who are not fully vaccinated. They should still get tested 1-3 days before domestic travel and again 3-5 days after travel. They should stay home and self-quarantine for 7 days after travel or 10 days if they don’t get tested after traveling. 

You can find more information here , including guidance for international travelers.

The vast majority of people need to be fully vaccinated before COVID-19 precautions can be lifted broadly. Until then, it is important that everyone continue to take precautions in public places, meaning wear a mask, stay six feet apart, avoid crowds and avoid poorly ventilated spaces.

In alignment with CDC guidelines, the American Red Cross continues to require face masks to be worn by both donors and staff at donation centers and blood drives.

FULLY VACCINATED PEOPLE CAN:

• Visit with other fully vaccinated people indoors without wearing masks or social distancing.
• Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or social distancing.
• Refrain from quarantine and testing following a known exposure if they have no symptoms.

However, fully vaccinated people should still watch for symptoms of COVID-19  for 14 days following an exposure. If they experience symptoms, they should isolate themselves from others, be tested for COVID-19 if indicated, and inform their health care provider of their vaccination status when they contact them.

FOR NOW, FULLY VACCINATED PEOPLE SHOULD CONTINUE TO:

• Wear a well-fitted mask and social distance in public.
• Wear masks, practice social distancing, and adhere to other prevention measures when visiting with unvaccinated people who are at  increased risk for severe COVID-19  disease or who have an unvaccinated household member who is at increased risk for severe illness.
• Wear masks, maintain physical distance and practice other prevention measures when visiting with unvaccinated people from multiple households
• Follow guidance issued by individual employers.

VACCINE UPDATE More than 3 million people are receiving a vaccine on an average day. The CDC reports that more than 108 million people have received at least one dose of a COVID-19 vaccine, including about 63 million people who have been fully vaccinated. This means that about 32% of the U.S. population has received at least one dose of vaccine and 19% has been fully vaccinated.

State and local governments decide when each group gets access to vaccines. Visit your state  or  local   health department for more information on eligibility and availability in your area.

Some people experience mild discomfort after they get a vaccine. This means the vaccine is working and creating an immune response in your body. If you experience side effects, it’s important to still make sure you get your second dose of the vaccine. More information is available here.

WHAT THE RED CROSS IS DOING As COVID-19 vaccination efforts continue, the American Red Cross is supporting local communities across the country in their work when requested.

Depending on the circumstances, our support may include helping to set up vaccination sites, collecting information from people being vaccinated, and providing water and snacks for medical staff and people waiting to be vaccinated.

As of April 6, the Red Cross has supported 146 events across 31 states. Red Cross volunteers who are medical professionals may also be working with local authorities to help give vaccinations if their state licenses permit them to do so. The Red Cross is also helping to vaccinate U.S. service members on bases around the globe and are active in U.S. veterans’ hospitals.

About the American Red Cross:

The American Red Cross shelters, feeds and provides comfort to victims of disasters; supplies about 40% of the nation’s blood; teaches skills that save lives; distributes international humanitarian aid; and supports veterans, military members and their families. The Red Cross is a nonprofit organization that depends on volunteers and the generosity of the American public to deliver its mission. For more information, please visit redcross.org or CruzRojaAmericana.org , or follow us on social media.

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Which Vaccinations Are Required for Travel?

By Cassie Shortsleeve

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

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

Make sure you’re current with routine vaccines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The bottom line

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

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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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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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Traveling with dogs to the U.S.? The new CDC rules you'll have to follow

All dogs coming into the U.S. from other countries must be at least 6 months old and microchipped to help prevent the spread of rabies, according to  new government rules  published Wednesday.

The new rules require vaccination for dogs that have been in countries where rabies is common. The update applies to dogs brought in by breeders or rescue groups as well as pets traveling with their U.S. owners.

“This new regulation is going to address the current challenges that we’re facing,” said Emily Pieracci, a rabies expert at the Centers for Disease Control and Prevention who was involved in drafting the updated regulations.

The CDC posted the  new rules in the federal register  on Wednesday. They take effect Aug. 1 when a temporary 2021 order expires. That order suspended bringing in dogs from  more than 100 countries  where rabies is still a problem.

The new rules require all dogs entering the U.S. to be at least 6 months, old enough to be vaccinated if required and for the shots to take effect; have a microchip placed under their skin with a code that can be used to verify rabies vaccination; and have completed a new CDC import form.

There may be additional restrictions and requirements based on where the dog was the previous six months, which may include blood testing from CDC-approved labs.

The CDC regulations were last updated in 1956, and a lot has changed, Pieracci said. More people travel internationally with their pets, and more rescue groups and breeders have set up overseas operations to meet the demand for pets, she said. Now, about 1 million dogs enter the U.S. each year.

Dogs were once common carriers of the rabies virus in the U.S. but the type that normally circulates in dogs was eliminated through vaccinations in the 1970s. The virus invades the central nervous system and is usually a fatal disease in animals and humans. It’s most commonly spread through a bite from an infected animal. There is no cure for it once symptoms begin.

Four rabid dogs have been identified entering the U.S. since 2015, and officials worried more might get through. CDC officials also were seeing an increase of incomplete or fraudulent rabies vaccination certificates and more puppies denied entry because they weren’t old enough to be fully vaccinated.

A draft version of the updated regulations last year drew a range of public comments.

Angela Passman, owner of a Dallas company that helps people move their pets internationally, supports the new rules. It can be especially tricky for families that buy or adopt a dog while overseas and then try to bring it to the U.S., she said. The update means little change from how things have been handled in recent years, she said.

“It’s more work for the pet owner, but the end result is a good thing,” said Passman, who is a board member for the International Pet and Animal Transportation Association.

But Jennifer Skiff said some of the changes are unwarranted and too costly. She works for Animal Wellness Action, a Washington group focused on preventing animal cruelty that helps organizations import animals. She said those groups work with diplomats and military personnel who have had trouble meeting requirements, a reason some owners were forced to leave their dogs behind.

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

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

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

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

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

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

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

Shots - Health News

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

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

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

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

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

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

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

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

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

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

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

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

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

Dog rescue advocates also welcomed the changes.

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

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

• importing dogs

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Ecuador, including the Galápagos Islands Traveler View

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

• Packing List

After Your Trip

Be aware of current health issues in Ecuador. 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

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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 Ecuador.

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 Ecuador. Unvaccinated travelers 60 years and older may get vaccinated before traveling to Ecuador.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

CDC recommends that travelers going to certain areas of Ecuador 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 Ecuador.

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 Ecuador. If you are bitten or scratched by a dog or other mammal while in Ecuador, there may be limited or no rabies treatment 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 Ecuador. 

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

Yellow Fever

Required for travelers ≥1 year old arriving from Brazil, Democratic Republic of the Congo, or Uganda; this includes >12-hour airport transits or layovers in any of these countries .

Recommended for travelers ≥9 months old going to areas <2,300 m (≈7,550 ft) elevation, east of the Andes Mountains, in the provinces of Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos, Tungurahua,* and Zamora-Chinchipe. Generally not recommended for travel limited to areas <2,300 m (≈7,550 ft) elevation, west of the Andes Mountains, in the provinces of Esmeraldas,* Guayas, Los Ríos, Manabí, Santa Elena, Santo Domingo de los Tsáchilas, and designated areas in the provinces of Azuay, Bolívar, Cañar, Carchi, Chimborazo, Cotopaxi, El Oro, Imbabura, Loja, and Pichincha. Not recommended for travel limited to areas >2,300 m (≈7,550 ft) elevation, the cities of Guayaquil or Quito (the capital), or the Galápagos Islands *CDC recommendations differ from those published by WHO .

Yellow Fever - CDC Yellow Book

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

• 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 Ecuador, 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 Ecuador. 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 .

Stay safe outdoors

If your travel plans in Ecuador 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 Ecuador. 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 Ecuador’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 Ecuador. 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 Ecuador 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 Ecuador, 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 Ecuador, see Travel and Transportation on US Department of State's country-specific information for Ecuador .

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.

Healthy Travel Packing List

Use the Healthy Travel Packing List for Ecuador 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 .

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

At a glance.

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

Requirements for all dogs

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

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

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

All dogs must:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Traveling with dogs to the US? The new rules you’ll need to follow

FILE - A trainer walks with a service dog through the Terminal C at Newark Liberty International Airport while taking part of a training exercise, Saturday, April 1, 2017, in Newark, N.J. All dogs coming into the U.S. from other countries must be at least 6 months old and microchipped, according to new government rules published Wednesday, May 8, 2024. The new rules were prompted by concerns about dogs coming from countries where rabies is common, and applies to dogs brought in by breeders or rescue groups as well as pets traveling with their U.S. owners. (AP Photo/Julio Cortez, File)

FILE - This undated electron microscope image made available by the Centers for Disease Control and Prevention shows rabies virions, dark and bullet-shaped, within an infected tissue sample. All dogs coming into the U.S. from other countries must be at least 6 months old and microchipped, according to new government rules published Wednesday, May 8, 2024. The new rules were prompted by concerns about dogs coming from countries where rabies is common, and applies to dogs brought in by breeders or rescue groups as well as pets traveling with their U.S. owners. (F. A. Murphy/CDC via AP, File)

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NEW YORK (AP) — All dogs coming into the U.S. from other countries must be at least 6 months old and microchipped to help prevent the spread of rabies, according to new government rules published Wednesday.

The new rules require vaccination for dogs that have been in countries where rabies is common. The update applies to dogs brought in by breeders or rescue groups as well as pets traveling with their U.S. owners.

“This new regulation is going to address the current challenges that we’re facing,” said Emily Pieracci, a rabies expert at the Centers for Disease Control and Prevention who was involved in drafting the updated regulations.

The CDC posted the new rules in the federal register on Wednesday. They take effect Aug. 1 when a temporary 2021 order expires. That order suspended bringing in dogs from more than 100 countries where rabies is still a problem.

The new rules require all dogs entering the U.S. to be at least 6 months, old enough to be vaccinated if required and for the shots to take effect; have a microchip placed under their skin with a code that can be used to verify rabies vaccination; and have completed a new CDC import form.

There may be additional restrictions and requirements based on where the dog was the previous six months, which may include blood testing from CDC-approved labs.

The CDC regulations were last updated in 1956, and a lot has changed, Pieracci said. More people travel internationally with their pets, and more rescue groups and breeders have set up overseas operations to meet the demand for pets, she said. Now, about 1 million dogs enter the U.S. each year.

Dogs were once common carriers of the rabies virus in the U.S. but the type that normally circulates in dogs was eliminated through vaccinations in the 1970s. The virus invades the central nervous system and is usually a fatal disease in animals and humans. It’s most commonly spread through a bite from an infected animal. There is no cure for it once symptoms begin.

Four rabid dogs have been identified entering the U.S. since 2015, and officials worried more might get through. CDC officials also were seeing an increase of incomplete or fraudulent rabies vaccination certificates and more puppies denied entry because they weren’t old enough to be fully vaccinated.

A draft version of the updated regulations last year drew a range of public comments.

Angela Passman, owner of a Dallas company that helps people move their pets internationally, supports the new rules. It can especially tricky for families that buy or adopt a dog while overseas and then try to bring it to the U.S., she said. The update means little change from how things have been handled in recent years, she said.

“It’s more work for the pet owner, but the end result is a good thing,” said Passman, who is a board member for the International Pet and Animal Transportation Association.

But Jennifer Skiff said some of the changes are unwarranted and too costly. She works for Animal Wellness Action, a Washington group focused on preventing animal cruelty that helps organizations import animals. She said those groups work with diplomats and military personnel who have had trouble meeting requirements, and was a reason some owners were forced to leave their dogs behind.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.