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News Release

P&o cruises updates covid-19 travel requirements.

P&O Cruises today (August 12, 2022) announced updated Covid-19 protocols and guidelines, with adjusted pre-travel testing requirements.

From Tuesday September 6, 2022 self-testing prior to travel will change from “mandatory” to “highly recommended” for vaccinated guests on the vast majority of holidays.

Only guests sailing on longer, more complex itineraries will be required to have an observed or in person antigen or PCR test with a fit to travel certificate prior to departure. These include a number of holidays of 16 nights or more and other specific cruises.

These new guidelines apply to all P&O Cruises itineraries sailing from Southampton and all other departure points with the exception of countries where government regulations and protocols may vary including Australia.

The vaccination policy for P&O Cruises guests remains the same and full details can be found at:

Preparing to sail | P&O Cruises (pocruises.com)

P&O Cruises president Paul Ludlow said: “These updated protocols reflect the current environment across the world and while certain key elements have relaxed, our commitment to protect the health and wellbeing of all guests, crew and the communities we visit remains an ongoing and vital consideration.

“They also ensure that the ease of cruising remains at the fore and that all guests of all ages can enjoy a holiday with unrivalled dining, relaxation and exploration options and unmatched service levels at extraordinary value for money.”

Exact requirements will be communicated to all guests in due course with the latest updates on www.pocruises.com from early September.

All the updated guidelines and protocols are subject to local regulations of applicable homeports and destinations.

About P&O Cruises

P&O Cruises is Britain’s favourite cruise line, welcoming guests to experience holidays with a blend of discovery, choice, relaxation and exceptional service catered towards British tastes.  P&O Cruises’ fleet of premium ships combine genuine service, a sense of occasion and attention to detail.

In May 2021, P&O Cruises launched Iona, its first Excel class ship. The new LNG-powered ship, with 5,200-guest capacity, is the largest ship built to serve the UK market. Iona features enhancements to already successful brand signature venues from the existing fleet, as well as features newly developed for Iona.

P&O Cruises’ second LNG-powered Excel class ship and sister ship to Iona is named Arvia, meaning from the seashore, and will join the fleet in December 2022. Arvia is the latest evolution in the P&O Cruises experience, embodying the newest trends in travel, dining and entertainment, and will be the epitome of a sunshine resort sailing year-round to the warmest climates.

The 185,000 tons ship, 345m in length, with 16 guest decks will feature Altitude Skywalk a unique high ropes experience, a swim-up bar and stunning infinity pool, a new restaurant Green & Co featuring Mizuhana serving a plant and fish-led menu, Ocean Studios cinema, 1,300sqm of shopping and the Oasis Spa and Health Club.

With over 200 destinations worldwide, P&O Cruises Itineraries are carefully curated to inspire discovery, and are varied to suit newcomers and experienced guests alike. With a wide choice of holidays from two days to three months there is something for everyone.

The company is part of Carnival Corporation & plc (NYSE/LSE: CCL; NYSE:CUK). 

For further press information please contact:

Michele Andjel, [email protected] 07730 732072

AIDA Cruises is the market leader in the German-speaking cruise market. Home of the smile, AIDA Cruises is the epitome of a premium-quality, relaxing cruise and operates one of the world’s most state-of-the-art fleets. Visit: www.aida.de

Carnival Cruise Line, also known as America’s Cruise Line, is a leader in contemporary cruising and operates a fleet of ships designed to provide fun and memorable vacation experiences at a great value. Visit: www.carnival.com

Costa Cruises delivers Italy’s finest at sea, bringing modern Italian lifestyle to its ships to provide guests with a true European experience that embodies a unique passion for life through warm hospitality, entertainment and gastronomy. Visit: www.costacruise.com

Cunard is the epitome of British refinement for travelers who relish the line’s impeccable White Star Service, gourmet dining, world-class entertainment, and the legacy of historic voyages and transatlantic travel. Visit: www.cunard.com

Holland America Line's premium fleet of spacious, elegant mid-sized ships feature sophisticated five-star dining, extensive entertainment and activities, innovative culinary enrichment programs and compelling worldwide itineraries. Visit: www.hollandamerica.com

P&O Cruises (UK) is Britain’s favorite cruise line with a fleet of ships combining genuine service and a sense of occasion and attention to detail, ensuring passengers have the holiday of a lifetime, every time. Visit: www.pocruises.co.uk

P&O Cruises (Australia) provides a quintessential holiday experience for Australians and New Zealanders, taking them to some of the world's most idyllic and hard-to-reach places across Asia and the South Pacific. Visit: www.pocruises.co.au

Princess is the world’s leading international cruise line and tour company operating a fleet of modern cruise ships, renowned for the innovative design and wide array of choices in dining, entertainment and amenities. Visit: www.princess.com

Seabourn provides ultraluxury cruising vacations in a unique, small-ship style that focuses on genuine, intuitive service, all-suite accommodations, superb cuisine and unique experiences in destinations worldwide. Visit: www.seabourn.com

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Which cruise lines require a Covid vaccine? Complete guide to major cruises

Author: Harriet Mallinson

Published on: 19 November 2021

Updated on: 23 November 2021

Cruise holidays may have returned but many rules still remain in place with most cruise lines requiring a Covid vaccine - which are they?

P&O Cruises, Royal Caribbean and Princess Cruises - along with all cruise lines currently operating right now - have vaccine policies in place that passengers must be aware of.

This is what you need to know about what the major cruise lines require regarding Covid vaccination.

Vaccine required? Yes (including crew)

"Guests will not be able to sail unless they are fully vaccinated and received their final dose of the vaccine no later than 14 days prior to embarkation," says Carnival .

"Please take a few moments to review your vaccination record prior to your cruise and confirm you meet this important requirement. Guests who did not receive their final dose within the required time will not be allowed to sail and no refund will be provided."

It adds: "Vaccine exemptions for cruises to the Caribbean will be limited to a very small number of children under 12, and teens and adults with a medical condition who can provide written confirmation from their medical provider that they cannot be vaccinated for medical reasons."

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Vaccine required? Yes

Celebrity says: "All crew and guests who are eligible to be vaccinated must be vaccinated in order to sail with us.

"All guests two and over must present a negative Covid-19 test prior to sailing."

- READ MORE: What's onboard Celebrity Cruises newest ship Apex? -

The latest advice from Cunard explains: "All guests (of all ages) will need to be fully vaccinated in order to travel on any voyage departing from October 13, 2021 up to and including April 17, 2022 for voyages on Queen Mary 2 and 17 May 2022 for voyages on Queen Elizabeth."

It adds: "The vaccine policy currently does not apply to sailings beyond these dates, or on Queen Victoria, scheduled to return to service on 22 April 2022.

- READ MORE: Everything you need to know about luxury line Cunard -

Disney Cruise Line

All guests are required to be vaccinated to sail with Disney. In fact, Disney has become the first cruise line to mandate that children need to be fully-jabbed as well.

"This will be a requirement for all Guests (US and international) ages five and up for sailings beginning on or after January 13, 2022," states Disney's website.

The change could pose a problem for Britons with children under 12 in the UK not yet eligible for the vaccine.

Disney added: "Guests who are not vaccine-eligible because of age must provide proof of a negative COVID-19 test result (paid for by the Guest) taken between three days and 24 hours before their sail date. Guests ages five through 11 may complete this testing requirement in lieu of being fully vaccinated for sailings that depart before January 13, 2022."

Fred. Olsen

Fred. Olsen details: "It will be a requirement for all guests to be fully vaccinated to join us on board this summer. We have made this decision following new research on the vaccine, which has found that those who are fully vaccinated are not only less likely to become seriously unwell, but also less likely to pass on the virus too.

"The safety and wellbeing of our guests and crew is always our utmost priority, and as a result, we will be requiring all guests to be fully vaccinated (with at least 14 days since the date of your second vaccination) to be able to sail with us.

"You will be required to prove that you have had both of your vaccines at check-in."

- READ MORE: How Holland America Line caters for families -

"Vaccinated cruises are available for guests who have received their final dose of an approved COVID-19 vaccine at least 14 days prior to the beginning of the cruise and have proof of vaccination," states Holland America Line .

"It’s important for guests to come prepared, as those who arrive at the embarkation terminal without the proper proof of vaccination will not be able to cruise, and no refund will be issued.

"We will also require ALL fully vaccinated guests to produce a negative, medically-observed viral COVID-19 test (PCR or antigen) taken within three days of their embarkation on all Holland America Line sailings."

MSC states: “Guests 12 years and older who are fully vaccinated are able to cruise and must present proof of COVID-19 vaccine with the final dose being administered at least 14 days before the cruise.”

- READ MORE: Guide to major cruise lines' face mask policies -

NCL says: "All guests and crew must be fully vaccinated, at least two weeks prior to departure, in order to board. "NCL will stay up to date with the science when considering changing its vaccination policy. As science, technology and government regulations evolve, we will update our health and safety protocols as needed and appropriate.”

"For international cruising, we now require all passengers to be double vaccinated – a negative test will no longer be enough," said a Riviera Travel spokesman.

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P&O states: "For all holidays departing [until] March 27, 2022, all guests aged 18 years and over must have completed their vaccination course at least 14 days prior to travel. This can either be two doses of the currently approved COVID-19 vaccines or the approved single-dose Janssen COVID-19 vaccine (approved by the MHRA). A single dose of any other vaccine will not be accepted.

"All guests aged between five and 17 years old will need to have completed their vaccination course a minimum of 14 days prior to sailing or will require a negative PCR test within 120 hours prior to travel. Guests four years old and younger will be permitted to travel providing their travelling parents/guardians meet the above requirements."

Caribbean cruises from now until March 27, 2022, have a stricter stance, however. P&O says: "Given the long-haul destinations and the number of different countries visited, combined with the current health protocols and entry requirements in the Caribbean, all guests (irrespective of age) must have completed their vaccination course at least 14 days prior to travel."

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Princess explains: "Cruises are available for guests who have ALL of the following: Received their final dose of an approved COVID-19 vaccine at least 14 days prior to the beginning of the cruise, and proof of vaccination."

- READ MORE: Vaccine, testing and entry requirements for holiday destinations -

Royal Caribbean

Vaccine required? Yes on select cruises

Viking Cruises

Viking details: "All of Viking’s sailings are available exclusively for vaccinated guests, until further notice."

- READ MORE: Viking reveals brand new 2023 expedition cruises to Americas -

Virgin states: "We will be requiring that all Sailors and Crew be vaccinated to sail with us." Passengers need: proof of vaccination (including brand and dates of doses) and they must be more than two weeks out from their final dose to come aboard.

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Every Cruise Line's Requirements for COVID Vaccines, Testing

A guide to every major cruise line's health requirements for safe sailing.

Cruise lines have shifted their requirements for passengers, making cruising accessible to practically everyone. Many popular cruise lines have eliminated the vaccine and pre-embarkation test as the industry is beginning to shift away from mandatory vaccines and testing.

The changes began shortly after the CDC ended a pandemic-era policy of publicly displaying COVID-19 cases onboard, different cruise lines to the public in July 2022. For those looking to check current COVID-19 trends onboard the CDC urges direct contact with the cruise line, and the organization will continue to monitor and offer guidelines to ships.

Below, we break down each line's list of regulations to sail as well as what travelers need to know to plan.

Avalon Waterways

Where they sail: These small-ship river cruises sail throughout Europe, Asia, South America, and down the Nile River in Egypt.

Who needs the vaccine: All international travelers from the U.S. must be fully vaccinated before boarding. Beginning March 2023 the vaccine is no longer required (but strongly encouraged).

What other safety measures are in place: All guests will undergo a health screening upon arrival and luggage will be disinfected. Avalon will provide COVID-19 testing for travelers who need to show proof of a negative test to return home at no extra cost. Depending on the location of the cruise a pre-departure COVID-19 test may or may not be required.

Find out more: Avalon Waterways

Where they sail : Azamara sails mid-size ships all over the world, to all seven continents.

Who needs the vaccine : All guests and crew 12 and older will be required to be fully vaccinated at least two weeks before boarding a ship. Beginning Dec. 1, 2022, the company plans to drop the vaccine requirement for departures from the U.S. and Europe.

What other safety measures are in place : Depending on the port of embarkation guests may or may not to pre-test to travel. For a full list of ports and whether they require a test guests can check online .

Azamara's ships have been upgraded with new HVAC filtration systems, and EPA-certified disinfectants are used to clean the ship.

Find out more : Azamara

Carnival Cruises

Where they sail: Carnival sails large ships around the world, including popular trips to the Caribbean. The company sailed its maiden voyage on the Mardi Gras out of Florida in July.

Who needs the vaccine: All guests are encouraged to be vaccinated but unvaccinated travelers, or vaccinated guests without proof of vaccination, will have to present the negative results of a PCR or antigen test taken no earlier than 3 days before sailing.

What other safety measures are in place: For cruises five days or less, there will no longer be pre-cruise testing for vaccinated passengers unless a specific port requires it. Itineraries including Bahamas, Bermuda, or Grand Cayman will still be required to test. All guests will also be required to fill out a health screening 72 hours before embarkation and undergo health screenings prior to boarding. Unvaccinated travelers on a cruise to Bermuda will be required to purchase travel insurance (children under 12 are exempt as long as they are traveling with vaccinated parents).

Both vaccinated and unvaccinated guests who have recovered from COVID-19 within three months of their sailing date, do not need the required pre-cruise COVID test before embarkation, only if they are at least 10 days past their COVID-19 infection, have no symptoms and present documentation of recovery from COVID-19 from their healthcare provider.

Find out more: Carnival Cruise Line

Celebrity Cruises

Where they sail: Celebrity Cruises sails all over the world.

Who needs the vaccine: The vaccine is no longer required to sail on cruises from the U.S. and Europe. A vaccine is required for sailings visiting Canada.

What other safety measures are in place: A pre-embarkation test is no longer required for vaccinated guests on sailings nine days or less. Unvaccinated passengers will still be required to test three days prior to sailing. Self-tests are acceptable from European and U.S. ports that don't stop in Bermuda or Canada.

Find out more : Celebrity Cruises

Where they sail: Cunard, which sails all over the world, is known for its transatlantic journeys aboard the Queen Mary 2.

Who needs the vaccine: All guests 18 and older must be fully vaccinated. Unvaccinated passengers under 18 will be required to undergo a PCR test within 72 hours of their departure.

What other safety measures are in place: Cunard has "enhanced" their onboard ventilation systems and implemented mandatory mask-wearing policies indoors. All guests aged 4 and older are required to have a negative COVID-19 test before boarding. Crew will be tested regularly while on board. Guests who have certain pre-existing medical conditions, including those who are on supplementary oxygen, will not be allowed to board.

Disney Cruise Line

Where they sail: Disney sails family-friendly journeys including to the Caribbean, Europe, and Alaska.

Who needs the vaccine: Vaccination is no longer required by highly suggested.

What other safety measures are in place: Unvaccinated guests must provide results of a COVID-19 test taken 1 to 2 days before sail date, at home tests are not accepted, this requirement will end Nov. 14. The Cruise line also has a full list of enhanced cleaning protocols.

Find out more: Disney Cruise Line

Grand Circle Cruise Line

Where they sail: Grand Circle Cruise Line sails small ships and river cruises all over the world, including an extensive list of European itineraries. The company plans to start sailing again in August, including to Greece, Turkey, and Italy.

Who needs the vaccine: All guests and crew are required to be fully vaccinated with the booster shot.

What other safety measures are in place: All ships have been equipped with High Efficiency Particular Air (HEPA) filters and buffets have been eliminated. The cruise line states some itineraries will require proof of a negative COVID-19 test prior to travel , and that instructors will be sent out 30 days prior to travel.

Find out mor e: Grand Circle Cruise Line

Holland America

Where they sail: Holland America sails large ships all over the world, including to the Mediterranean, Caribbean, Europe, and more.

Who needs the vaccine: Unvaccinated guests are welcome but will be required to self-test three days before cruising.

What other safety measures are in place: Vaccinated passengers traveling on ships for less than 16 days excluding itineraries with the Panama Canal, trans-ocean, and other selected itineraries will no longer be required to test.

Lindblad Expeditions

Where they sail: Lindblad Expeditions is known for its adventurous trips to hard-to-reach destinations like Antarctica and the Russian Far East, partnering with National Geographic to add to the experience.

Who needs the vaccine: All guests 12 and older need to be vaccinated before boarding. Boosters are recommended but not required.

What other safety measures are in place: Pre-departure testing will not be required unless for a specific destination.

Margaritaville at Sea

Where they sail: Margaritaville at Sea offers 3-day cruises to Grand Bahama Island departing from the port of Palm Beach. The cruise line also offers the opportunity to take the ship one way to the Bahamas to allow guests to stay at the Margaritaville resort, and then take the ship back to the Bahamas at a later date.

Who needs the vaccine: All guests are welcome regardless of vaccination status, according to the cruise line.

What other safety measures are in place: All crew members must be vaccinated for COVID-19 and the cruise line states there are vaccination requirements on board (but does not specify).

Find out more: Margaritaville at Sea

MSC Cruises

Where they sail: MSC Cruises sails large ocean cruises around the world, including throughout Europe, South America, the Persian Gulf, and the Caribbean. In August, the company started sailing to the Bahamas with a stop at its private island, Ocean Cay.

Who needs the vaccine: Vaccinations are recommended but no longer required.

What other safety measures are in place: Fully-vaccinated passengers are no longer required to show proof of a negative test unless it is required of the destination. Unvaccinated children must show proof of a negative PCR test.

Norwegian Cruise Line

Where they sail: Norwegian sails big ocean cruises all around the world, including popular itineraries all throughout the Caribbean and Greece.

Who needs the vaccine: All passengers may sail regardless of vaccination status.

What other safety measures are in place: Testing is no longer required for any passenger regardless of vaccination status with the exception of local government mandates.

Find out more : Norwegian Cruise Line

Oceania Cruises

Where they sail: Oceania Cruises sails all over the world, including offering several World Cruise itineraries.

Who needs the vaccine: All passengers regardless of vaccination status are allowed to sail.

What other safety measures are in place: Only unvaccinated guests will be required to show proof of a negative PCR or antigen test taken 72 hours prior to boarding. Unvaccinated children aged 12 years and younger are exempt.

P&O Cruises

Where they sail: The UK-based cruise line sails around Europe, including to the Canary Islands, as well as to the Caribbean from Southampton in the UK.

Who needs the vaccine: Although P&O Cruises' policy states that passengers over the age of 15 are required to be vaccinated, the latest update on its website says guests will be contacted directly in regards to vaccination protocol.

What other safety measures are in place: All guests are required to undergo a COVID-19 test at the terminal. Masks will be required on board indoors, and all shore excursions will be with vetted operators.

Princess Cruises

Where they sail: The global cruise line sails large ocean ships all around the world, from Australia to Alaska.

Who needs the vaccine: All guests are welcome on board, but unvaccinated passengers will be required to test and may need an additional medical exemption at some ports.

Regent Seven Seas Cruises

Where they sail: Regent Seven Seas offers all-inclusive luxury cruises around the globe, which include perks like free airfare, free excursions, and complimentary unlimited drinks on board.

Who needs the vaccine: All guests are now welcome. Unvaccinated passengers will be required to test 3-days before embarkation.

What other safety measures are in place: Pre-departure testing may not be necessary depending on the port. Currently cruises leaving from Bermuda, Canada, and Greece will require a test.

Royal Caribbean International

Where they sail: Royal Caribbean sails large ocean ships all over the world, including many popular itineraries throughout the Caribbean and Asia.

Who needs the vaccine: Everyone is welcome regardless of vaccination status, passengers traveling to Bermuda or Canada are required to be vaccinated.

W hat other safety measures are in place: On Royal Caribbean, unvaccinated travelers 12 and older leaving from a U.S. or Caribbean port still have to get tested within three days of embarkation,  according to the cruise line , vaccinated guests are exempt.

Royal Caribbean will accept a variety of tests as proof to board, including simply taking a photo of a self-administered home test.

Find out more : Royal Caribbean International

Where they sail: The British cruise line, exclusively for guests 50 and older, sails both ocean and river cruises around the globe.

Who needs the vaccine: All guests must be fully vaccinated, including a booster shot at least 14 days before boarding a ship. Saga was the first major cruise line to implement this vaccination policy.

What other safety measures are in place: Ocean Cruise guests will be required to get tested for COVID-19 in the terminal. Masks are required on bus transfers, in hotels, and on excursions.

Find out more : Saga

Where they sail: Seabourn's mid-size luxury cruises head all around the world, from Alaska to the Caribbean.

Who needs the vaccine: Vaccinations are not required on most cruise itineraries, unvaccinated guests will be required to present a negative test taken within three days of embarkation.

What other safety measures are in place: Masks are recommended onboard in most indoor venues and the casinos are frequently sanitized.

Where they sail: Silversea brings guests all around the world in luxury and style, including to the Galapagos and Antarctica.

Who needs the vaccine: All guests are welcome, however, unvaccinated guests may not be welcome on all sailings depending on local regulations.

What other safety measures are in place: Vaccinated guests do not need a pre-departure test unless local regulations such as cruises leaving from Australia, Bermuda, Canada, or Greece require it. Unvaccinated travelers will need a negative COVID-19 test within 72 hours of embarkation.

UnCruise Adventures

Where they sail: This small-ship company is known for its Alaska journeys as well as adventures in places like the Galapagos and island hopping in Hawaii.

Who needs the vaccine: As of April 7, all guests are welcome on board regardless of vaccination status.

What other safety measures are in place: Guests will no longer be required to present proof of vaccination or a COVID-19 test prior to, or during any point of sailing and the cruise line will no longer be running at limited capacity. These measures go into effect on April 7, until then guests 12 and older must provide proof of vaccination, and itineraries may sail at less then full capacity.

Masks are required in public spaces, according to the company "bandana" and "buff" face masks will not be accepted.

Victory Cruise Lines

Where they sail: Victory Cruise Lines is known for its Great Lakes cruises, providing all-inclusive sailings to see breathtaking sights from Niagara Falls to the iconic architecture of Chicago from Lake Michigan. Beyond the U.S., Victory Cruise Lines sails to Mexico's Yucatán Peninsula.

Who needs the vaccine: All guests and crew will be required to be vaccinated before boarding, and will be required to show physical proof prior to boarding.

What other safety measures are in place: Testing is no longer required on any river cruise.

Luggage is then disinfected before being brought onto the ship and staterooms cleaned with electrostatic fogging. Masks will be required during the embarkation process and while riding a shore excursion bus, but will not be required on board.

Viking Cruises

Where they sail: Viking sails ocean and river cruises all over the world, including throughout Europe. This summer, Viking will sail several voyages, including around England for UK residents, to Bermuda, and to Iceland in June.

Who needs the vaccine: All guests must be fully vaccinated to board a ship. Guests who are eligible must have a booster.

What other safety measures are in place: In addition to vaccines, all guests may be required to undergo a saliva PCR test at embarkation as well as "frequent" testing throughout the journey. All staterooms are equipped with independent air handling units.

Virgin Voyages

Where they sail: The brand-new cruise line is launching mini sailings from England for UK residents, and has cruises throughout the Caribbean, and transatlantic options.

Who needs the vaccine: All are welcome regardless of vaccination status, the cruise line removed all vaccine and testing requirements for all its ships in late October, according to the company.

What other safety measures are in place: Virgin Voyages was the first cruise line to eliminate pre-departure testing for vaccinated guests. The cruise line will continue to work with an advisory board to help ensure health and safety on board at all times, including the use of air filtration systems and sanitization of high touch surface areas.

Find out more : Virgin Voyages

Windstar Cruises

Where they sail: Windstar operates small-ship cruises and several sailing vessels all around the globe, including to places like Central America .

Who needs the vaccine: All guests will be required to be fully vaccinated at least 14 days before boarding one of Windstar's yachts. Boosters are highly encouraged and are recommended to be administered at least one week prior to travel.

What other safety measures are in place: Guests no longer need a pre-embarkation test unless a specific destination requires it.

Alison Fox is a contributing writer for Travel + Leisure. When she's not in New York City, she likes to spend her time at the beach or exploring new destinations and hopes to visit every country in the world. Follow her adventures on Instagram .

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Everything you need to know about fully vaccinated cruises

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• Here's what you need to know before you plan a trip.

Across the world, cruise ships are setting sail for the first time since the pandemic started. 

The CDC is urging every traveler — including those planning to board cruise ships — to be fully vaccinated.

Here's what you need to know before booking a fully vaccinated cruise.

Safety protocols could vary by your cruise's port of departure 

Cruise lines and departure port locations influence whether travelers are required to be fully vaccinated or not.

Officials in Texas and Florida have passed measures that ban businesses from requiring proof of vaccination in the state, which goes against some cruise lines' requirements, CBS reported . 

In a recent court ruling, a federal judge ruled that the CDC can't enforce its conditional sailing orders against Florida cruise ships, which required cruises to run "trial" voyages before operating passenger voyages and recommends that 95% of passengers are vaccinated, Insider previously reported .

Now, the CDC cannot enforce its order on ships within, departing from, or arriving at a Florida port, and starting July 18, the order will become a "non-binding" guideline for ship operators, according to CNN .

Check your cruise line for its vaccination requirement

Related stories

Many large cruise lines plan to continue to require a vaccine before boarding a ship. 

Carnival Cruise Lines' first cruises this summer sail from Galveston, Texas, July 3, and Miami, Florida, in July. Its first two cruises will both require everyone to be fully vaccinated, the cruise line announced in a statement .

On Celebrity Cruises, guests 16 and older will also be expected to bring their vaccination card. Starting August 2, passengers 12 and older will need to be vaccinated, according to Celebrity Cruises' website .

Norwegian Cruise Line requires vaccinations for every guest through at least October 31, its website states.

At the time of writing, American Queen Steamboat Company , Azamara , Crystal Cruises , Cunard , Disney Cruise Lines in the UK , Grand Circle Cruise Line , Holland America , Lindblad Expeditions , Oceania Cruises , Ponant , P&O Cruises , Princess Cruises , Regent Seven Seas Cruises , Saga ,  Seabourn , Silversea , UnCruise Adventures , Victory Cruise Lines , Viking , Virgin Voyages , and Windstar Cruises require passengers to be vaccinated. 

Royal Caribbean International's vaccine requirements vary based on ships' ports of departure. The cruise line requires passengers 16 years and older on ships leaving from all US ports except Florida to be fully vaccinated but says passengers departing from Florida ports are "strongly recommended" to be vaccinated. Those who aren't fully vaccinated will be required to show proof of a negative COVID-19 test, according to Royal Caribbean's website.

As the vaccine continues to be accessible to younger people, more cruise companies may adapt their policies to require passengers 12 years and older to be vaccinated.

Many cruise lines are requiring workers to be vaccinated

While the passengers on the ship might not have to be fully vaccinated, many crew members do. 

Royal Caribbean, MSC Cruises, Regent Seven Seas Cruises, and Silversea are just a few cruises that require their workers to be fully vaccinated. 

What to expect onboard a cruise

Depending on the cruise, there may be a list of accepted vaccines, guidance on whether children need to quarantine beforehand, and other information on how the ship is preparing to welcome guests. 

The CDC's current guidelines state that if 95% of crew and 95% of passengers are vaccinated, it's up to the cruise's discretion whether masks and social distancing are in place.

The CDC also advises all passengers, even if they're fully vaccinated, to get tested for COVID-19 one to three days before their trip and three to five days after the trip. 

Watch: How COVID-19 is impacting US Army basic training — where training continues with new physical distancing measures

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• Know Before You Go

Healthy Cruising with P&O

At P&O Cruises the health, safety and well-being of our valued guests, the communities we visit and our loyal crew, is a top priority.

While the Eastern Seaboard and Western Australian Cruise Protocols have now been lifted, we will continue to have enhanced measures in place to help you stay healthy during your cruise holiday.

Below are some of the ways we’re keeping our ships clean and healthy.

Vaccinations

While there is no longer a requirement for vaccinations, we strongly encourage guests to remain up to date with vaccinations for COVID-19 and influenza.

Onboard Healthcare

Our highly trained medical staff of doctors and nurses are experienced in, and capable in caring for a broad range of medical conditions. Each of our ships have an onboard medical centre, equipped with testing and treatment capabilities.

Cleaning & Sanitisation

Our onboard protocols include regular cleaning and sanitisation of all public areas and guest rooms using medical-grade disinfectant. Hand washing sinks and sanitisation stations are available throughout each ship.

Onboard Ventilation

Upgraded filters have been fitted to our HVAC units, including some with the latest UV light treatment systems to facilitate high quality air recirculation. HEPA exhaust filtration is also used in key areas such as onboard medical centres and isolation rooms.

This page was last updated on 29 August 2023. We will keep you updated on any changes to our enhanced health and safety measures as they happen.

Looking for more information on vaccinations, COVID-19 protocols and more, visit our FAQ’s page here.

Frequently Asked Questions

Healthy cruising, preparing for your cruise.

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• Section 2 - Interactions Between Travel Vaccines & Drugs
• Section 2 - Travelers’ Diarrhea

Yellow Fever Vaccine & Malaria Prevention Information, by Country

Cdc yellow book 2024.

Author(s): Mark Gershman, Rhett Stoney (Yellow Fever) Holly Biggs, Kathrine Tan (Malaria)

The following pages present country-specific information on yellow fever (YF) vaccine requirements and recommendations, and malaria transmission information and prevention recommendations. Country-specific maps are included to aid in interpreting the information. The information in this chapter was accurate at the time of publication; however, it is subject to change at any time due to changes in disease transmission or, in the case of YF, changing entry requirements for travelers. Updated information reflecting changes since publication can be found in the online version of this book and on the Centers for Disease Control and Prevention (CDC) Travelers’ Health website. Recommendations for prevention of other travel-associated illnesses can also be found on the CDC Travelers’ Health website .

Yellow Fever Vaccine

Entry requirements.

Entry requirements for proof of YF vaccination under the International Health Regulations (IHR) differ from CDC’s YF vaccination recommendations. Under the IHR, countries are permitted to establish YF vaccine entry requirements to prevent the importation and transmission of YF virus within their boundaries. Certain countries require proof of vaccination from travelers arriving from all countries ( Table 5-25 ); some countries require proof of vaccination only for travelers above a certain age coming from countries with risk for YF virus transmission. The World Health Organization (WHO) defines areas with risk for YF virus transmission as countries or areas where YF virus activity has been reported currently or in the past, and where vectors and animal reservoirs exist.

Unless issued a medical waiver by a yellow fever vaccine provider, travelers must comply with entry requirements for proof of vaccination against YF.

WHO publishes a list of YF vaccine country entry requirements and recommendations for international travelers approximately annually. But because entry requirements are subject to change at any time, health care professionals and travelers should refer to the online version of this book and the CDC Travelers’ Health website for any updates before departure.

CDC Recommendations

CDC’s YF vaccine recommendations are guidance intended to protect travelers from acquiring YF virus infections during international travel. These recommendations are based on a classification system for destination-specific risk for YF virus transmission: endemic, transitional, low potential for exposure, and no risk ( Table 2-08 ). CDC recommends YF vaccination for travel to areas classified as having endemic or transitional risk (Maps 5-10 and 5-11 ). Because of changes in YF virus circulation, however, recommendations can change; therefore, before departure, travelers and clinicians should check CDC’s destination pages for up-to-date YF vaccine information.

Duration of Protection

In 2015, the US Advisory Committee on Immunization Practices published a recommendation that 1 dose of YF vaccine provides long-lasting protection and is adequate for most travelers. The recommendation also identifies specific groups of travelers who should receive additional doses, and others for whom additional doses should be considered (see Sec. 5, Part 2, Ch. 26, Yellow Fever ). In July 2016, WHO officially amended the IHR to stipulate that a completed International Certificate of Vaccination or Prophylaxis is valid for the lifetime of the vaccinee, and YF vaccine booster doses are not necessary. Moreover, countries cannot require proof of revaccination (booster) against YF as a condition of entry, even if the traveler’s last vaccination was >10 years ago.

Ultimately, when deciding whether to vaccinate travelers, clinicians should take into account destination-specific risks for YF virus infection, and individual risk factors (e.g., age, immune status) for serious YF vaccine–associated adverse events, in the context of the entry requirements. See Sec. 5, Part 2, Ch. 26, Yellow Fever , for a full discussion of YF disease and vaccination guidance.

Table 2-08 Yellow fever (YF) vaccine recommendation categories 1

Malaria prevention.

The following recommendations to protect travelers from malaria were developed using the best available data from multiple sources. Countries are not required to submit malaria surveillance data to CDC. On an ongoing basis, CDC actively solicits data from multiple sources, including WHO (main and regional offices); national malaria control programs; international organizations; CDC overseas offices; US military; academic, research, and aid organizations; and the published scientific literature. The reliability and accuracy of those data are also assessed.

If the information is available, trends in malaria incidence and other data are considered in the context of malaria control activities within a given country or other mitigating factors (e.g., natural disasters, wars, the coronavirus disease 2019 pandemic) that can affect the ability to control malaria or accurately count and report it. Factors such as the volume of travel to that country and the number of acquired cases reported in the US surveillance system are also examined. In developing its recommendations, CDC considers areas within countries where malaria transmission occurs, substantial occurrences of antimalarial drug resistance, the proportions of species present, and the available malaria prophylaxis options.

Clinicians should use these recommendations in conjunction with an individual risk assessment and consider not only the destination but also the detailed itinerary, including specific cities, types of accommodations, season, and style of travel, as well as special health conditions (e.g., pregnancy). Several medications are available for malaria prophylaxis. When deciding which drug to use, consider the itinerary and length of trip, travelers’ previous adverse reactions to antimalarials, drug allergies, medical history, and drug costs. For a thorough discussion of malaria and guidance for prophylaxis, see Sec. 5, Part 3, Ch. 16, Malaria .

Afghanistan

Entry requirements : None

CDC recommendations : Not recommended

• All areas <2,500 m (≈8,200 ft) elevation (April–December)
• Chloroquine
• P. vivax  (primarily)
• P. falciparum (less commonly)
• Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3

Other Vaccines to Consider

See Health Information for Travelers to Afghanistan

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission 1

No malaria transmission

See Health Information for Travelers to Albania

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1

See Health Information for Travelers to Algeria

American Samoa (US)

See Health Information for Travelers to American Samoa

See Health Information for Travelers to Andorra

Entry requirements : Required for arriving travelers  ≥9 months old

CDC recommendations : Recommended for all travelers ≥9 months old

• P. falciparum (primarily)
• P. malariae , P. ovale , and P. vivax (less commonly)

See Health Information for Travelers to Angola

Anguilla (U.K.)

See Health Information for Travelers to Anguilla (U.K.)

See Health Information for Travelers to Antarctica

Antigua and Barbuda

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1

See Health Information for Travelers to Antigua and Barbuda

CDC recommendations : Recommended for travelers ≥9 months old going to Corrientes and Misiones Provinces. Generally not recommended for travel to Formosa Province or to designated areas of Chaco, Jujuy, and Salta Provinces. Not recommended for travel limited to provinces and areas not listed above.

Related Maps

Map 2-01 Yellow fever vaccine recommendations for Argentina & neighboring countries

See Health Information for Travelers to Argentina

See Health Information for Travelers to Armenia

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1 Entry will be denied if a valid vaccination certificate cannot be provided.

See Health Information for Travelers to Aruba

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1 Travelers arriving from the Galápagos Islands of Ecuador are exempt from this requirement.

See Health Information for Travelers to Australia

See Health Information for Travelers to Austria

See Health Information for Travelers to Azerbaijan

Azores (Portugal)

See Health Information for Travelers to Azores

Bahamas, The

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1

See Health Information for Travelers to The Bahamas

See Health Information for Travelers to Bahrain

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission; this includes airport transits or layovers in countries with risk for YF virus transmission. 1

• Districts of Chittagong Hill Tract (Bandarban, Khagrachari, and Rangamati); and the following districts: Chattogram (Chittagong) and Cox’s Bazar (in Chattogram [Chittagong] Division); Mymensingh, Netrakona, and Sherpur (in Mymensingh Division); Kurigram (in Rangpur Division); Habiganj, Moulvibazar, Sunamganj, and Sylhet (in Sylhet Division)
• No malaria transmission in Dhaka (the capital)
• P. falciparum (90%)
• P. vivax (10%)
• P. malariae  (rare)

See Health Information for Travelers to Bangladesh

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission. 1 Travelers arriving from Guyana or Trinidad & Tobago are exempt from this requirement, unless an outbreak is occurring.

See Health Information for Travelers to Barbados

See Health Information for Travelers to Belarus

See Health Information for Travelers to Belgium

• Rare transmission
• No malaria transmission in Belize City or on islands frequented by tourists (e.g., Ambergris Caye)
• P. vivax (primarily)
• None (insect bite precautions / mosquito avoidance only) 4

See Health Information for Travelers to Belize

Entry requirements : Required for all arriving travelers ≥9 months old

• P. falciparum  (primarily)
• P. malariae ,  P. ovale,  and  P. vivax  (less commonly)

See Health Information for Travelers to Benin

Bermuda (U.K.)

See Health Information for Travelers to Bermuda (U.K.)

• Rare cases in rural areas <1,700 m (≈5,500 ft) elevation in districts along the southern border shared with India
• P. falciparum  (less commonly)
• None (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Bhutan

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission. 1

CDC recommendations : Recommended for travelers ≥9 months old going to areas <2,300 m (≈7,550 ft) elevation, east of the Andes Mountains: the entire departments of Beni, Pando, Santa Cruz, and designated areas in the departments of Chuquisaca, Cochabamba, La Paz, and Tarija. Not recommended for travel limited to areas >2,300 m (≈7,550 ft) elevation and any areas not listed above, including the cities of La Paz (administrative capital) and Sucre (constitutional [legislative and judicial] capital).

• All areas <2,500 m (≈8,200 ft) elevation
• No malaria transmission in La Paz (administrative capital)
• P. vivax  (99%)
• P. falciparum  (1%)
• Atovaquone-proguanil, doxycycline, mefloquine, primaquine 5 , tafenoquine 3

Map 2-02. Yellow fever vaccine recommendations for Bolivia & neighboring countries

See Health Information for Travelers to Bolivia

See Health Information for Travelers to Bonaire

Bosnia and Herzegovina

See Health Information for Travelers to Bosnia and Herzegovina

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission; this includes transits through countries with risk for YF virus transmission. 1

• Districts/ subdistricts of Bobirwa, Boteti, Chobe (including Chobe National Park), Ghanzi, Mahalapye, Ngamiland (Ngami), North East (including its capital, Francistown), Okavango, Serowe/ Palapye, and Tutume
• Rare cases or sporadic foci of transmission in districts/ subdistricts of Kgalagadi North, Kgatleng, Kweneng, and Southern
• No malaria transmission in Gaborone (the capital)
• P. malariae ,  P. ovale , and  P. vivax  (less commonly)
• Districts/subdistricts of Bobirwa, Boteti, Chobe (including Chobe National Park), Ghanzi, Mahalapye, Ngamiland (Ngami), North-East (including its capital, Francistown), Okavango, Serowe/Palapye, and Tutume: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• Areas with rare cases or sporadic foci of transmission: no chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Botswana

CDC recommendations : Recommended for travelers ≥9 months old going to the states of Acre, Amapá, Amazonas, Distrito Federal (including the capital city, Brasília), Espírito Santo,* Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Paraná,* Piauí, Rio de Janeiro (including the city of Rio de Janeiro and all coastal islands),* Rio Grande do Sul,* Rondônia, Roraima, Santa Catarina,* São Paulo (including the city of São Paulo and all coastal islands),* Tocantins, and designated areas of Bahia*. Vaccination is also recommended for travelers going to Iguaçu Falls. Not recommended for travel limited to any areas not listed above, including the cities of Fortaleza and Recife *In 2017, in response to a large YF outbreak in multiple eastern states, CDC expanded its vaccination recommendations for travelers going to Brazil. The expanded YF vaccination recommendations for these states are preliminary. For updates, refer to the CDC Travelers’ Health website.

• All areas in the states of Acre, Amapá, Amazonas, Rondônia, and Roraima
• Present in the states of Maranhão, Mato Grosso, and Pará, but rare cases in their capital cities (São Luis [capital of Maranhão], Cuiabá [capital of Mato Grosso], Belém [capital of Pará])
• Rural and forested areas in the states of Espírito Santo, Goiás, Minas Gerais, Mato Grosso do Sul, Piauí, Rio de Janeiro, São Paolo, and Tocantins
• No malaria transmission in the cities of Brasília (the capital), Rio de Janeiro, or São Paolo
• No malaria transmission at Iguaçu Falls
• P. vivax  (90%)
• P. falciparum  (10%)
• Areas with rare cases: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4
• Map 2-03 Yellow fever vaccine recommendations for Brazil & neighboring countries
• Map 2-04 Malaria prevention in Brazil

See Health Information for Travelers to Brazil

British Indian Ocean Territory; includes Diego Garcia (U.K.)

See Health Information for Travelers to British Indian Ocean Territory (U.K.)

• No human malaria
• Rare transmission of P. knowlesi 6 in primarily forested or forest-fringe areas
• P. knowlesi 6 (100%)
• None (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Brunei

See Health Information for Travelers to Bulgaria

Burkina Faso

Entry requirements : Required for all arriving travelers ≥9 months old

CDC recommendations : Recommended for all travelers ≥9 months old.

• P. malariae ,  P. ovale , and  P. vivax (less commonly)

See Health Information for Travelers to Burkina Faso

Burma (Myanmar)

• All areas <1,000 m (≈3,300 ft) elevation, including Bagan
• Rare transmission in areas >1,000 m (≈3,300 ft) elevation
• Chloroquine and mefloquine
• P. vivax (60%)
• P. falciparum (40%)
• P. knowlesi 6 , P. malariae , and P. ovale (rare)
• Areas <1,000 m (≈3,300 ft) elevation in the regions of Bago and Tanintharyi, and in the states of Kachin, Kayah, Kayin, and Shan: Atovaquone-proguanil, doxycycline, tafenoquine 3
• Areas <1,000 m (≈3,300 ft) elevation in all other areas: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine  3
• Areas >1,000 m (≈3,300 ft) elevation: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only)  4

See Health Information for Travelers to Burma (Myanmar)

Entry requirements : Required for all arriving travelers ≥9 months old.

CDC recommendations : Recommended for all travelers ≥9 months old.

See Health Information for Travelers to Burundi

• Present throughout the country
• No (or negligible) malaria transmission in the cities of Phnom Penh (the capital) and Siem Reap
• No (or negligible) malaria transmission at the main temple complex at Angkor Wat
• P. vivax (80%)
• P. falciparum (20%)
• P. knowlesi 6 (rare)
• Atovaquone-proguanil, doxycycline, tafenoquine 3

See Health Information for Travelers to Cambodia

Entry requirements : Required for all arriving travelers ≥1 year old.

See Health Information for Travelers to Cameroon

See Health Information for Travelers to Canada

Canary Islands ( Spain )

See Health Information for Travelers to Canary Islands (Spain)

• No indigenous cases reported since 2018
• Previously, rare cases on Santiago (São Tiago) Island and Boa Vista Island
• Previously, chloroquine
• Previously, P. falciparum (primarily)

See Health Information for Travelers to Cape Verde

Cayman Islands (U.K.)

See Health Information for Travelers to Cayman Islands (U.K.)

Central African Republic

Entry requirements : Required for all arriving travelers ≥9 months old .

See Health Information for Travelers to Central African Republic

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission. 1

CDC recommendations : Recommended for travelers ≥9 months old going to areas south of the Sahara Desert. Not recommended for travel limited to areas in the Sahara Desert.

See Health Information for Travelers to Chad

See Health Information for Travelers to Chile

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1 Travelers with itineraries limited to Hong Kong Special Administrative Region (SAR) or Macao SAR are exempt from this requirement.

See Health Information for Travelers to China

Christmas Island (Australia)

See Health Information for Travelers to Christmas Island (Australia)

Cocos (Keeling) Islands (Australia)

See Health Information for Travelers to Cocos (Keeling) Islands (Australia)

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

CDC recommendations : Recommended for all travelers ≥9 months old except as follows. Generally not recommended for travel limited to the cities of Barranquilla, Cali, Cartagena, or Medellín. Not recommended for travel limited to areas >2,300 m (≈7,550 ft) elevation, the archipelago department of San Andrés and Providencia, or the city of Bogotá (the capital).

• All areas <1,700 m (≈5,600 ft) elevation
• No malaria transmission in the cities of Bogotá (the capital), Cartagena, or Medellín
• P. falciparum  (50%)
• P. vivax  (50%)

Map 2-05 Yellow fever vaccine recommendations for Colombia & neighboring countries

See Health Information for Travelers to Colombia

• P. malariae and P. vivax (rare)

See Health Information for Travelers to Comoros

Congo, Republic of the (Congo-Brazzaville)

Entry requirements : Required for all arriving travelers ≥9 months old.

See Health Information for Travelers to Congo, Republic of the

Cook Islands (New Zealand)

See Health Information for Travelers to Cook Islands (New Zealand)

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission. 1 Included in this requirement are travelers arriving from Tanzania and Zambia, and designated areas of: Colombia (the entire country, except the cities of Barranquilla, Bogotá, Cali, Cartagena, and Medellín, and the archipelago department, San Andrés and Providencia); Ecuador (the provinces of Morona-Santiago, Napo, Orellana, Pastaza, Sucumbíos, and Zamora-Chinchipe, and excluding the rest of the country); Paraguay (the entire country, except the city of Asunción); Peru (the entire country, except the cities of Cusco and Lima, the regions of Cajamarca, Lambayeque, Piura, and Tumbes, and the highland tourist areas of Machu Picchu and the Inca Trail); Trinidad & Tobago (the entire country, except the urban areas of Port of Spain; travelers with itineraries limited to the island of Tobago, and travelers with airport transits or layovers are also exempt from this requirement). Travelers arriving from Argentina and Panama are exempt from this requirement.

• Present in the provinces of Alajuela and Limón
• Rare to no transmission in other parts of the country
• P. falciparum (86%)
• P. vivax (14%)
• Alajuela and Limón Provinces: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, tafenoquine 3
• All other areas: None (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Costa Rica

Côte d'Ivoire (Ivory Coast)

See Health Information for Travelers to Côte d'Ivoire

See Health Information for Travelers to Croatia

See Health Information for Travelers to Cuba

Curaçao, Netherlands

See other recommended vaccines and medicines for travelers to Curaçao

See Health Information for Travelers to Cyprus

See Health Information for Travelers to Czech Republic

Democratic Republic of the Congo (Congo-Kinshasa)

CDC recommendations : Recommended for all travelers ≥9 months old

See Health Information for Travelers to Democratic Republic of the Congo

See Health Information for Travelers to Denmark

• P. falciparum (60–70%)
• P. vivax (30–40%)
• P. ovale (rare)

See Health Information for Travelers to Djibouti

See Health Information for Travelers to Dominica

Dominican Republic

Entry requirements : Required for travelers ≥1 year old arriving from the following states in Brazil: Espírito Santo, Mina Gerais, Rio de Janeiro, São Paulo; this includes >12-hour airport transits or layovers in any of these states

• Primarily in the provinces near the border with Haiti, and the provinces (including resort areas) of La Altagracia, San Cristóbal, San Juan, and Santo Domingo
• In the Distrito Nacional, city of Santo Domingo (the capital), primarily in the La Ciénaga and Los Tres Brazos areas
• Rare transmission in other provinces
• P. falciparum  (100%)
• Provinces near the border with Haiti, and the provinces (including resort areas) of La Altagracia, San Cristóbal, San Juan, and Santo Domingo: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, tafenoquine 3
• All other areas: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Dominican Republic

Easter Island (Chile)

Entry requirements : Easter Island has not stated its YF vaccination certificate requirements

See Health Information for Travelers to Easter Island (Chile) .

Ecuador, including the Galápagos Islands

Entry requirements : 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 .

CDC recommendations : 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 .

• Areas <1,500 m (≈5,000 ft) elevation in the provinces of Carchi, Cotopaxi, Esmeraldas, Morona-Santiago, Orellana, Pastaza, and Sucumbíos
• Rare cases <1,500 m (≈5,000 ft) in all other provinces
• No malaria transmission in the cities of Guayaquil or Quito (the capital)
• No malaria transmission on the Galápagos Islands
• P. vivax  (85%)
• P. falciparum  (15%)
• Transmission areas in the provinces of Carchi, Cotopaxi, Esmeraldas, Morona-Santiago, Orellana, Pastaza, and Sucumbíos: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• All other areas with reported malaria transmission: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

Map 2-06 Yellow fever vaccine recommendations for Ecuador & neighboring countries

See Health Information for Travelers to Ecuador .

See Health Information for Travelers to Egypt .

El Salvador

See Health Information for Travelers to El Salvador .

Equatorial Guinea

• P. malariae, P. ovale , and P. vivax  (less commonly)

See Health Information for Travelers to Equatorial Guinea .

CDC recommendations : Generally not recommended for travel to the regions of: Anseba, Debub (also known as South or Southern Region), Gash Barka, Ma’ekel (also known as Ma’akel or Central Region), or Semenawi K’eyih Bahri (also known as Northern Red Sea Region). Not recommended for travel to any areas not listed above, including the Dahlak Archipelago.

• All areas <2,200 m (≈7,200 ft) elevation
• No malaria transmission in Asmara (the capital)
• P. falciparum  (80–85%)
• P. vivax (15–20%)
• P. malariae and P. ovale (rare)

Map 5-10 Yellow fever vaccine recommendations for Africa

See Health Information for Travelers to Eritrea .

See Health Information for Travelers to Estonia .

Eswatini (Swaziland)

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission; this includes airport transits or layovers in countries with risk for YF virus transmission. 1

• Eastern areas bordering Mozambique and South Africa, including the entire region of Lubombo and the eastern half of Hhohho, Manzini, and Shiselweni Regions
• P. malariae , P. ovale , and  P. vivax  (less commonly)

See Health Information for Travelers to Swaziland .

CDC recommendations : Recommended for all travelers ≥9 months old except as follows. Generally not recommended for travel limited to the regions of Afar or Somali.

• All areas <2,500 m (≈8,200 ft) elevation, except none in Addis Ababa (the capital)
• P. falciparum  (80%)
• P. vivax  (20%)
• P. malariae and P. ovale  (rare)

Map 2-07 Yellow fever vaccine recommendations for Ethiopia & neighboring countries

See Health Information for Travelers to Ethiopia .

Falkland Islands (Islas Malvinas), UK Overseas Territory (also claimed by Argentina)

See Health Information for Travelers to Falkland Islands (Islas Malvinas) .

Faroe Islands (Denmark)

See Health Information for Travelers to Faroe Islands (Denmark) .

See Health Information for Travelers to Fiji .

See Health Information for Travelers to Finland .

See Health Information for Travelers to France .

French Guiana

• Areas associated with gold mining, primarily the communes near the border with Brazil and Suriname, especially Régina and Saint-Georges-de-l’Oyapock; also, the communes of Kourou, Matoury, and Saint-Élie
• No malaria transmission in coastal areas west of Kourou
• No malaria transmission in Cayenne City (the capital)
• P. falciparum (15%)

See Health Information for Travelers to French Guiana (France) .

French Polynesia, including the Society Islands [Bora-Bora, Moorea & Tahiti]; Marquesas Islands [Hiva Oa & Ua Huka]; and Austral Islands (Tubuai & Rurutu), France

See Health Information for Travelers to French Polynesia (France) .

• P. malariae , P. ovale , and P. vivax  (less commonly)

See Health Information for Travelers to Gabon .

Gambia, The

See Health Information for Travelers to The Gambia .

See Health Information for Travelers to Georgia .

See Health Information for Travelers to Germany .

• P. malariae,   P. ovale, and   P. vivax (less commonly)

See Health Information for Travelers to Ghana .

Gibraltar (U.K.)

See Health Information for Travelers to Gibraltar (U.K.) .

• Rare, local transmission in agricultural areas, associated with imported malaria (May–November)
• No malaria transmission in tourist areas
• Not applicable
• P. vivax  (100%)

See Health Information for Travelers to Greece .

Greenland (Denmark)

See Health Information for Travelers to Greenland (Denmark) .

See Health Information for Travelers to Grenada .

Guadeloupe (including Marie-Galante, La Désirade & Îles des Saintes)

See Health Information for Travelers to Guadeloupe .

Guam (U.S.)

See Health Information for Travelers to Guam (U.S.) .

• Primarily in the departments of Alta Verapaz, Escuintla, Izabal, Petén, and Suchitapéquez
• Few cases reported in other departments
• No malaria transmission in the cities of Antigua or Guatemala City (the capital)
• No malaria transmission at Lake Atitlán
• P. vivax (99%)
• P. falciparum  (1%)
• Departments of Alta Verapaz, Escuintla, Izabal, Petén, and Suchitapéquez: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine 5 , tafenoquine 3
• Other areas with reported malaria transmission: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Guatemala .

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission. 1 Required for all arriving travelers from all countries if traveler is ≥9 months of age and arriving at Ahmed Sékou Touré International Airport in Conakry.

See Health Information for Travelers to Guinea .

Guinea-Bissau

See Health Information for Travelers to Guinea-Bissau .

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission; this includes >4-hour airport transits or layovers in countries with risk for YF virus transmission. 1

• Rare cases in the cities of Georgetown (the capital) and New Amsterdam
• All areas (except the cities of Georgetown and New Amsterdam): Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• Cities of Georgetown and Amsterdam: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Guyana .

• All (including Labadee, also known as Port Labadee)
• P. falciparum (99%)
• P. malariae  (rare)
• Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, tafenoquine 3

See Health Information for Travelers to Haiti .

Entry requirements : Required for travelers 1-60 years old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1

• Throughout the country and on the island of Roat á n and other Bay Islands
• No malaria transmission in the cities of San Pedro Sula or Tegucigalpa (the capital)
• P. vivax (93%)
• P. falciparum  (7%)
• Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, tafenoquine 3

See Health Information for Travelers to Honduras .

Hong Kong Special Administrative Region, China

See Health Information for Travelers to Hong Kong SAR (China) .

See Health Information for Travelers to Hungary .

See Health Information for Travelers to Iceland .

• Arrive within 6 days of leaving an area with risk for YF virus transmission, or
• Have been in such an area in transit (exception: passengers and members of flight crews who, while in transit through an airport in an area with risk for YF virus transmission, remained in the airport during their entire stay and the health officer agrees to such an exemption), or
• Arrive on a ship that started from or touched at any port in an area with risk for YF virus transmission ≤30 days before its arrival in India, unless such a ship has been disinsected in accordance with the procedure recommended by the World Health Organization (WHO), or
• Arrive on an aircraft that has been in an area with risk for YF virus transmission and has not been disinsected in accordance with the Indian Aircraft Public Health Rules, 1954, or as recommended by WHO.
• Africa: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Sudan, Sudan, Togo, Uganda
• Americas: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad & Tobago (Trinidad only), Venezuela
• Throughout the country, including the cities of Bombay (Mumbai) and New Delhi (the capital)
• No malaria transmission in areas >2,000 m (≈6,500 ft) elevation in Himachal Pradesh, Jammu and Kashmir, or Sikkim
• P. vivax (50%)
• P. falciparum (>40%)

See Health Information for Travelers to India .

• All areas of eastern Indonesia (the provinces of Maluku, North Maluku, East Nusa Tenggara, Papua, and West Papua), including the town of Labuan Bajo and the Komodo Islands in the Nusa Tenggara region
• Rural areas of Kalimantan (Borneo), West Nusa Tenggara (includes the island of Lombok), Sulawesi, and Sumatra
• Low transmission in rural areas of Java, including Pangandaran, Sukabumi, and Ujung Kulon
• No malaria transmission in the cities of Jakarta (the capital) or Ubud
• No malaria transmission in the resort areas of Bali or Java, the Gili Islands, or the Thousand Islands (Pulau Seribu)
• Chloroquine ( P. falciparum and P. vivax )
• P. falciparum (60%)
• P. vivax (40%)

See Health Information for Travelers to Indonesia .

• Previously, March-November in rural areas of Fars Province, Sistan-Baluchestan Province, and southern, tropical parts of Hormozgan and Kerman Provinces.
• Recent outbreaks in Sistan-Baluchestan Province near the border with Pakistan.
• Previously, P. vivax (93%)
• Previously, P. falciparum  (7%)
• Sistan-Baluchestan Province along the border with Pakistan: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 2
• All other areas with previous transmission: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Iran .

See Health Information for Travelers to Iraq .

See Health Information for Travelers to Ireland .

See Health Information for Travelers to Israel, including the West Bank and Gaza .

Italy (including Holy See [Vatican City])

See Health Information for Travelers to Italy .

See Health Information for Travelers to Jamaica .

See Health Information for Travelers to Japan .

See Health Information for Travelers to Jordan .

Entry requirements : Required for travelers arriving from countries with risk for YF virus transmission; this includes airport transits or layovers in countries with risk for YF virus transmission. 1

See Health Information for Travelers to Kazakhstan .

CDC recommendations : Recommended for all travelers ≥9 months old except as follows. Generally not recommended for travel limited to: the city of Nairobi (the capital); the counties of the former North Eastern Province (Mandera, Wajir, and Garissa); or the counties (except Taita-Taveta) of the former Coast Province (Kilifi, including the city of Malindi; Kwale; Lamu; Mombasa, including the city of Mombasa; Tana River) .

• All areas (including game parks) <2,500 m (≈8,200 ft) elevation, including the city of Nairobi (the capital)
• Map 2-08 Yellow fever vaccine recommendations for Kenya & neighboring countries
• Map 2-09 Malaria prevention in Kenya

See Health Information for Travelers to Kenya .

Kiribati (formerly Gilbert Islands), includes Tarawa, Tabuaeran (Fanning Island), and Banaba (Ocean Island)

See Health Information for Travelers to Kiribati .

See Health Information for Travelers to Kosovo .

See Health Information for Travelers to Kuwait .

See Health Information for Travelers to Kyrgyzstan .

• All, except in Vientiane (the capital) where there is no transmission
• P. vivax (55%)
• P. falciparum (45%)
• P. knowlesi 6 , P. malariae, and P. ovale (rare)
• Areas bordering Burma (the provinces of Bokeo and Luang Namtha), Cambodia; Thailand (the provinces of Champasak and Salavan); and Vietnam: Atovaquone-proguanil, doxycycline, tafenoquine 3
• All other areas with malaria transmission: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3

See Health Information for Travelers to Laos .

See Health Information for Travelers to Latvia .

See Health Information for Travelers to Lebanon .

See Health Information for Travelers to Lesotho .

See Health Information for Travelers to Liberia .

See Health Information for Travelers to Libya .

Liechtenstein

See Health Information for Travelers to Liechtenstein .

See Health Information for Travelers to Lithuania .

See Health Information for Travelers to Luxembourg .

Macau Special Administrative Region, China

See Health Information for Travelers to Macau SAR (China) .

• All; except in Antananarivo (the capital) where malaria transmission is rare
• P. ovale and P. vivax (less commonly)
• All areas (except the city of Antananarivo): Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• Antananarivo: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

See Health Information for Travelers to Madagascar .

Madeira Islands (Portugal)

See Health Information for Travelers to Madeira Islands (Portugal) .

See Health Information for Travelers to Malawi .

• No indigenous cases of human malaria since 2017
• Zoonotic transmission of simian malaria occurs in rural, forested areas
• No malaria transmission in other areas, including Kuala Lumpur (the capital), in Penang State, on Penang Island, or in George Town (capital of Penang State)
• P. knowlesi 6 (primarily)
• Previously, P. falciparum , P. malariae , P. ovale , and P. vivax
• In rural, forested areas: atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3

See Health Information for Travelers to Malaysia .

See Health Information for Travelers to Maldives .

See Health Information for Travelers to Mali .

See Health Information for Travelers to Malta .

Marshall Islands

See Health Information for Travelers to Marshall Islands .

See Health Information for Travelers to Martinique (France) .

• All; except in the regions of Dakhlet Nouadhibou and Tiris Zemmour where there is no transmission

See Health Information for Travelers to Mauritania .

See Health Information for Travelers to Mauritius .

Mayotte (France)

See Health Information for Travelers to Mayotte (France) .

• Chiapas and southern part of Chihuahua state
• Rare in the states of Campeche, Durango, Nayarit, Quintana Roo, Sinaloa, Sonora, and Tabasco
• No malaria transmission along the U.S.–Mexico border
• Chiapas and southern part of Chihuahua state: Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine 5 , tafenoquine 3
• All other areas with malaria transmission: No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

Map 2-10 Malaria prevention in Mexico

See Health Information for Travelers to Mexico .

Micronesia, Federated States of (including Chuuk, Kosrae, Pohnpei & Yap)

See Health Information for Travelers to Micronesia, Federated States of .

See Health Information for Travelers to Moldova .

See Health Information for Travelers to Monaco .

See Health Information for Travelers to Mongolia .

See Health Information for Travelers to Montenegro .

Montserrat, United Kingdom

See Health Information for Travelers to Montserrat (U.K.) .

See Health Information for Travelers to Morocco .

See Health Information for Travelers to Mozambique .

• In the regions of Kavango (East and West), Kunene, Ohangwena, Omaheke, Omusati, Oshana, Oshikoto, Otjozondjupa, and Zambezi
• Rare in other parts of the country
• No malaria transmission in Windhoek (the capital)
• Kavango (East and West), Kunene, Ohangwena, Omaheke, Omusati, Oshana, Oshikoto, Otjozondjupa, and Zambezi: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3

See Health Information for Travelers to Namibia .

See Health Information for Travelers to Nauru .

• Throughout the country in areas <2,000 m (≈6,500 ft) elevation
• No malaria transmission in Kathmandu (the capital) or on typical Himalayan treks
• P. falciparum (<10%)

See Health Information for Travelers to Nepal .

Netherlands

See Health Information for Travelers to The Netherlands .

Netherlands Antilles (Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten)

Entry requirements : See Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten for yellow fever information.

• See Bonaire, Curaçao, Saba, St. Eustasius, and St. Maarten for malaria information.

New Caledonia (France)

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1 In the event of an epidemic threat to the territory, a specific vaccination certificate may be required.

See Health Information for Travelers to New Caledonia (France) .

New Zealand

See Health Information for Travelers to New Zealand .

• Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS)
• Rare cases in the departments of Boaco, Chinandega, Estelí, Jinotega, León, Matagalpa, and Nueva Segovia
• No malaria transmission in Managua (the capital)
• P. falciparum  (20%)
• Región Autónoma Atlántico Norte (RAAN) and Región Autónoma Atlántico Sur (RAAS): Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, tafenoquine 3

See Health Information for Travelers to Nicaragua .

See Health Information for Travelers to Niger .

CDC recommendations : Recommended for all travelers ≥9 months old.  

See Health Information for Travelers to Nigeria .

Niue (New Zealand)

See Health Information for Travelers to Niue (New Zealand) .

Norfolk Island (Australia)

See Health Information for Travelers to Norfolk Island (Australia) .

North Korea

• Southern provinces
• P. vivax (100%)
• Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine 5 , tafenoquine 3

See Health Information for Travelers to North Korea .

North Macedonia

See Health Information for Travelers to North Macedonia .

Northern Mariana Islands (U.S.), includes Saipan, Tinian, and Rota Island

See Health Information for Travelers to Northern Mariana Islands (U.S.) .

See Health Information for Travelers to Norway .

Entry requirements : Required for travelers ≥9 months old arriving from countries with risk for YF virus transmission, with the addition of Rwanda and Tanzania; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1

• Rare sporadic transmission after importation only
• Previously, P. falciparum and P. vivax

See Health Information for Travelers to Oman .

• All areas (including all cities) <2,500 m (≈8,200 ft) elevation

See Health Information for Travelers to Pakistan .

See Health Information for Travelers to Palau .

CDC recommendations : Recommended for travelers ≥9 months old going to all mainland areas east of the Canal Zone including Darién Province, the indigenous provinces (comarcas indígena) of Emberá and Kuna Yala (also spelled Guna Yala), and areas of the provinces of Colón and Panamá, east of the Canal Zone. Not recommended for travel limited to the Canal Zone; areas west of the Canal Zone; Panama City (the capital); Balboa district (Pearl Islands) of Panamá Province; or the San Blas Islands of Kuna Yala Province.

• The provinces of Bocas del Toro, Chiriquí, Colón, Darién, Panamá, and Veraguas
• The indigenous provinces (comarcas indígena) of Emberá, Kuna Yala (also spelled Guna Yala) and Ngäbe-Buglé
• No malaria transmission in the province of Panamá Oeste, in the Canal Zone, or in Panama City (the capital)
• Chloroquine (east of the Panama Canal)
• P. vivax (97%)
• P. falciparum  (3%)
• Darién, Emberá, Kuna Yala, and eastern Panamá Provinces : Atovaquone-proguanil, doxycycline, mefloquine, primaquine 5 , tafenoquine 3
• Bocas del Toro, Chiriquí, Colón, Veraguas, and Ngäbe-Buglé Provinces : Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine 5 , tafenoquine 3
• Map 2-11 Yellow fever vaccine recommendations for Panama & neighboring countries
• Map 2-12 Malaria prevention in Panama

See Health Information for Travelers to Panama .

Papua New Guinea

• Chloroquine (both P. falciparum and P. vivax )
• P. falciparum (75%)
• P. vivax (25%)

See Health Information for Travelers to Papua New Guinea .

Entry requirements : Required for travelers ≥1 year old arriving from Bolivia, Brazil, Peru, or Venezuela; this includes this includes >24-hour transits or layovers in those countries 1

CDC recommendations : Recommended for all travelers ≥9 months old except as follows. Generally not recommended for travel limited to the city of Asunción (the capital).

See Health Information for Travelers to Paraguay .

CDC recommendations : Recommended for travelers ≥9 months old going to areas <2,300 m (≈7,550 ft) elevation in the regions of Amazonas, Cusco, Huánuco, Junín, Loreto, Madre de Dios, Pasco, Puno, San Martín, and Ucayali, and designated areas of Ancash (far northeast), Apurímac (far north), Ayacucho (north and northeast), Cajamarca (north and east), Huancavelica (far north), La Libertad (east), and Piura (east). Generally not recommended for travel limited to the following areas west of the Andes: the regions of Lambayeque and Tumbes, and designated areas of Cajamarca (west-central), and Piura (west). Not recommended for travel limited to areas >2,300 m (≈7,550 ft) elevation, areas west of the Andes not listed above, the city of Lima (the capital), and the highland tourist areas (the city of Cusco, the Inca Trail, and Machu Picchu).

• All areas of the country <2,500 m (≈8,200 ft) elevation, including the cities of Iquitos and Puerto Maldonado, and only the remote eastern areas in the regions of La Libertad and Lambayeque
• No malaria transmission in the following areas: Lima Province; the cities of Arequipa, Ica, Moquegua, Nazca, Puno, or Tacna; the highland tourist areas (the city of Cusco, Machu Picchu, Lake Titicaca); along the Pacific Coast
• Map 2-13 Yellow fever vaccine recommendations for Peru & neighboring countries
• Map 2-14 Malaria prevention in Peru

See Health Information for Travelers to Peru .

Philippines

• Palawan and Mindanao Islands
• No malaria transmission in metropolitan Manila (the capital) or other urban areas
• P. falciparum (85%)
• P. vivax (15%)

See Health Information for Travelers to Philippines .

Pitcairn Islands (U.K.)

See Health Information for Travelers to Pitcairn Islands (U.K.) .

See Health Information for Travelers to Poland .

See Health Information for Travelers to Portugal .

Puerto Rico (U.S.)

See Health Information for Travelers to Puerto Rico (U.S.) .

See Health Information for Travelers to Qatar .

Réunion (France)

See Health Information for Travelers to Réunion (France) .

See Health Information for Travelers to Romania .

See Health Information for Travelers to Russia .

CDC recommendations : Generally not recommended for travel to Rwanda.

See Health Information for Travelers to Rwanda .

Saba, Netherlands

See Health Information for Travelers to Saba .

Saint Barthelemy, France

Saint helena, united kingdom.

Entry requirements : Required for travelers ≥1 year old arriving from countries with risk for YF virus transmission. 1 *For YF vaccine entry requirements and recommendations and malaria prevention information for Ascension Island and Tristan da Cunha archipelago, see: UNITED KINGDOM (including CHANNEL ISLANDS, ISLE OF MAN, ASCENSION ISLAND & TRISTAN DA CUNHA ARCHIPELAGO)

See Health Information for Travelers to Saint Helena (U.K.) .

Saint Kitts (Saint Christopher) & Nevis

See Health Information for Travelers to Saint Kitts and Nevis .

Saint Lucia

See Health Information for Travelers to Saint Lucia .

Saint Martin, France

Saint pierre and miquelon (france).

See Health Information for Travelers to Saint Pierre and Miquelon (France) .

Saint Vincent and the Grenadines

See Health Information for Travelers to Saint Vincent and the Grenadines .

Samoa (formerly Western Somoa)

See Health Information for Travelers to Samoa (formerly Western Samoa) .

See Health Information for Travelers to San Marino .

São Tomé and Príncipe

CDC recommendations : Generally not recommended for travel to São Tomé and Príncipe.

See Health Information for Travelers to São Tomé and Príncipe.

Saudi Arabia

• Asir and Jazan (also spelled Jizan) Regions near the Yemen border only
• No malaria transmission in the cities of Jeddah, Mecca, Medina, Riyadh (the capital), or Ta’if
• P. vivax (rare)

See Health Information for Travelers to Saudi Arabia .

See Health Information for Travelers to Senegal .

See Health Information for Travelers to Serbia .

See Health Information for Travelers to Seychelles .

Sierra Leone

Entry requirements : Required for all arriving travelers.

See Health Information for Travelers to Sierra Leone .

See Health Information for Travelers to Singapore .

Sint Eustatius, Netherlands

Entry requirements : Required for travelers ≥6 months old arriving from countries with risk for YF virus transmission. 1

See Health Information for Travelers to Sint Eustatius .

Sint Maarten, Netherlands

See Health Information for Travelers to Sint Maarten .

See Health Information for Travelers to Slovakia .

See Health Information for Travelers to Slovenia .

Solomon Islands

• P. vivax (70%)
• P. falciparum (30%)
• P. ovale (<1%)

See Health Information for Travelers to Solomon Islands .

CDC recommendations : Generally not recommended for travel to the regions of Bakool, Banaadir, Bay, Galguduud, Gedo, Hiiraan (also spelled Hiran), Lower Juba (also known as Jubbada Hoose), Middle Juba (also known as Jubbada Dhexe), Lower Shabelle (also known as Shabeellaha Hoose), or Middle Shabelle (also known as Shabeellaha Dhexe). Not recommended for travel to areas not listed above.

• P. vivax (5–10%)

See Health Information for Travelers to Somalia .

South Africa

• Along the border with Mozambique and Zimbabwe
• KwaZulu-Natal Province: uMkhanyakude District; the districts of King Cetshwayo and Zululand (few cases) Limpopo Province: the districts of Mopani and Vhembe; the districts of Capricorn, Greater Sekhukhune, and Waterberg (few cases)
• Mpumalanga Province: Ehlanzeni District
• Kruger National Park
• KwaZulu-Natal Province (uMkhanyakude District); Limpopo Province (the districts of Mopani and Vhembe); Mpumalanga Province (Ehlanzeni District); and Kruger National Park: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• All other areas with malaria transmission (including the districts of King Cetshwayo and Zululand in KwaZulu-Natal Province, and the districts of Capricorn, Greater Sekhukhune, and Waterberg in Limpopo Province): No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

Map 2-15 Malaria prevention in South Africa

See Health Information for Travelers to South Africa .

South Georgia & the South Sandwich Islands, UK Overseas Territory (also claimed by Argentina)

Entry requirements : South Georgia & the South Sandwich Islands has not stated its YF vaccination certificate requirements.

See Health Information for Travelers to South Georgia and the South Sandwich Islands (U.K.) .

South Korea

Entry requirements : Required if traveling from a country with risk of YF virus transmission and ≥1 year of age. 1

• Limited to the months of March– December in rural areas in the northern parts of the provinces of Inch’ŏn (also spelled Incheon), Kangwŏn (also spelled Gangwon), and Kyŏnggi (also spelled Gyeonggi), including the demilitarized zone (DMZ)
• Atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine 5 , or tafenoquine 3

See Health Information for Travelers to South Korea .

South Sudan

See Health Information for Travelers to South Sudan .

See Health Information for Travelers to Spain .

See Health Information for Travelers to Sri Lanka .

CDC recommendations : Recommended for travelers ≥9 months old going to areas south of the Sahara Desert. Not recommended for travel limited to areas in the Sahara Desert or the city of Khartoum (the capital).

See Health Information for Travelers to Sudan .

• Primarily in Sipaliwini District, near the border with French Guiana
• Limited transmission in Brokopondo, Marowijne, and Para (near the border with French Guiana)
• No malaria transmission in the districts along the Atlantic Coast or in Paramaribo (the capital)
• Sipaliwini District near the border with French Guiana: Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• All other areas with malaria transmission: No chemoprophylaxis recommended (insect bite precautions / mosquito avoidance only) 4

See Health Information for Travelers to Suriname .

See Health Information for Travelers to Sweden .

Switzerland

See Health Information for Travelers to Switzerland .

See Health Information for Travelers to Syria .

See Health Information for Travelers to Taiwan .

• No indigenous cases reported since 2014
• Previously, P. vivax (90%)
• Previously, P. falciparum  (10%)

See Health Information for Travelers to Tajikistan .

CDC recommendations : Generally not recommended for travel to Tanzania.

• All areas below 1,800 m (≈5,900 ft) elevation
• P. malariae and P. ovale (less commonly)

See Health Information for Travelers to Tanzania .

• Primarily the provinces that border Burma, Cambodia (few cases in Buri Ram Province), and Malaysia (few cases in Satun Province) Also, the provinces of Phitsanulok and Ubon Ratchathani (bordering Laos), and Surat Thani (especially in the rural forest and forest-fringe areas of these provinces)
• Rare to few cases in other parts of Thailand, including the cities of Bangkok (the capital), Chiang Mai, and Chiang Rai, or on the islands of Koh Pha Ngan, Koh Samui, or Phuket
• No malaria transmission on the islands of Krabi Province (Ko Lanta, Koh Phi, Koh Yao Noi, Koh Yao Yai) or in Pattaya City
• P. falciparum (<20%)
• Provinces that border Burma, Cambodia (except Buri Ram Province), and Malaysia (except Satun Province); the provinces of Phitsanulok, Ubon Ratchathani, and Surat Thani: Atovaquone-proguanil, doxycycline, tafenoquine 3
• All other areas with malaria transmission (including the provinces of Buri Ram and Satun): No chemoprophylaxis recommended (insect bite precautions and mosquito avoidance only) 4

Map 2-16 Malaria prevention in Thailand

See Health Information for Travelers to Thailand .

Timor-Leste

• Rare cases; outbreak in Indonesia border area in mid-2020
• Previously, P. falciparum (50%)
• Previously, P. vivax (50%)
• Previously, P. malariae  and  P. ovale  (each <1%)

See Health Information for Travelers to Timor-Leste (East Timor) .

See Health Information for Travelers to Togo .

Tokelau (New Zealand)

See Health Information for Travelers to Tokelau (New Zealand) .

See Health Information for Travelers to Tonga .

Trinidad and Tobago

CDC recommendations : Recommended for travelers ≥9 months old going to densely forested areas on Trinidad. Not recommended for cruise ship passengers, airplane passengers in transit, or travel limited to Tobago.

See Health Information for Travelers to Trinidad and Tobago .

See Health Information for Travelers to Tunisia .

See Health Information for Travelers to Turkey .

Turkmenistan

See Health Information for Travelers to Turkmenistan .

Turks and Caicos Islands (U.K.)

See Health Information for Travelers to Turks and Caicos Islands (U.K.) .

See Health Information for Travelers to Tuvalu .

See Health Information for Travelers to Uganda .

See Health Information for Travelers to Ukraine .

United Arab Emirates

See Health Information for Travelers to United Arab Emirates .

United Kingdom (including Channel Islands, Isle of Man, Ascension Island & Tristan Da Cunha Archipelago)

See Health Information for Travelers to United Kingdom .

United States of America

See Health Information for Travelers to United States .

See Health Information for Travelers to Uruguay .

See Health Information for Travelers to Uzbekistan .

• P. vivax (75%–90%)
• P. falciparum (10-25%)

See Health Information for Travelers to Vanuatu .

Entry requirements : Required for travelers ≥1 year old arriving from Brazil; this includes >12-hour airport transits or layovers in Brazil

CDC recommendations : Recommended for all travelers ≥9 months old except as follows. Generally not recommended for travel limited to the Distrito Capital or the states of Aragua, Carabobo, Miranda, Vargas, or Yaracuy. Not recommended for travel limited to areas >2,300m (≈7,550 ft) elevation in the states of Mérida, Táchira, or Trujillo; the states of Falcón or Lara; Margarita Island; or the cities of Caracas (the capital) or Valencia .

• All areas <1,700 m (≈5,600 ft) elevation and Angel Falls
• P. vivax (75%)
• P. falciparum  (25%)

Map 2-17 Yellow fever vaccine recommendations for Venezuela & neighboring countries

See Health Information for Travelers to Venezuela .

• Rural areas only. Rare cases in the Mekong and Red River Deltas
• None in the cities of Da Nang, Hai Phong, Hanoi, Ho Chi Minh City (Saigon), Nha Trang, and Quy Nhon.
• P. falciparum (65%)
• P. vivax (35%)
• Provinces of Bình Dương, Bình Phước, Đắk Lắk, Đắk Nông, Gia Lai, Khánh Hòa, Kon Tum, Lâm Đồng, Ninh Thuận, Tây Ninh: Atovaquone-proguanil, doxycycline, tafenoquine 3
• All other areas with malaria transmission (except Mekong and Red River Deltas): Atovaquone-proguanil, doxycycline, mefloquine, tafenoquine 3
• Mekong and Red River Deltas: No chemoprophylaxis recommended (insect bite precautions / mosquito avoidance only) 4

See Health Information for Travelers to Vietnam .

Virgin Islands, British

See Health Information for Travelers to Virgin Islands, British .

Virgin Islands, U.S.

See Health Information for Travelers to Virgin Islands, U.S. .

Wake Island, U.S.

See Health Information for Travelers to Wake Island .

• All areas <2,000 m (≈6,500 ft) elevation
• No malaria transmission in Sana’a (the capital)

See Health Information for Travelers to Yemen .

Entry requirements : Required for travelers ≥1 year of age arriving from countries with risk for YF virus transmission; this includes >12-hour airport transits or layovers in countries with risk for YF virus transmission. 1

CDC recommendations : Generally not recommended for travel to North-Western Province or Western Province. Not recommended for travel to any areas not listed above.

See Health Information for Travelers to Zambia .

See Health Information for Travelers to Zimbabwe .

1 Current as of November 2022. This is an update of the 2010 map created by the Informal WHO Working Group on the Geographic Risk of Yellow Fever.

2 Refers to Plasmodium falciparum malaria, unless otherwise noted.

3 Tafenoquine can cause potentially life-threatening hemolysis in people with glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Rule out G6PD deficiency with a quantitative laboratory test before prescribing tafenoquine to patients.

4 Mosquito avoidance includes applying topical mosquito repellant, sleeping under an insecticide-treated mosquito net, and wearing protective clothing (e.g., long pants and socks, long-sleeve shirt). For additional details on insect bite precautions, see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods.

5 Primaquine can cause potentially life-threatening hemolysis in people with G6PD deficiency. Rule out G6PD deficiency with a quantitative laboratory test before prescribing primaquine to patients.

6 P. knowlesi is a malaria species with a simian (macaque) host. Human cases have been reported from most countries in Southwest Asia and are associated with activities in forest or forest-fringe areas. P. knowlesi has no known resistance to antimalarials.

Yellow Fever Maps

2 In 2017, the Centers for Disease Control and Prevention (CDC) expanded its YF vaccination recommendations for travelers going to Brazil because of a large YF outbreak in multiple states in that country. Please refer to the CDC  Travelers’ Health website for more information and updated recommendations.

3 YF vaccination is generally not recommended for travel to areas where the potential for YF virus exposure is low. Vaccination might be considered, however, for a small subset of travelers going to these areas who are at increased risk for exposure to YF virus due to prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites. Factors to consider when deciding whether to vaccinate a traveler include destination-specific and travel-associated risks for YF virus infection; individual, underlying risk factors for having a serious YF vaccine–associated adverse event; and destination entry requirements.

The following authors contributed to the previous version of this chapter: Mark D. Gershman, Emily S. Jentes, Rhett J. Stoney (Yellow Fever) Kathrine R. Tan, Paul M. Arguin (Malaria)

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Travel | Travel: Here’s why the best way to see French…

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Travel | travel: here’s why the best way to see french polynesia is on a cruise ship.

Experience should tell well-traveled warm-weather wanderlusters that when offered this greeting at a tropical resort, it’s best to take it with a grain of sea salt. Too many times has this heat-seeking holiday maker been burned, not by the sun’s rays, but that seemingly hospitable phrase.

At the five-star GoldenEye resort in Jamaica, for one, “paradise” had me waking up in a bedsheet speckled with blood despite having the protection, or not, of a mosquito net and generous layer of insect repellant. Las Brisas Acapulco is a luxury property affectionally called “The Pink and White Paradise,” but the only color I saw was red due to loud service carts whizzing past our room at all hours of the night. A drive-by shooting across the street was the cherry on top during a visit that was far from utopian.

If I had a nickel — or other small-value coin of foreign currency — for every time a tropical destination failed to live up to the paradisical hype, that would be a tidy sum and fodder for a tell-all travel book. But since life is short and we need more positivity in this topsy-turvy world, let’s not dwell on places where slices of heaven are inadvertently mixed with bits of hell. We should instead focus our travel binoculars on a corner of the world that rarely disappoints.

We’re talking about French Polynesia in the center of the serene South Pacific. Made up of five archipelagoes and 118 islands, nearly half of them uninhabited, this pinch-me place is a popular setting for screensaver graphics and wall calendars. It literally is the model of what many of us picture as the quintessential tropical paradise.

Who doesn’t dream of cooling off with a fruity libation while lounging beside palm trees swaying in the breeze on a pristine white-sand beach? Here’s where that vision becomes reality, and the icing on the coconut cake are views of crystal-clear turquoise waters surrounded by lush, green mountains. Even sweeter, unlike many vacation destinations near the equator, French Polynesia gets the seal of approval — a Level 1 travel advisory — from the U.S. State Department for safety.

Air Tahiti Nui, American, Delta, French Bee, Hawaiian and United airlines all fly between Tahiti and Los Angeles or San Francisco, and it’s a minimum of eight hours in the air. Although not a short trip, or a cheap one with roundtrips costing north of a grand, the ROI is a French-accented dream vacation with a joie de vivre.

Blessed with unmatched beauty, unique culture, friendly people and an alluring sense of seclusion, French Polynesia is a favored nation for honeymooners, celebrants of milestone anniversaries and others with the urge to splurge somewhere sultry besides the likes of South Florida, Hawaii, Costa Rica and the Caribbean.

Staying at a resort is how 80% of visitors do French Polynesia, per the country’s tourism authority ( tahititourisme.com ), and many go big with lodging at one of those luxurious overwater bungalows synonymous with the destination. The pinnacle of posh is arguably The St. Regis Bora Bora Resort ( www.stregisborabora.com ), where from inside your high-class hut you can watch sea life though glass-bottom flooring, and outside jump into an aquamarine lagoon off your private platform with a perfect view of iconic Mount Otemanu.

Making a full-service, five-star resort your base for an entire vacation sounds like paradise, and the majority of visitors would seem to agree. But know that if you ever want to explore other islands to get a different taste of Tahitian-French culture, that, mon amie, can be a hassle. Because flights and ferry service are limited to certain islands and days of the week, even the most resourceful hotel concierge may try to talk guests out of this well-intentioned, yet impractical idea.

If catching “island fever” after spending a few days on one property is a possibility, then your best ticket to paradise could be a cruise. By ship is the easiest way to visit multiple islands in a sprawling destination that’s roughly the size of Europe. On a typical 7- to 10-day journey around the Society Islands, for example, ships make calls in Moorea, Taha’a, Raiatea, Huahine and, of course, Bora Bora, before returning to Tahiti. Paul Gauguin, Windstar and Silversea are offering the most roundtrips with this itinerary over the next year, give or take a port, and of special note are those that anchor overnight in Bora Bora.

One of the benefits of cruising is you go to many places and unpack only once. But when given the opportunity to abandon ship to spend a night in an overwater villa, fussing with luggage a second time is a pleasant inconvenience. On a recent weeklong “More Society Islands & Tahiti” voyage aboard the 332-passenger Paul Gauguin, at least two guests skipped out on their spacious veranda stateroom with butler in exchange for an “Overwater Deluxe Villa” at the St. Regis, the only Forbes five-star resort in Bora Bora. That coveted category starts at $1,530 a night. By comparison, the InterContinental Tahiti and Hilton Tahiti were reporting midweek availability in July with rates starting at $330 and $370, respectively, but with markedly less wow factor.

Selling points of the St. Regis include snorkeling safely in the stunning Lagoonarium stocked with more than 120 species of fish, adults-only nooks and crannies, a heavenly spa, themed dining events nearly every night at one of the six restaurants and bars (the luau-like Polynesian Evening on Wednesdays is a high-energy hoot), and among the recreational offerings is an assigned bicycle for every guest.

The good life continues back on the Paul Gauguin ( www.pgcruises.com ). With an excellent 1:1.5 crew-to-guest ratio, service on the Paul Gauguin is solid — quite possibly the most caring and friendly this sea-legged scribe has experienced. Several among the crew flaunted other talents at a delightfully entertaining crew show on the penultimate evening.

On other nights in the understatedly beautiful 314-seat Grand Salon, Polynesian culture is shared through song and dance by impressive local acts. Late-night entertainment is often a weak link on small ships, but not here; the Santa Rosa Band and pianist-singer Jerry Lomocso are two versatile acts out of the Philippines worthy of the extended contracts they just received.

Shipboard entertainment, a stern-side marina for watersports, and most organized activities are included in the cruise fare, which for a 7-day sail can be booked for as low as $5,000, double occupancy. What’s not included are treatments at the well-managed Algotherm Spa and shore excursions. That’s typical even for luxury-category cruising. Looking at a few tours, ATVing in Huahine costs $279 per machine (single or double), but the views along the route, road and off-road, are priceless; “Coral Garden Drift Snorkeling” ($120 in Raiatea, $125 in Taha’a) takes swimmers to one of the best spots in the world; and the “WaveRunner Adventure” in Moorea ($239 per machine, single or double) includes a pitstop at a motu for a thrilling ray encounter.

Adventures of the epicurean kind were mostly successful on the recent cruise; dishes starring steaks, shellfish, lamb and veggies were of the high caliber one would expect from French-based Ponant, which acquired the ship in 2019, and is known for outstanding cuisine. A tip of the chapeau to Cheese Night at L’Etoile restaurant, featuring a dazzling spread of 15 types of prized French fromage.

Like the food, pretty much everything about the Paul Gauguin goes down smoothly. Even the ship’s bones are specially designed for smooth navigation in Polynesian waters, and at the risk of causing a nerd alert, here’s why: A 17-foot draft allows the ship to get in close to shallow lagoons and isolated islands, maximizing stopover time.

As for parts of the ship we can actually see, recent refurbishments have the 27-year-old ship looking younger and more distinguished than when I sailed on it in 2018. If only the spa’s $210 “Deep Regenerating Sun Care” treatment could have done that for me.

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