From vaccines to testing: What travelers need to know before the new US travel system on Nov. 8

cdc required vaccines travel

  • The U.S. is launching a new travel system on Nov. 8.
  • Vaccinated foreign air travelers will need to show proof of full vaccination and test for COVID-19.
  • The new travel system also adds more stringent testing requirements for unvaccinated U.S. travelers.

The United States is about to make it much easier for vaccinated international travelers to visit.  

The White House announced that a new air travel system will take effect Nov. 8, allowing entry for fully vaccinated foreign tourists .  The system is set to launch nearly two years after the U.S. began imposing travel restrictions to prevent the spread of COVID-19 . 

The move by the White House will essentially have the U.S. drop its travel ban on dozens of countries while also making entry more challenging for the unvaccinated. The new system will allow entry for foreign nationals only with vaccinations approved for emergency use by the World Health Organization and would add testing requirements for unvaccinated Americans.

Here’s what we know about the new travel requirements:

What are the entry requirements for foreign nationals?

Starting Nov. 8, non-citizen, non-immigrant air travelers   will need to show proof of full vaccination as well as a pre-departure negative coronavirus test taken within three days of travel before they can board a plane to the U.S. 

Learn more: Best travel insurance

Acceptable forms of proof of vaccination include:

  • Digital or paper verifiable record, such as a vaccination certificate or a digital pass with a QR code.  
  • Nonverifiable paper record, such as a printout of a COVID-19 vaccination record or COVID-19 vaccination certificate.
  • Nonverifiable digital record, such as a digital photo of a vaccination card or record, downloaded vaccine record, downloaded vaccination certificate or a mobile phone application without a QR code.  

The U.S. will accept nucleic acid amplification tests, including PCR tests, and antigen tests. The rules will go into effect for passengers on planes leaving for the U.S. at or after 12:01 a.m. ET on Nov. 8.  

Airlines will collect basic personal contact information   from all U.S.-bound travelers for contact tracing. Airlines are required to keep the information on hand so the Centers for Disease Control and Prevention   can reach out to travelers who may have been infected or exposed to COVID-19.

Masking will be required, but there will be no quarantine mandate for vaccinated travelers or unvaccinated children .

► US  travel bans: How COVID-19 travel restrictions have impacted families and couples

The change will make entering the U.S. possible for travelers from countries now listed on the U.S. travel ban, which prohibits entry for travelers who have been in any of the regions within the past 14 days. The travel ban  took effect in early 2020 and includes :

  • United Kingdom
  • Republic of Ireland
  • South Africa
  • The European Schengen area (Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Monaco, San Marino and Vatican City)

Currently, the U.S. asks international air passengers only to get tested within three days of their flight to the U.S. and show either the negative test result or proof of recovery  from COVID-19 before boarding. 

What about the land borders with Mexico and Canada?

New travel rules will also take effect for foreign nationals arriving by land or passenger ferry.

Starting Nov. 8, fully vaccinated foreign nationals can cross the land borders for nonessential reasons such as tourism or visiting friends and family . These travelers will need to verbally attest to their reason for travel and vaccination status and be prepared to show proof of vaccination  upon request. U.S. Customs and Border Protection will accept both digital and paper records showing proof of vaccination, including documents not in English.   Foreign nationals will also need appropriate travel documentation to enter the country.  

CBP will spot-check travelers' vaccination documents, and those without documented proof of vaccination can be denied entry. Travelers under 18 will be exempt from the vaccination requirement as long as they are traveling with a fully vaccinated adult, according to Matthew Davies, CBP's executive director of admissibility and passenger programs.  

The new travel rules will go into effect as soon as a port of entry opens on Nov. 8, or at midnight for ports that operate 24 hours a day changes will go into effect at midnight on Nov. 8 for ports that operation 24 hours a day.  

U.S. citizens reentering the country should also bring a Western Hemisphere Travel Initiative document, such as a valid passport, trusted traveler program card, enhanced driver's license or enhanced tribal card. 

Entry rules along the border will change again in early January, with all travelers – including those traveling for essential purposes – required to show proof of full vaccination. 

► US land borders: Travelers in Mexico and Canada plan their next US visit after new land border policy announced

Which vaccines does the US accept for travel?

The CDC has announced that vaccines approved for emergency use by the U.S. Food and Drug Administration and World Health Organization will be accepted for air travel. White House officials expect the CDC to approve the same vaccines for travelers entering the U.S. by land or ferry.  

The FDA has authorized three COVID-19 vaccines for emergency use during the pandemic: Moderna, Johnson & Johnson and Pfizer-BioNTech, the last of which has received the FDA's full stamp of approval.

Vaccines with WHO approval for emergency use include:

  • Johnson & Johnson
  • Pfizer-BioNTech
  • Oxford-AstraZeneca/Covishield 

The CDC confirmed that it would accept a mix-and-match approach to vaccinations. Travelers who have any combination of FDA- or WHO-approved vaccines will be considered fully vaccinated.

The new travel policy does not accept foreign travelers who have had COVID and received just one shot in a two-dose series. White House press secretary Jen Psaki said Tuesday that the administration will "continue to review" its entry requirements.  

► Covaxin gets WHO emergency approval: Travelers vaccinated with Covaxin can enter US   

► 'You feel lonely and left out': These fully vaccinated travelers want to visit the US. They may not be allowed in.

How do the new rules affect kids? 

Foreign nationals under 18 are exempt from the vaccination requirement. Children under two will not need to take a pre-departure COVID test.

Kids 2 and older traveling with a fully vaccinated adult can test three days prior to departure, while children traveling alone or with unvaccinated adults will need to get tested within one day of departure. 

Currently, all air passengers 2 or older, including U.S. citizens and permanent residents, need to show a negative coronavirus test to fly to the U.S.

What are the entry requirements for Americans?

The new travel system adds more stringent testing requirements for unvaccinated U.S. travelers.

Starting Nov. 8, unvaccinated U.S. citizens and permanent residents will need to take a test one day before departure and test again upon arrival in the U.S. 

► New travel rules: What US travelers need to know about the new COVID rules for international flights

Entry requirements will not change for vaccinated Americans. They will still need to show proof of a negative coronavirus test taken no more than three days before departure. 

Americans will not need to be fully vaccinated to board international flights to the U.S.

Are there any exemptions?

There is a limited set of travelers who are exempt from the vaccine requirement for entry.

Children under 18, certain COVID-19 vaccine clinical trial participants and travelers with adverse reactions to the vaccines – such as people who have had severe anaphylactic allergic reactions to a prior COVID-19 vaccine –  will be exempt.

People traveling on non-tourist visas from countries with less than 10% of its population vaccinated who need to enter the U.S. for emergency or humanitarian reasons are also exempt from the vaccine requirement. There are about 50 countries considered to have low vaccine availability at this time.

These exempt travelers will generally need to show that they will comply with public health mandates, including a requirement to be vaccinated in the U.S. if they plan to stay more than 60 days.  

Unless they have recovered from COVID-19 within the last 90 days, unvaccinated travelers  must agree to be tested with a COVID-19 viral test three to five days after their arrival and quarantine for seven days, even if their post-arrival test comes back negative. 

Unvaccinated travelers who are not U.S. citizens or permanent residents must also agree to self-isolate if their post-arrival test is positive or if they develop COVID-19 symptoms. 

Unvaccinated children under 18 will not need to quarantine but will still need to take a post-arrival test. 

► Who is exempt?: These select groups of unvaccinated foreign travelers can enter the US

The CDC will not give exemptions  to people who object to the vaccinations due to religious or moral convictions. 

There will also be testing accommodations for travelers who can prove they recently recovered from the coronavirus. These travelers will need to show a positive COVID-19 viral test result on a sample taken no more than 90 days before their flight's departure and a letter from a licensed healthcare provider or public health official saying they are cleared for travel.  

Follow USA TODAY reporter Bailey Schulz on Twitter: @bailey_schulz . 

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Vaccines for Travelers

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

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

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

Which vaccines do I need before traveling?

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

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

How far in advance should I get vaccinated before traveling?

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

Where can I go to get travel vaccines?

Start by finding a:

  • Travel clinic
  • Health department
  • Yellow fever vaccination clinic

Learn more about where you can get vaccines .

What resources can I use to prepare for my trip?

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

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

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

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

Find out which vaccines you need

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

Take the quiz now !

Get Immunized

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

Find out how to get protected .

Update January 10, 2024

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The Administration will end the COVID-19 vaccine requirements for international air travelers at the end of the day on May 11, the same day that the COVID-19 public health emergency ends. This means starting May 12, noncitizen nonimmigrant air passengers will no longer need to show proof of being fully vaccinated with an accepted COVID-19 vaccine to board a flight to the United States. CDC’s Amended Order Implementing Presidential Proclamation on Safe Resumption of Global Travel During the COVID-19 Pandemic will no longer be in effect when the Presidential Proclamation Advancing the Safe Resumption of Global Travel During the COVID-19 Pandemic is revoked .

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

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

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

  • Starting on November 8, non-citizen, non-immigrant air travelers to the United States will be required to be fully vaccinated and to provide proof of vaccination status prior to boarding an airplane to fly to the U.S.

Proof of Vaccination:

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

Accepted Vaccines:

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

Enhanced Testing:

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

Requirements for Children:

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

Limited Exceptions from the Vaccination Requirement:

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

Contact Tracing:

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

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The novel coronavirus, first detected at the end of 2019, has caused a global pandemic.

Coronavirus Updates

Cdc says travel is safe for fully vaccinated people, but opposes nonessential trips.

Rachel Treisman

cdc required vaccines travel

The Centers for Disease Control and Prevention updated its domestic travel guidance for fully vaccinated people on Friday, lifting certain requirements while continuing to advise mitigation measures like mask-wearing and hand-washing. Angus Mordant/Bloomberg via Getty Images hide caption

The Centers for Disease Control and Prevention updated its domestic travel guidance for fully vaccinated people on Friday, lifting certain requirements while continuing to advise mitigation measures like mask-wearing and hand-washing.

The Centers for Disease Control and Prevention has updated its domestic travel guidance for fully vaccinated people, lifting certain testing and self-quarantine requirements and recommending precautions like wearing a mask and avoiding crowds. But health officials continue to discourage nonessential travel, citing a sustained rise in cases and hospitalizations.

The CDC updated its website on Friday to reflect the latest scientific evidence, writing that "people who are fully vaccinated with an FDA-authorized vaccine can travel safely within the United States."

The announcement comes less than a month after the CDC first released updated guidance about gatherings for fully vaccinated people, which it described as a "first step" toward returning to everyday activities.

Air Travel Is Opening Up Again, But That Doesn't Mean The Pandemic Is Over

The CDC considers someone fully vaccinated two weeks after they receive the last dose of vaccine. Those individuals will no longer need to get tested before or after travel unless their destination requires it, and do not need to self-quarantine upon return.

The new guidance means, for example, that fully vaccinated grandparents can fly to visit their healthy grandkids without getting a COVID-19 test or self-quarantining as long as they follow other recommended measures while traveling, according to CDC Director Rochelle Walensky.

Those measures include wearing a mask over their nose and mouth, staying 6 feet from others and washing their hands frequently. Masks are required on all planes traveling into, within or out of the U.S., under an executive order issued by President Biden.

But Walensky, speaking at a White House COVID-19 Response Team briefing on Friday, nonetheless discouraged all nonessential travel, citing a continued increase in the seven-day average of cases and hospitalizations.

"While we believe that fully vaccinated people can travel at low risk to themselves, CDC is not recommending travel at this time due to the rising number of cases," Walensky said.

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She said that while vaccinated people can do more things safely, most Americans are not yet fully vaccinated. Those who are not must have a negative test 1-3 days before they travel under CDC guidance. They must either get tested 3-5 days after they return and self-quarantine for 7 days, or self-quarantine for 10 days with no test.

Walensky said on Monday that there is more travel occurring now than throughout the pandemic, including the winter holidays. She acknowledged that people have been looking to get away over spring break or take advantage of what they perceive as a "relative paucity in cases," and she said the country was seeing an uptick in cases as a result.

"The thing that's different this time is that we actually have it in our power to be done with the scale of the vaccination," she said. "And that will be so much slower if we have another surge to deal with as well."

The U.S. is already seeing an uptick in domestic travel, and many Americans are looking to book trips in the coming months in what experts described to NPR as a sign of "clear pent up demand for travel."

As the country's supply of COVID-19 doses has grown, so has Biden's goal for the number of shots in arms during his first 100 days, doubling the target to 200 million by the end of this month. Many states have already expanded eligibility to all adults or are set to do so in the coming weeks, well ahead of the president's May 1 deadline.

According to NPR's vaccine tracker , 16.9% of the U.S. population is fully vaccinated, and 30% has had at least one dose. Researchers estimate that 70% to 85% of the country would need to have immunity for COVID-19 to stop spreading through communities.

International travel restrictions remain

The CDC is not lifting travel restrictions barring the entry of most non-U.S. citizens from places including China, Brazil, South Africa and parts of Europe. It will continue to require airline passengers entering the U.S. to get a test within three days of their departure and show proof of a negative result before boarding.

The travel industry has been pushing for some of these restrictions to end. A group of 26 organizations sent a letter to White House COVID-19 czar Jeffrey Zients urging the federal government "to partner with us to develop, by May 1, 2021, a risk-based, data-driven roadmap to rescind inbound international travel restrictions."

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"To be clear, at this time, we do not support removal or easing of core public health protections, such as the universal mask mandate, inbound international testing requirement, physical distancing or other measures that have made travel safer and reduced transmission of the virus," they wrote. "However, the data and science demonstrate that the right public health measures are now in place to effectively mitigate risk and allow for the safe removal of entry restrictions."

Travel and tourism have taken a considerable hit because of the pandemic with industry groups noting that overseas travel to the U.S. declined by 81% in 2020, causing billions of dollars in losses. Without lifting international travel bans, the U.S. Travel Association estimates that some 1.1 million American jobs will not be restored and billions in spending will be lost by the end of the year.

"Fortunately, enough progress has been made on the health front that a rebound for domestic leisure travel looks possible this year, but that alone won't get the job done," Roger Dow, the association's president and CEO, said in a statement . "A full travel recovery will depend on reopening international markets, and we must also contend with the challenge of reviving business travel."

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  • COVID-19 vaccine
  • Centers for Disease Control and Prevention

Which Vaccinations Are Required for Travel?

By Cassie Shortsleeve

Mountain hiking

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

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

Make sure you’re current with routine vaccines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Stanley Stewart

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

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

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

The bottom line

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

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COVID-19 international travel advisories

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

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

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

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

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

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

LAST UPDATED: December 6, 2023

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  • Section 7 - Traveling Safely with Infants & Children
  • Section 7 - International Adoption

Vaccine Recommendations for Infants & Children

Cdc yellow book 2024.

Author(s): Michelle Weinberg

Vaccinating children for travel requires careful evaluation. Whenever possible, children should complete routine childhood immunizations on a normal schedule. Travel at an earlier age, however, might require accelerated vaccine schedules. Not all travel-related vaccines are effective in infants, and some are specifically contraindicated.

See recommended childhood and adolescent immunization schedules . The Centers for Disease Control and Prevention (CDC) provides a catch-up schedule for children and adolescents who start a vaccination schedule late or who are >1 month behind. Tables also describe the recommended minimum intervals between doses for children who need to be vaccinated on an accelerated schedule, which could be necessary before international travel.

Country-specific vaccination recommendations and requirements for departure and entry vary over time. For example, proof of yellow fever vaccination is required for entry into certain countries. Meningococcal vaccination is required for travelers entering Saudi Arabia for Umrah or the annual Hajj pilgrimage. The World Health Organization (WHO) has issued temporary vaccination recommendations for residents of and long-term visitors to countries with active circulation of wild or vaccine-derived poliovirus. Some countries might require coronavirus disease 2019 (COVID-19) vaccine, testing, or both for entry. Check the CDC Travelers’ Health website for current requirements and recommendations.

Additional information about diseases and routine vaccination is available in the disease-specific chapters in Section 5. See tools for determining routine and catch-up childhood vaccination .

Modifying Immunization Schedules for Infants & Young Children Before International Travel

Several factors influence recommendations for the age at which a vaccine is administered, including age-specific risks for the disease and its complications, age-dependent ability to develop an adequate immune response to a vaccine, and potential interference with the immune response by passively transferred maternal antibodies.

Immunization schedules for infants and children in the United States do not provide guidance on modifications for people traveling internationally before the age when specific vaccines are routinely recommended. Age limits for vaccine administration are based on the risk for potential adverse events (e.g., yellow fever vaccine), lack of efficacy data or inadequate immune response (e.g., influenza vaccine, polysaccharide vaccines), maternal antibody interference and immaturity of the immune system (e.g., measles-mumps-rubella [MMR] vaccine), or lack of safety data.

To help parents decide when to travel with an infant or young child, advise them that the earliest opportunity to receive routinely recommended immunizations in the United States (except for doses of hepatitis B vaccine at birth and age 1 month) is when the baby is 6 weeks old. In general, live-virus vaccines (MMR, varicella, yellow fever) should be administered on the same day or spaced ≥28 days apart.

Routine Infant & Childhood Vaccines

Children should be vaccinated against diphtheria, Haemophilus influenzae type b (Hib), hepatitis A and hepatitis B virus, human papillomavirus, influenza, measles, mumps, Neisseria meningitidis , pertussis, polio, rotavirus, rubella, Streptococcus pneumoniae , tetanus, and varicella. To complete a vaccine series before travel, doses can be administered at the minimum ages and dose intervals. Inform parents that infants and children who have not received all recommended vaccine doses might not be fully protected. Rotavirus vaccine is unique among the routine vaccines given to infants in the United States because it has maximum ages for both the first and last doses; specifically consider the timing of travel so that the infant will be able to receive the complete vaccine series, if possible.

Coronavirus Disease 2019

The COVID-19 pandemic continues to evolve, and CDC’s vaccination recommendations are updated regularly. See the most current recommendations for children and teens . COVID-19 vaccines available for use in the United States can be administered simultaneously with all other vaccines.

Hepatitis A

Hepatitis A infection is usually mild or asymptomatic in infants and children <5 years old. Infected children can, however, transmit the infection to older children and adults, age groups at greater risk for severe disease. Ensure vaccination for all children traveling to areas with an intermediate or high risk for hepatitis A (see Sec. 5, Part 2, Ch. 7, Hepatitis A ). Routine hepatitis A vaccination for children aged ≥12 months consists of 2 doses, separated by ≥6 months. Ideally, the first dose should be administered ≥2 weeks before travel. When protection against hepatitis A is recommended, infants aged 6–11 months should receive 1 dose of hepatitis A vaccine before travel outside the United States.

Hepatitis A vaccine is considered safe and immunogenic in infants; doses administered before 12 months of age, however, can result in a suboptimal immune response, particularly in infants with passively acquired maternal antibody. Therefore, doses administered to infants <12 months old are not considered to provide long-term protection; initiate the 2-dose hepatitis A vaccine series at age 12 months according to the routine immunization schedule.

Hepatitis A Immune Globulin

When protection against hepatitis A is recommended, infants <6 months old should receive immune globulin (IG) before travel. One dose of 0.1 mL/kg intramuscularly provides protection for ≤1 month. Infants who do not receive vaccination who will be traveling for >1 month but ≤2 months should receive an IG dose of 0.2 mL/kg. If the traveler remains in a high-risk setting, IG (0.2 mL/kg) should be administered every 2 months until hepatitis A vaccine can be given at ≥6 months of age, if not contraindicated.

For optimal protection, children aged ≥1 year who are immunocompromised or who have chronic medical conditions, and who will be traveling to a high-risk area in <2 weeks, should receive the initial dose of hepatitis A vaccine and IG at separate anatomic injection sites.

Recommended Dosing Intervals for Coadministration of Live-Virus Vaccines

Hepatitis A IG is an antibody-containing product that does not interfere with the immune response to yellow fever vaccine but can inhibit the response to other injected live-virus vaccines (e.g., MMR, varicella) for up to 6 months after administration (see Sec. 2, Ch. 3, Vaccination & Immunoprophylaxis—General Principles ).

MMR vaccine is recommended for all infants aged 6–11 months traveling internationally. Because measles in infancy is a more severe disease than hepatitis A, administer hepatitis A vaccine and MMR vaccine simultaneously to infants aged 6–11 months to provide protection against hepatitis A and measles, but do not give hepatitis A IG.

If the interval between MMR or varicella vaccine administration and subsequent administration of an antibody-containing product is <14 days, repeat vaccination after the recommended interval unless serologic testing indicates a protective antibody response. For information about dosing intervals, see The Timing and Spacing of Immunobiologics, General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices, Table 3-4 ) and Table 3-5 .

Hepatitis B

For certain age groups, hepatitis B vaccine can be administered with an accelerated schedule of 4 doses of vaccine given at 0, 1, 2, and 12 months; the last dose can be given after the child returns from travel (see Sec. 5, Part 2, Ch. 8, Hepatitis B , for details).

Influenza viruses circulate predominantly in the winter months in temperate regions (typically November–April in the Northern Hemisphere and April–September in the Southern Hemisphere) but can occur year-round in tropical climates (see Sec. 5, Part 2, Ch. 12, Influenza ). Because influenza viruses can circulate any time of the year, travelers aged ≥6 months who were not vaccinated during the influenza season in their country of residence should be vaccinated ≥2 weeks before departure if vaccine is available.

Children aged 6 months–8 years who have never received influenza vaccine, or who have not previously received a lifetime total of ≥2 doses, should receive 2 doses separated by ≥4 weeks. See annually updated recommendations about seasonal influenza vaccination .

Measles-Mumps-Rubella or Measles-Mumps-Rubella-Varicella

Children traveling abroad need to be vaccinated against measles, mumps, and rubella at an age earlier than what is routinely recommended. Infants 6–11 months old should receive 1 MMR vaccine dose. Infants vaccinated before age 12 months must be revaccinated on or after their first birthday with 2 doses of MMR vaccine (separated by ≥28 days) or measles-mumps-rubella-varicella (MMRV) vaccine (separated ≥3 months). The minimum interval between any varicella-containing vaccine (MMRV or monovalent varicella) is 3 months.

MMRV vaccine is licensed for use in children aged 12 months–12 years and should not be given outside this age group. Recipients of a first dose of MMRV vaccine have a greater risk for febrile seizures compared with recipients of MMR and varicella vaccines administered concomitantly. Unless the caregiver expresses a preference for MMRV, CDC recommends administering separate MMR and varicella vaccine for the first dose of MMR and varicella vaccination for children 12–47 months.

Meningococcal

Quadrivalent conjugate.

Children aged 2 months–18 years who travel to or reside in areas of sub-Saharan Africa known as the meningitis belt during the dry season (December–June) should receive quadrivalent meningococcal conjugate (MenACWY) vaccine (see Sec. 5, Part 1, Ch. 13, Meningococcal Disease ). In addition, travelers are required to have meningococcal vaccination to enter Saudi Arabia when traveling to Mecca for Umrah or the annual Hajj pilgrimage. The CDC Travelers’ Health website provides annual health requirements and recommendations for US travelers going to Mecca for Umrah or Hajj (also see Sec. 10, Part 1, Ch. 2, Saudi Arabia: Hajj & Umrah Pilgrimages ).

The schedule for primary series meningococcal vaccine and booster doses varies depending on the vaccine administered.

Meningococcal B

Unless an outbreak of serogroup B disease has been reported, vaccination with a serogroup B meningococcal (MenB) vaccine is not routinely recommended for travel to the meningitis belt or other regions of the world. Although MenB vaccine is not licensed in the United States for children <10 years of age, some European countries recently introduced MenB vaccine as a routine immunization for infants. Some countries might have other meningococcal vaccines available. Consider meningococcal vaccination for infants residing in these countries according to the routine infant immunization recommendations of that country.

Polio vaccine is recommended for travelers going to countries with evidence of wild poliovirus (WPV) or vaccine-derived poliovirus circulating during the last 12 months, and for travelers with a high risk for exposure to someone with imported WPV infection when traveling to some countries that border areas with WPV circulation. Refer to the CDC Travelers’ Health website destination pages for current polio vaccine recommendations.

Ensure that travelers complete the recommended age-appropriate polio vaccine series and receive a single lifetime booster dose, if necessary. Infants and children should receive an accelerated schedule to complete the routine series. See Sec. 5, Part 2, Ch. 17, Poliomyelitis , and CDC’s Immunization Schedules website for information about accelerated schedules.

People ≥18 years of age traveling to areas where polio vaccine is recommended and who have received a routine series with either inactivated polio vaccine (IPV) or live oral polio vaccine in childhood should receive a single lifetime booster dose of IPV before departure. Available data do not indicate the need for more than a single lifetime booster dose with IPV. Requirements for long-term travelers might apply, however, when departing from certain countries.

Long-Term Travelers to Countries With Poliovirus Transmission

In May 2014, the World Health Organization (WHO) declared the international spread of polio to be a Public Health Emergency of International Concern under the authority of the International Health Regulations (2005). To prevent further spread of disease, WHO issued temporary polio vaccine recommendations for long-term travelers (staying >4 weeks) and residents departing from countries with WPV transmission (“exporting WPV” or “infected with WPV”) or with circulating vaccine-derived polioviruses types 1 or 3.

Long-term travelers and residents could be required to show proof of polio vaccination when departing from these countries for any destination. All polio vaccination administration should be documented on an International Certificate of Vaccination or Prophylaxis (ICVP). See ordering information and instructions on how to fill out the ICVP . The polio vaccine must be received 4 weeks–12 months before the date of departure from the polio-infected country.

Country requirements can change, so clinicians should check for updates on the CDC Travelers’ Health website.

Travel Vaccines for Infants & Children

Dengue can cause mild to severe illness (see Sec. 5, Part 2, Ch. 4, Dengue ). Although many people have asymptomatic infections, for some children dengue can be life-threatening. Travelers should adhere to mosquito protection measures during travel to dengue-endemic areas (see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods ).

In June 2021, the Advisory Committee on Immunization Practices (ACIP) recommended the use of a live attenuated dengue virus vaccine, Dengvaxia (Sanofi Pasteur), to prevent disease in children aged 9–16 years. Children eligible to receive the vaccine include those with laboratory-confirmed previous dengue virus infection who live in areas of the United States, including the US territories of American Samoa, Puerto Rico, and the US Virgin Islands; and freely associated states, the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau. Dengvaxia is not approved for use in US travelers who are visiting but who do not live in areas where dengue is endemic.

Only people who test positive for previous dengue infection or who have other laboratory-confirmed evidence of a previous dengue infection are eligible for vaccination with Dengvaxia. In people without previous dengue infection, Dengvaxia can increase the risk for severe illness and hospitalization if the person gets infected after vaccination. Serodiagnostic tests recommended by health authorities with acceptable performance (≥75% sensitivity, ≥98% specificity) are available to test for evidence of previous dengue infection.

The vaccine is a series of 3 doses, administered 6 months apart at month 0, 6, and 12 months.

Japanese Encephalitis

Japanese encephalitis (JE) virus is transmitted by mosquitoes and is endemic throughout most of Asia and parts of the western Pacific. JE risk can be seasonal in temperate climates and year-round in more tropical climates. Risk to short-term travelers and those who confine their travel to urban centers is considered low. JE vaccine is recommended for travelers who plan to spend ≥1 month in endemic areas during JE virus transmission season. Consider JE vaccine for short-term (<1 month) travelers whose itinerary or activities could increase their risk for JE virus exposure. The decision to vaccinate a child should follow the more detailed recommendations found in Sec. 5, Part 2, Ch. 13, Japanese Encephalitis .

An inactivated Vero cell culture–derived JE vaccine (IXIARO) was licensed by the US Food and Drug Administration (FDA) in 2009 for use in the United States for travelers aged ≥17 years. In 2013, the recommendations were expanded, and the vaccine was licensed for use in children ≥2 months of age. For children aged 2 months–17 years, the primary series consists of 2 intramuscular doses administered 28 days apart. For travelers who received their primary JE vaccine series ≥1 year prior to potential JE virus exposure, ACIP recommends providing a booster dose before departure. See information on age-appropriate dosing .

Rabies virus causes an acute viral encephalitis that is virtually 100% fatal. Traveling children can be at increased risk for rabies exposure, mainly from dogs that roam the streets in low- and middle- income countries. Bat bites carry a potential risk for rabies throughout the world. In addition to taking measures to avoid animal bites and scratches (see Sec. 4, Ch. 7, Zoonotic Exposures: Bites, Stings, Scratches & Other Hazards ), preexposure and postexposure rabies prophylaxis is part of a broader approach to preventing this disease. Follow the recommendations in Sec. 5, Part 2, Ch. 18, Rabies , when making decisions about whether to provide rabies preexposure prophylaxis for children.

Preexposure Prophylaxis

In June 2021, to align with the recently revised adult schedule, ACIP adjusted the number of recommended doses of rabies preexposure prophylaxis in children downward, from 3 to 2. For immunocompetent children <18 years old, administer the first dose of vaccine on day 0 and a second dose 7 days later (see Sec. 5, Part 2, Ch. 19, . . . perspectives: Rabies Immunization ).

The advantages of the revised schedule are that it is both less expensive and easier to complete prior to travel. There are, however, no data on the duration of protection afforded by this 2-dose series. Because of this uncertainty, travelers with a sustained risk for rabies exposure should either have a titer drawn or receive a third dose of vaccine within 3 years of the initial series. Travelers unlikely to visit an at-risk destination after 3 years require no further titers or boosters unless they have a subsequent exposure.

Postexposure Prophylaxis

Children who have not received preexposure immunization and who might have been exposed to rabies require a weight-based dose of human rabies immune globulin (RIG) and a series of 4 rabies vaccine doses on days 0, 3, 7, and 14. Decisions about any changes in how to manage postexposure prophylaxis, schedule deviations for pre- or postexposure prophylaxis, and postexposure prophylaxis initiated abroad are expected from the ACIP.

Tick-Borne Encephalitis

Tick-borne encephalitis (TBE) is a viral disease transmitted by Ixodes ticks in parts of Asia and Europe. Rare in US travelers, TBE is usually asymptomatic but can appear as a biphasic illness with central nervous system involvement (see Sec. 5, Part 2, Ch. 23, Tick-Borne Encephalitis ). Although TBE infection tends to be less severe in children, residual symptoms and neurologic deficits have been described.

Most infections result from the bite of infected tick, typically acquired when a person is bicycling, camping, hiking, or participating in other outdoor activities in brushy or forested areas. TBE also can be acquired by ingesting unpasteurized dairy products from infected animals, or, rarely, from direct person-to-person spread via blood transfusion, solid organ transplantation, or breastfeeding.

In August 2021, the FDA approved a TBE vaccine for people aged ≥1 year ; in February 2022, ACIP approved recommendations for vaccine use among people traveling or moving to a TBE-endemic area who will have extensive tick exposure based on planned outdoor activities and itinerary. Primary vaccination consists of 3 doses; the schedule varies by age. For children 1–15 years old, give the second dose 1–3 months after the first dose; for children aged ≥16 years, give the second dose 14 days–3 months after the first dose. All children should receive the third dose 5–12 months after receiving their second dose of the vaccine. A booster (fourth) dose can be given ≥3 years after completion of the primary immunization series if ongoing exposure or reexposure is expected.

Typhoid fever is caused by the bacterium Salmonella enterica serotype Typhi (see Sec. 5, Part 1, Ch. 24, Typhoid & Paratyphoid Fever ). Travelers can avoid typhoid fever by following safe food and water precautions and frequently washing hands. Typhoid vaccine is recommended for travelers going to areas with a recognized risk for Salmonella Typhi exposure.

Two typhoid vaccines are licensed for use in the United States: Vi capsular polysaccharide vaccine (ViCPS) administered intramuscularly, and oral live attenuated vaccine (Ty21a). Both vaccines induce a protective response in 50%–80% of recipients. The ViCPS vaccine can be administered to children aged ≥2 years, who should receive a booster dose 2 years later if continued protection is needed. The Ty21a vaccine consists of a series of 4 capsules (1 taken orally every other day), which can be administered to children aged ≥6 years. Do not open capsules for administration; capsules must be swallowed whole. All 4 doses should be taken ≥1 week before potential exposure. A booster series for Ty21a should be taken every 5 years, if indicated.

Yellow Fever

Yellow fever, a disease transmitted by mosquitoes, is endemic to certain areas of Africa and South America (see Sec. 5, Part 2, Ch. 26, Yellow Fever ). Proof of vaccination against yellow fever is required for entry into some countries (see Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country ). Infants and children ≥9 months old and without contraindications should be vaccinated before traveling to countries where yellow fever is endemic.

Infants aged <9 months are at greater risk for developing encephalitis from yellow fever vaccine, which is a live-virus vaccine. Studies conducted during the early 1950s identified 4 cases of encephalitis out of 1,000 children aged <6 months who received yellow fever vaccine. An additional 10 cases of encephalitis associated with yellow fever vaccine administered to infants aged <4 months were reported worldwide during the 1950s.

Advise travelers with infants aged <9 months against traveling to areas where yellow fever is endemic. ACIP advises against administering yellow fever vaccine to infants aged <6 months. Infants aged 6–8 months should be vaccinated only if they must travel to areas of ongoing epidemic yellow fever, and if a high level of protection against mosquito bites is not possible. Clinicians considering vaccinating infants aged 6–8 months can consult their respective state health departments or CDC toll-free at 800-CDC-INFO (800-232-4636).

The following authors contributed to the previous version of this chapter: Michelle S. Weinberg

Bibliography

Centers for Disease Control and Prevention. Japanese encephalitis vaccine: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2019;68(2):1–33.

Centers for Disease Control and Prevention. Meningococcal vaccination: recommendations of the Advisory Committee on Immunization Practices, 2020. MMWR Recomm Rep. 2020;69(9):1–41.

Centers for Disease Control and Prevention. Prevention of Hepatitis A virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2020;69(5):1–38.

Centers for Disease Control and Prevention. Use of a Modified Preexposure Prophylaxis Vaccination Schedule to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices—United States, 2022. MMWR Morb Mortal Wkly Rep. 2022;71:619–27.

Centers for Disease Control and Prevention. Yellow fever vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2015;64(23):647–50.

Global Polio Eradication Initiative. Public health emergency status: IHR public health emergency of international concern. Temporary recommendations to reduce international spread of poliovirus. Geneva: Global Polio Eradication Initiative; 2021. Available from: https://polioeradication.org/polio-today/polio-now/public-health-emergency-status .

Jackson BR, Iqbal S, Mahon B; Centers for Disease Control and Prevention (CDC). Updated recommendations for the use of typhoid vaccine—Advisory Committee on Immunization Practices, United States, 2015. MMWR Morb Mortal Wkly Rep. 2015;64(11):305–8.

Kimberlin DW, Barnett E, Lynfield R, Sawyer MH, editors. Red Book 2021–2024. Report of the Committee on Infectious Diseases, 32nd edition. Elk Grove Village (IL): American Academy of Pediatrics; 2021.

Paz-Bailey G, Adams L, Wong JM, Poehling KA, Chen WH, McNally V, et al. Dengue vaccine: recommendations of the Advisory Committee on Immunization Practices, United States, 2021. MMWR Recomm Rep. 2021;70(6);1–16.

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Watch CBS News

Going abroad? Time to check if you're up to date on measles immunity, CDC says

By Alexander Tin

Edited By Allison Elyse Gualtieri

March 13, 2024 / 1:43 PM EDT / CBS News

The Centers for Disease Control and Prevention updated its guidance Wednesday for travelers in the wake of a global rise in measles outbreaks, as cases have mounted  across 17 states .

Americans planning to travel abroad should consult their doctors at least six weeks before traveling if they are unsure about whether they are up to date on their vaccines, the agency now says, in order to avoid catching the highly contagious virus during their trip.

The CDC previously said in November that travelers only needed to schedule an appointment at least one month before their trip, in order to have enough time to get vaccinated .

Russia and Malaysia were also added Wednesday to the CDC's map of 46 countries now facing large measles outbreaks. However, the agency warns that the global rise in measles cases remains a threat in other parts of the world too.

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

It is not clear what prompted the CDC's new measles guidance tweaks. A spokesperson for the agency did not immediately answer a request for comment.

In recent weeks, health authorities have ramped up their plea for Americans to get vaccinated before spring break travel this year. 

Officials have cited recent outbreaks linked to travelers who were infected abroad and had been eligible to be vaccinated. 

Those include a cluster over the winter in Philadelphia , linked to an unvaccinated baby. The infant had been old enough to get a shot of the measles-mumps-rubella or MMR vaccine, which is recommended for travelers at least 6 months old. 

Another had been in Idaho, which state health authorities linked to an unvaccinated adult who traveled to Europe, where many countries are now facing resurgent outbreaks of the virus.

"The World Health Organization has noted a significant increase in measles cases worldwide, with a 30-fold increase in Europe.  This includes popular international tourist destinations for Americans, like England," the CDC said in a report on March 8.

What to know about the measles vaccine

Two doses of MMR vaccine offers 97% protection against measles, the CDC says , and at least one dose offers 93%. The shot offers lifelong protection against measles.

Most Americans got two doses of the vaccine by the time they were 6 years old, under CDC recommendations and widespread school requirements, though vaccination rates have slipped in recent years.

For adults born after 1957 who are unsure if they are protected, all are recommended to get at least one dose of the vaccine if they do not have evidence of immunity , like records of vaccination or previous infection.

Growing measles cases in the U.S.

In the United States, state and local health authorities have announced at least 55 confirmed or suspected cases of measles so far this year across 17 states. 

That is close to the 58 total measles cases the CDC says were reported for all of 2023. The last peak of yearly measles cases was in 2019. That year 1,274 infections were reported, making up the most on record in a single year since 1992.

Most new cases in the past week have been in Illinois, where Chicago health authorities have been responding to an outbreak in a migrant shelter. That outbreak prompted the deployment of CDC and state teams to aid the response, as the city has sought to screen and vaccinate hundreds potentially exposed.

New infections have also been announced over the past week in California and Arizona.

A spokesperson for the California Department of Public Health said Wednesday there were four reported measles cases statewide, and that "cases have been linked to travel to countries with epidemics in the wake of decreased routine immunization."

Hundreds may have been exposed at a hospital in Sacramento, authorities warned on March 8, after a child contracted the virus following a trip outside of the country.

State officials said their measles trends remain "similar to pre-pandemic levels" so far.

Officials in Arizona's Coconino County also announced a new case on March 11. Three previous infections were reported this year in Arizona's Maricopa County, which spans Phoenix, but the new case wasn't linked to those or to international travel, a county health and human services department spokesperson said Tuesday.

Alexander Tin is a digital reporter for CBS News based in the Washington, D.C. bureau. He covers the Biden administration's public health agencies, including the federal response to infectious disease outbreaks like COVID-19.

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cdc required vaccines travel

Visa or vaccines? How to know your international travel requirements

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Almost all of us have dreamed of going to destinations such as a safari in Africa, the Himalayas in Asia, or the crystal clear beaches of Bora Bora in French Polynesia. However, every time we think about trips to an international destination, many times we give up the idea because it could be very difficult or we do not know what documents or procedures we need to visit them.

However, there are excellent free tools with accurate information that can help you know if you need a visa to travel or if you need any vaccinations or preventive medical treatment.

Start the day smarter. Get all the news you need in your inbox each morning.

How to know if you need a travel visa

Having a passport will not necessarily guarantee you entry to other countries. Although many destinations do not require any permit or visa for U.S. citizens, many others do. How can you check if you need a visa, electronic authorization, or some special permission to enter another country? You must enter the website of the Department of State and choose the destination you plan on visiting. There, you will find a section that tells you the country's entry requirements and if you need any visas.

This is a very useful tool since it connects you directly with the downloads or electronic services of the countries you will visit so that you can start your process and request the required document. It is important that you always use the official pages of government entities to ensure that the information is correct and that you are not paying additional for an ordinary procedure.

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Get off the beaten path: 4 spectacular (and cheap) European destinations

How to know if you need vaccines and preventive treatments

Do I need to be vaccinated to travel to a destination? What vaccines do I need? Which are recommended and which are required? These are very common questions. The answers can be found on the website of the Centers for Disease Control and Prevention . Upon entering, you can select your destination and find information about necessary vaccinations, required vaccinations, recommended preventive medical treatments and general information about the destination.

For example, when we visit tropical countries many times vaccines such as yellow fever are required and many others such as Patitis or Typhoid are also recommended. In places with reported cases of cholera or malaria, it is important to carry preventive medications for emergencies.

A very important fact is that the CDC page tells you where you can get the vaccination centers near your residence so you can schedule an appointment to meet the requirements for your trip.

Two vacations in one: How to add a second destination to your trip (for little or no cost)

These two free information tools from official government entities are very useful whenever you travel to an international destination. In my experience, every time I start organizing a new trip, the first exercise I do is to confirm what I need to be able to enter that destination. Preparing and being informed can save you a lot of last-minute pain.

Wilson "Wil" Santiago Burgos is the founder of  Mochileando.com , one of the largest travel platforms in Puerto Rico and the Latin American market in the U.S.

This article originally appeared on USA TODAY: Visa or vaccines? How to know your international travel requirements

If you’re planning to fly in the summer of 2023, you can check out the Transportation Department's Airline Customer Service Dashboard for information on which airlines already offer compensation in cash, miles or vouchers – and which ones don’t.

CDC updates and simplifies respiratory virus recommendations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Following Measles Outbreaks, Officials Grow Wary of Renewed Threat

Cases this year have already topped the total in 2023. Unvaccinated travelers account for most infections.

A close-up view of an MMR vaccine dose on a tray in a clinic.

By Apoorva Mandavilli

Measles, a highly contagious but preventable disease, is resurging in pockets of the United States, a warning of the dangers of the strengthening anti-vaccine movement.

Listen to this article with reporter commentary

Open this article in the New York Times Audio app on iOS.

The Centers for Disease Control and Prevention has recorded more cases this year than the 58 tallied in all of 2023, although the agency is not expected to release exact numbers until Friday. On Monday, the agency advised health care providers to ensure that unvaccinated patients, especially those traveling internationally, stay updated on their immunizations.

The number of cases is likely to keep rising because of a sharp spike in measles worldwide, along with spring travel to some regions with outbreaks, including Britain, said Dr. Manisha Patel, chief medical officer at the C.D.C.’s respiratory disease division.

Nearly all the cases in the United States so far are related to unvaccinated travelers. “We’re not going to see widespread measles cases going throughout the country,” Dr. Patel said. “But we do expect additional cases and outbreaks to happen.”

Measles is among the most contagious of diseases; each infected person can spread the virus to as many as 18 others. The virus is airborne and can stay aloft up to two hours after an infected person has left the room, spreading rapidly through homes, schools and child care facilities.

In Chicago, one case of measles at a migrant shelter has grown to 13 , prompting the C.D.C. to send a team to help contain the outbreak. (Two additional cases in the city appear to be unrelated.)

In Florida, seven students at an elementary school contracted measles even as the state’s surgeon general, Dr. Joseph Ladapo, left it to parents to decide whether unvaccinated children should attend school.

In southwest Washington, officials identified measles in six unvaccinated adult members of a family living in two counties. And in Arizona, an international traveler infected with measles dined at a restaurant and transmitted the virus to at least two others .

Measles was eliminated in the United States in 2000, and American children generally must be immunized to attend school. Yet sporadic cases lead to larger outbreaks every few years. But now a drop in vaccination rates, exacerbated by the coronavirus pandemic, has experts worried about a resurgence.

When vaccinations lag, “the first disease to appear is measles, because it’s highly infectious,” said Dr. Saad Omer, dean of the O’Donnell School of Public Health at U.T. Southwestern in Dallas.

Nine of 10 unvaccinated people in close contact with a measles patient will become infected, according to the C.D.C.

Measles is far less deadly in countries with high immunization rates and good medical care. Fewer than three of every 1,000 American children with measles will die as a result of severe complications like pneumonia or encephalitis, the swelling of the brain.

Still, about one in five people with measles may end up in a hospital.

Because widespread measles outbreaks have been rare, most Americans, including doctors, may not recognize the vibrant red rash that accompanies respiratory symptoms in a measles infection. They may have forgotten the impact of the disease on individuals and communities.

“Most of our local health department folks have never seen a measles outbreak,” said Dr. Christine Hahn, state epidemiologist of Idaho, which contained a small cluster of cases last year.

“It’s going to be a big challenge to us to respond if and when we get our next outbreak,” she said.

Before the first measles vaccine was introduced in the 1960s, the disease killed an estimated 2.6 million people worldwide each year. But its full impact may have been much greater.

Measles cripples the immune system, allowing other pathogens easier entry into the body. A 2015 study estimated that measles may have accounted for as many as half of all infectious disease deaths in children.

For about a month after the acute illness, measles can stun the body’s first response to other bacteria and viruses, said Dr. Michael Mina, chief science officer of the digital health company eMed and formerly an epidemiologist at the Harvard T.H. Chan School of Public Health.

That leaves patients “massively susceptible to bacterial pneumonias and other things,” said Dr. Mina, who was the lead author on the 2015 study.

“It’s very risky for people in those first few weeks post measles,” he added.

The virus also induces a sort of immune-system amnesia. Normally the body “remembers” the bacteria and viruses it has fought before. Dr. Mina and his colleagues showed in 2019 that people who have measles lose between 11 and 73 percent of their hard-won immune repertoire, a loss that can last for years.

That does not mean the body no longer recognizes those pathogens at all, but it does shrink the arsenal of weapons available to fight them.

“People should be aware that if they’re choosing not to vaccinate, that’s the position they’re putting themselves and their family in,” Dr. Mina said.

The C.D.C. recommends receiving the first dose of the measles vaccine after 12 months of age, and a second between ages 4 and 6. Even a single dose of the vaccine is 93 percent effective. Measles vaccination averted 56 million deaths between 2000 and 2021, according to the World Health Organization.

Vaccination rates in the United States have shown a distinct, if small, dip to 93 percent in the 2022-23 school year from 95 percent in 2019-20 — the level required to protect everyone in the community. Rates of vaccination exemptions increased in 40 states and the District of Columbia.

In a survey last year , just over half of Republicans said that public schools should require measles vaccinations, compared with about 80 percent before the pandemic. (Support for vaccines among Democrats held steady.)

While national or state-level vaccination rates may be high, there may be pockets of low immunization that provide tinder for the measles virus, Dr. Omer said.

If there are enough unvaccinated cases to sustain an outbreak, even those who are vaccinated but whose immunity may have waned are vulnerable, he said.

In Idaho, 12 percent of kindergarten-age children do not have a record of vaccination. Some of the gap results from parents unable or unwilling to share records with the schools, and not because their children are not immunized, Dr. Hahn said.

Still, online schools, which proliferated through the pandemic and remain popular in the state, have some of the highest rates of vaccine exemptions, she said.

In September, a young Idaho man brought measles back after international travel and became ill enough to be hospitalized . Along the way, he exposed fellow passengers on two flights, dozens of health care workers and patients, and nine unvaccinated family members. All nine developed measles.

Idaho got “very lucky” with the outbreak because the family lived in a remote area, Dr. Hahn said. But there are most likely many other areas in the state where an outbreak would be difficult to contain.

“We’ve got plenty of tinder, if you will,” she added.

Some large outbreaks in recent years exploded among huge clusters of unvaccinated people, including the Amish in Ohio and the Orthodox Jewish community in New York City.

In September 2018, one unvaccinated child returned to New York City from Israel, ferrying measles virus picked up during an outbreak in that country.

Even though the city maintains high vaccination rates, that single case set off an outbreak that raged for nearly 10 months, the largest in the country in decades. The city declared a public health emergency for the first time in more than 100 years.

“We had more than 100 chains of transmission,” said Dr. Oxiris Barbot, the city’s health commissioner at the time, and now the president and chief executive of United Hospital Fund.

“Keeping all of that straight was a challenge,” she recalled. “And to have to investigate over 20,000 exposures like that, that was huge.”

Working with community leaders, city officials hurriedly administered about 200,000 doses of vaccine. More than 550 city staff members were involved in the response, and the final cost to the city’s health department topped $8 million.

The C.D.C. is working with state and local health departments to identify pockets of low vaccination and prepare them for outbreaks, Dr. Patel said. The agency is also training health care providers to recognize measles symptoms, particularly in patients with a history of international travel.

Measles is a slippery adversary, but public health is intimately familiar with the tools needed to contain it: screening, tracing contacts and vaccinating the susceptible.

“We’re not helpless bystanders,” Dr. Omer said. “The focus needs to be on meat-and-potatoes public health.”

Audio produced by Tally Abecassis .

Apoorva Mandavilli is a reporter focused on science and global health. She was a part of the team that won the 2021 Pulitzer Prize for Public Service for coverage of the pandemic. More about Apoorva Mandavilli

FactCheck.org

Explaining the New CDC Guidance on What To Do if You Have COVID-19

By Kate Yandell

Posted on March 15, 2024

Q: Is one day isolation sufficient to stop forward transmission of COVID-19? 

A: People with COVID-19 could potentially transmit it to others well beyond a day after developing symptoms or testing positive. New guidance from the CDC advises people to isolate until they have been fever-free and with symptoms improving for at least 24 hours, and then take precautions for five days, which covers the period when “most people are still infectious.”

FULL ANSWER

The Centers for Disease Control and Prevention on  March 1  updated its  guidance  on preventing the spread of respiratory viruses, consolidating advice on a  range  of common respiratory illnesses including COVID-19, flu and respiratory syncytial virus, or RSV.

Since  December 2021 , the agency had recommended individuals isolate for at least five days after developing symptoms of COVID-19, or after a positive test if asymptomatic. After five days, the agency  recommended  various symptom-based criteria for leaving isolation combined with additional continued precautions, such as masking.

cdc required vaccines travel

The new guidance drops the standard minimum of five days of isolation in favor of a symptom-based approach. The agency advises people to stay home and away from others when they are sick with a respiratory virus. People can cease isolation if, over a period of 24 hours, their overall symptoms have been improving and they have been fever-free without using fever-reducing medications. 

Many people have had questions about what the new guidance means for people who have COVID-19. Some, like our reader, have referred to the idea that the guidance means only one day of isolation is needed. “do you agree with Biden that one day isolation for covid is fine and dandy??”  asked  one person on X, formerly known as Twitter.

But that’s not what Biden or the CDC is recommending.

“It’s not saying isolate for 24 hours,” epidemiologist  Ronit Dalmat , a research scientist at the University of Washington, told us, referring to the CDC guidance. “It’s saying if you have a fever, absolutely stay home” until it has been gone for 24 hours, and also stay home until other symptoms are improving.

Nor does the CDC say people are guaranteed not to spread COVID-19 or other respiratory illnesses after their symptoms have improved. “Keep in mind that you may still be able to spread the virus that made you sick, even if you are feeling better,” the guidance says. “You are likely to be less contagious at this time, depending on factors like how long you were sick or how sick you were.”

The guidance recommends continuing to take precautions for five days after resuming normal activities. These include physical distancing, testing, improving air quality, using good hygiene and wearing a well-fitting mask, such as an N95 or KN95.

“The total number of days of precautions when sick, that is, a period of staying home and away from others plus 5 days of additional actions, covers the period during which most people are still infectious,” the CDC  wrote  in an FAQ.

“That whole period could be quite a while,” Dalmat said. “That could be 10 days for some people.”

The CDC said in background materials accompanying the new guidance that it looked at data from countries and states that had adopted similar policies for COVID-19 isolation and had not seen “clear increases in community transmission or hospitalization rates.”

“The updated guidance on steps to prevent spread when you are sick particularly reflects the key reality that many people with respiratory virus symptoms do not know the specific virus they are infected with,” the CDC said. The agency noted that its survey data indicated less than half of people with cold or cough symptoms would take an at-home COVID-19 test.

Some on social media have misinterpreted the guidance as an admission that it was always reasonable  to liken  COVID-19 to the flu, as was done early in the pandemic despite the marked difference in the diseases’ severity.

But the new CDC guidance acknowledges the continued seriousness of COVID-19 while also detailing the ways in which treatments, vaccines and population immunity have improved outcomes for people with the disease.

“COVID-19 remains a greater cause of severe illness and death than other respiratory viruses, but the differences between these rates are much smaller than they were earlier in the pandemic,” the CDC said . The agency explained that the risks are reduced due to the availability of COVID-19 treatments and population immunity to the virus, both from vaccination and prior infection. The agency also said that long COVID remains a risk, although the prevalence appears to be falling.

The Science on COVID-19 Transmission

Whether someone  transmits  COVID-19 depends on  multiple factors . These include a person’s infectious viral load, but also the susceptibility of the people the infected person encounters and the precautions taken.

There’s no one-size-fits-all answer to how long a particular individual will shed infectious virus and how much they will shed. “Everybody has a slightly different ability to control the amount of virus in their system, which is a part of what makes the virus shed,” Dalmat said. Variation in how people’s bodies fight a virus affects “how much virus you are putting in the world that is infectious.” 

There’s evidence that a relatively small number of people who shed particularly high levels of the virus over the course of their infections have been responsible for a disproportionate number of COVID-19 cases, and many people with COVID-19 do not infect others.

However, according to the CDC, the data on the typical overall length of shedding has not significantly changed, even as new variants of SARS-CoV-2 — the virus that causes COVID-19 — have arisen. “Even as the SARS-CoV-2 virus has continued to evolve, the duration of shedding infectious virus has remained relatively consistent, with most individuals no longer infectious after 8-10 days,” the agency said .

The CDC accompanied this statement with a figure showing data collected by the Respiratory Virus Transmission Network from five U.S. sites between November 2022 and May 2023 (see below). One line on the graph (light blue) shows how often researchers were able to isolate and grow — or culture — virus from people with COVID-19.

cdc required vaccines travel

Trying to culture the virus that causes COVID-19 from a respiratory sample — a laborious process used  in research — indicates whether someone is carrying infectious virus. The figure shows that the proportion of people with culturable virus began to increase two days before symptoms begin, or before a positive test for those who were asymptomatic, peaking around one to two days after symptom onset. After that, the rate began falling, with around one-third of people having culturable virus at day five. By day 10, the percentage had dropped to around 10%.

A different  study , published in 2023 in the International Journal of Infectious Diseases, combined data from multiple studies done in people diagnosed with COVID-19 in 2021 and 2022. The average duration of shedding of culturable virus was just over five days from symptom onset or first positive PCR test, whichever came first.

Another metric for assessing infectiousness in people with COVID-19 is viral load, often measured as the amount of viral materials, such as RNA or proteins, found in a respiratory sample. A 2023 study published in Clinical Infectious Diseases found that median viral load for people diagnosed with COVID-19 peaked around three or four days after symptoms started. The study assessed people seeking testing for respiratory infections between April 2022 and April 2023.

cdc required vaccines travel

Someone who is shedding infectious virus may or may not  transmit it to others. One factor is that the average person is less susceptible to infection today than they were early in the pandemic, Dalmat said.

“Even if the person is producing the exact same amount of virus today as they could have three years ago, the people on the other end on average are less likely to get infected,” Dalmat said, explaining that today  more than 98%  of the population has had some exposure to COVID-19 itself, COVID-19 vaccines or both.

When people do get infected, the cases tend to be less severe.   “Among the people who get infected with COVID these days, on average it is much rarer that it turns into a very serious illness,” Dalmat said, while also acknowledging that a lot of individuals “are still very vulnerable.” People at elevated risk for severe disease include those who are elderly or immune compromised.

While the CDC guidance harmonizes suggested precautions for COVID-19 and other common respiratory viruses, there are  differences  in the  details  of how COVID-19 and other respiratory viruses are spread.

The new guidance is meant to be a general rule of thumb but does not apply to health care settings or cases where there is an outbreak of a disease that requires special instructions, the CDC said. The CDC also  said  the agency is working on specific guidance for schools, which should be available prior to the 2024/2025 school year.

Masks, Tests and Other Precautions

Isolating from other people when sick is a key way to reduce one’s risk of spreading COVID-19. But the CDC guidance lists additional ways to reduce the chances of spreading a respiratory illness.

Masks  can help prevent the wearer from spreading a respiratory virus. They can also protect others from inhaling a virus, particularly well-fitting masks such as N95 or KN95 respirators, the guidance says. Individuals can take measures to improve their  hygiene  and the  air quality  in their surroundings and maintain  physical distance  from others, such as by avoiding crowded spaces.

The CDC still recommends  testing  to help high-risk people who are sick determine whether to seek treatment for a specific virus. For instance, someone with COVID-19 may benefit from receiving  Paxlovid  within five days of when their symptoms start. The guidance also  lists  tests as a tool that can help people decide when they need to take precautions to avoid spreading disease.

cdc required vaccines travel

At-home rapid antigen tests can be helpful for people who are recovering from COVID-19 and want to see if they still have infectious virus, Dalmat said. In their research, she and her colleagues found that among people who tested positive for COVID-19 on a rapid antigen test, subsequent negative antigen test results were “very, very highly correlated to whether you had infectious virus or not,” she said. That means people with COVID-19 who start to test negative on rapid antigen tests as they get better likely are no longer at risk of infecting others.

However, the CDC  cautions  that rapid antigen tests early in the course of a person’s infection often miss COVID-19. People who are sick should be taking precautions regardless of test results, Dalmat said. “They shouldn’t test and have a negative test be the end of it,” she said.

The authors of the Clinical Infectious Diseases  study , which measured viral loads over the course of infection, wrote that “our data in combination with others’ suggest that symptomatic individuals testing positive for SARS-CoV-2 by PCR currently may not reliably test positive on a rapid antigen test until the third, fourth, or even fifth day of symptoms.”

The CDC guidance says people can end isolation when they have been fever-free and their symptoms have been improving for at least 24 hours. Dalmat cautioned that the definition of improving symptoms is somewhat ambiguous. 

“Symptoms improving can mean different things to different people,” Dalmat said, adding that people should make sure their symptoms are truly getting better. “If your symptoms are not really improving – not kind of plateauing but really improving — you should continue to stay home and continue to take whatever measures you are taking in your household.”

Editor’s note: SciCheck’s articles providing accurate health information and correcting health misinformation are made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation.

Branswell, Helen. “ CDC Eases Isolation Guidance for Covid and Other Respiratory Illnesses .” STAT. 1 Mar 2024.

“ Preventing Spread of Respiratory Viruses When You’re Sick .” CDC website. Updated 1 Mar 2024.

“ CDC’s Updated Respiratory Virus Guidance: What to Do When You Are Sick .” CDC website. 1 Mar 2024.

“ CDC Updates and Shortens Recommended Isolation and Quarantine Period for General Population .” CDC website. 27 Dec 2021.

“ Isolation and Precautions for People with COVID-19 .” CDC website. Updated 11 Mar 2023.

Cali Dreaming NaphiSoc (@NaphiSoc). “ Prof Hotez: do you agree with Biden that one day isolation for covid is fine and dandy?? ” X. 2 Mar 2024.

Dalmat, Ronit. Interview with FactCheck.org. 

“ Respiratory Virus Guidance Update FAQs .” CDC website. Updated 1 Mar 2024.

“ Background for CDC’s Updated Respiratory Virus Guidance .” CDC website. Updated 1 Mar 2024.

Matt Kim 🇰🇷🇺🇸 (@mattattack009). “ Zero Accountability .” Instagram. 4 Mar 2024.

DiedSuddenly (@DiedSuddenly_). “ Turns out everything they told you about Covid was a lie. Of course they knew this 3 years ago, and they’ll show zero remorse for what they have done .” X. 2 Mar 2024.

Citizen Free Press (@CitizenFreePres). “ … and then one day, four years later on a Friday afternoon when no one was looking, the CDC admitted that the great conspiracy theory about Covid was true .” X. 1 Mar 2024.

Rieder, Rem. “ Trump’s Deceptive Comparison of the Coronavirus to the Flu .” FactCheck.org. 9 Sep 2020.

“ How is COVID-19 transmitted? ” FactCheck.org. Updated 11 Feb 2022.

Puhach, Olha et al. “ SARS-CoV-2 Viral Load and Shedding Kinetics .” Nature Reviews Microbiology. 2 Dec 2022.

Wu, Yu et al. “ Duration of Viable Virus Shedding and Polymerase Chain Reaction Positivity of the SARS-CoV-2 Omicron Variant in the Upper Respiratory Tract: A Systematic Review and Meta-Analysis .” International Journal of Infectious Diseases. 18 Feb 2023.

Frediani, Jennifer K. et al. “ The New Normal: Delayed Peak SARS-CoV-2 Viral Loads Relative to Symptom Onset and Implications for COVID-19 Testing Programs .” Clinical Infectious Diseases. 28 Sep 2023.

Cevik, Muge and Kalil, Andre C. “ Omicron Variant: Assessing the Duration of Viral Shedding and Its Implications .” Clinical Microbiology and Infection. 25 Nov 2022.

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Wu, Katherine J. “ Why Are We Still Flu-Ifying COVID? ” The Atlantic. 28 Feb 2024.

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CDC, AMA Issue Calls to Get Vaccinated Against Measles

By Ernie Mundell HealthDay Reporter

cdc required vaccines travel

TUESDAY, March 19, 2024 (HealthDay News) -- Two of America's leading health organizations are highlighting a global rise in measles cases as yet another reason for families to make sure they get the measles vaccine.

The U.S. Centers for Disease Control and Prevention and the American Medical Association (which represents the nation's doctors), each issued advisories on Monday stressing the need for vaccination.

Besides a total of 58 known cases of measles in the United States, "many countries, including travel destinations such as Austria, the Philippines, Romania, and the United Kingdom, are experiencing measles outbreaks," the CDC said in a statement .

Ahead of the summer travel season, "to prevent measles infection and reduce the risk of community transmission from importation, all U.S. residents traveling internationally, regardless of destination, should be current on their MMR [measles-mumps-rubella] vaccinations," the agency said.

U.S. Cities With the Most Homelessness

cdc required vaccines travel

Measles is one of the most contagious illnesses: It's thought that 90% of unvaccinated people who are in contact with an infected person will become infected themselves.

However, the standard two-dose measles vaccination is 97% effective in preventing infection, the CDC noted.

In the AMA statement , organization president Dr. Jesse Ehrenfeld said rising rates of anti-vaxxer sentiment since 2019 have left Americans more vulnerable to measles -- a disease that was once nearly eradicated in the United States.

“As evident from the confirmed measles cases reported in 17 states so far this year, when individuals are not immunized as a matter of personal preference or misinformation, they put themselves and others at risk of disease — including children too young to be vaccinated, cancer patients and other immunocompromised people," he said.

"In fact, with lower vaccination coverage among kindergarteners during the 2022–23 school year, the CDC estimates that approximately 250,000 kindergartners are at risk for measles infection," Ehrenfeld noted.

Travel guidance

Children whose families do not have international travel plans should get the first dose of vaccine at between 12 to 15 months of age, and the second dose between 4 and 6 years of age, the CDC advised.

International travel plans bring a separate list of recommendations:

According to the CDC, unvaccinated babies whose families are planning to travel internationally should receive the first dose of the measles vaccine between 6 months and 11 months of age, prior to departure.

Infants who already had a first dose of vaccine before their first birthday "should receive two more doses of MMR vaccine, the first of which should be administered when the child is age 12 through 15 months and the second at least 28 days later."

Any unvaccinated child aged 12 months or older should get two doses of the MMR vaccine, separated by 28 days.

Any teenager or adult "without evidence of measles immunity" should get two doses of the MMR vaccine, separated by 28 days.

Americans planning to fly to other countries should consult their doctors at least six weeks before they leave, if they are unsure about whether they are up to date on their measles vaccines, the CDC  guidance  says.

Domestic outbreaks

Outbreaks are also occurring within the United States.

Officials have cited recent outbreaks linked to travelers who were infected abroad and had been eligible to be vaccinated,  CBS News  reported. 

Those include a cluster of cases reported over the winter in  Philadelphia linked to an unvaccinated baby. The infant had been old enough to get a shot of the measles-mumps-rubella (MMR) vaccine.

Another outbreak occurred in Idaho, which state health authorities linked to an unvaccinated adult who traveled to Europe,  CBS News  reported.

Most new cases in the past week have been in Chicago, where health authorities have been trying to stem an outbreak in a migrant shelter. New infections have also been announced over the past week in  California  and Arizona.

A spokesperson for the California Department of Public Health told  CBS News  there were four reported measles cases statewide, and that "cases have been linked to travel to countries with epidemics in the wake of decreased routine immunization."

Meanwhile, officials in Arizona's Coconino County also  announced  a new case on March 11. Three previous infections were reported this year in Arizona's Maricopa County, which includes Phoenix, but the new case wasn't linked to those or to international travel,  CBS News  reported.

Always unpleasant, sometimes fatal

Many people may believe that measles is just an uncomfortable but transient illness, but the truth is that it can prove very severe -- especially for kids.

Even in its "uncomfortable" form, measles is not easy, explained  Dr. Aaron Milstone  and  Dr. Lisa Lockherd Maragakis , two infectious disease experts at Johns Hopkins Medicine in Baltimore.

Besides the hallmark rash, which begins on the face and can cover the body, measles can involve high fever, cough, conjunctivitis (red, runny eyes) and congestion.

Without complications, measles typically runs its course in a week. When complications do arise, things can get much worse, however.

Complications "can include ear infections, pneumonia and encephalitis, or inflammation of the brain, that can lead to permanent neurologic damage and even death," the two doctors wrote. "On average, measles kills between one and three of every 1,000 infected children."

More information:

Find out more about measles at the World Health Organization .

SOURCES: U.S. Centers for Disease Control and Prevention and American Medical Association, statements, March 18, 2023; Johns Hopkins Medicine; CBS News

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cdc required vaccines travel

IMAGES

  1. Need travel vaccines? Plan ahead.

    cdc required vaccines travel

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

    cdc required vaccines travel

  3. Travel Vaccination Clinic

    cdc required vaccines travel

  4. Covid Vaccine Card: What You Need to Know

    cdc required vaccines travel

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

    cdc required vaccines travel

  6. CDC updates travel guidelines for those vaccinated, unvaccinated

    cdc required vaccines travel

COMMENTS

  1. Need travel vaccines? Plan ahead.

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

  2. Think Travel Vaccine Guide

    Vaccination (2-dose vaccine): Recommended for most travelers. --Administer 2 doses, at least 6 months apart. --At least 1 dose should be given before travel. Consultation: Advise patient to wash hands frequently and avoid unsafe food and water. Hepatitis B. Sexual contact, contaminated needles, & blood products, vertical transmission.

  3. Travelers' Health

    See the full list of Travel Health Notices, including: CDC Travelers' Health Branch provides updated travel information, notices, and vaccine requirements to inform international travelers and provide guidance to the clinicians who serve them.

  4. Travel Vaccines to Protect Your Family

    Protect your child and family when traveling in the United States or abroad by: Getting the shots required for all countries you and your family plan to visit during your trip. Making sure you and your family are up-to-date on all routine U.S. vaccines. Staying informed about travel notices and alerts and how they can affect your family's ...

  5. Travelers' Health Most Frequently Asked Questions

    If you need to contact a US embassy or consulate, call 1-888-407-4747 (from the US or Canada) OR 00-1-202-501-4444 (from other countries). Travel healthy, from CDC's Travelers' Health! CDC Travelers' Health Branch provides health advice to international travelers, including advice about medications and vaccines.

  6. Ghana

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

  7. Recommended Vaccines for Adults

    Get vaccinated before you travel The vaccines recommended or required for an international traveler depend on several factors, including age, health, and itinerary. Take these steps to make sure you are prepared for your trip: Make sure you are up-to-date with all recommended vaccines.

  8. Routine Vaccines

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

  9. Stay Up to Date with COVID-19 Vaccines

    The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.

  10. CDC Travel Guidelines: What You Need to Know

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

  11. What travelers need to know about the new US travel requirements

    The U.S. is launching a new travel system on Nov. 8. Vaccinated foreign air travelers will need to show proof of full vaccination and test for COVID-19. The new travel system also adds more ...

  12. Vaccines for Travelers

    Vaccines for Travelers. Vaccines protect travelers from serious diseases. Depending on where you travel, you may come into contact with diseases that are rare in the United States, like yellow fever. Some vaccines may also be required for you to travel to certain places. Getting vaccinated will help keep you safe and healthy while you're ...

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

    Last Updated: May 4, 2023. The Administration will end the COVID-19 vaccine requirements for international air travelers at the end of the day on May 11, the same day that the COVID-19 public health emergency ends. This means starting May 12, noncitizen nonimmigrant air passengers will no longer need to show proof of being fully vaccinated with ...

  14. Fact Sheet: Biden Administration Releases Additional Detail for

    Starting on November 8, non-citizen, non-immigrant air travelers to the United States will be required to be fully vaccinated and to provide proof of COVID-19 vaccination status prior to boarding ...

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

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

  16. Which Vaccinations Are Required for Travel?

    Make sure you're current with routine vaccines. The Centers for Disease Control and Prevention (CDC) recommends all travelers be up to date on routine vaccines before travel. Routine vaccines ...

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

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

  18. COVID-19 international travel advisories

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

  19. CDC eases certain Covid-19 vaccine requirements for international ...

    The travel requirements don't apply to US citizens, lawful permanent residents, or immigrants. Earlier this month, the CDC signed off on a plan to streamline Covid-19 vaccination. As part of the ...

  20. Vaccine Recommendations for Infants & Children

    Country-specific vaccination recommendations and requirements for departure and entry vary over time. For example, proof of yellow fever vaccination is required for entry into certain countries. Meningococcal vaccination is required for travelers entering Saudi Arabia for Umrah or the annual Hajj pilgrimage.

  21. Plan for Travel

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

  22. Going abroad? Time to check if you're up to date on measles immunity

    Most Americans got two doses of the vaccine by the time they were 6 years old, under CDC recommendations and widespread school requirements, though vaccination rates have slipped in recent years.

  23. Measles Outbreaks Have CDC Tweaking Travel Guidelines

    Two doses of MMR vaccine offers 97% protection against measles, the CDC says, while one dose offers 93% protection. The protection is lifelong, experts say. The protection is lifelong, experts say.

  24. Your COVID-19 Vaccination

    The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.

  25. Visa or vaccines? How to know your international travel requirements

    A very important fact is that the CDC page tells you where you can get the vaccination centers near your residence so you can schedule an appointment to meet the requirements for your trip.

  26. CDC updates and simplifies respiratory virus recommendations

    CDC released today updated recommendations for how people can protect themselves and their communities from respiratory viruses, including COVID-19. The new guidance brings a unified approach to addressing risks from a range of common respiratory viral illnesses, such as COVID-19, flu, and RSV, which can cause significant health impacts and strain on hospitals and health care workers.

  27. Following Measles Outbreaks, Officials Grow Wary of Renewed Threat

    Vaccination rates in the United States have shown a distinct, if small, dip to 93 percent in the 2022-23 school year from 95 percent in 2019-20 — the level required to protect everyone in the ...

  28. Explaining the New CDC Guidance on What To Do if You Have COVID-19

    CDC website. Updated 1 Mar 2024. "Background for CDC's Updated Respiratory Virus Guidance." CDC website. Updated 1 Mar 2024. Matt Kim (@mattattack009). "Zero Accountability." Instagram ...

  29. CDC, AMA Issue Calls to Get Vaccinated Against Measles

    According to the CDC, unvaccinated babies whose families are planning to travel internationally should receive the first dose of the measles vaccine between 6 months and 11 months of age, prior to ...