Travel vaccinations for Brazil: yellow fever, recommended vaccines and malaria

Brazil does not require any vaccination for travellers arriving directly from Germany. The German Federal Foreign Office (Auswärtiges Amt) recommends vaccination against hepatitis A and yellow fever, because most federal states, including Rio de Janeiro, São Paulo, Brasília and the Iguaçu Falls, carry a high yellow fever risk. Malaria is mainly a concern in the Amazon basin, while dengue and other mosquito-borne viruses occur nationwide. Which further vaccinations make sense depends on your route, length of stay and travel style.

Entry rules: yellow fever proof and onward travel

If you fly straight from Germany to Brazil, you do not need to show proof of vaccination. Onward travel is a different matter: according to the Foreign Office, certain other countries may require a yellow fever certificate if you arrive from Brazil. The Foreign Office also notes that countries in South and Central America are carrying out more checks and changing their entry rules. Check the requirements of every country on your route, including transit stops, for example if you combine Brazil with Peru or Colombia.

In Germany, yellow fever vaccination is only available at approved yellow fever vaccination centres. Under the WHO International Health Regulations, the certificate in your International Certificate of Vaccination is valid from the tenth day after vaccination and then for life. The vaccination centre will tell you whether a booster makes sense if your vaccination was a long time ago. For background, see our guide to yellow fever vaccination.

Vaccinations recommended by the Foreign Office

The table at the top of this page summarises the recommendations. Here is how to read them:

• For all travellers: hepatitis A.
• Yellow fever: recommended by the Foreign Office. It lists the following as high-risk areas: Acre, Amapá, Amazonas, the Distrito Federal with Brasília, Espírito Santo, Goiás, Maranhão, Mato Grosso, Mato Grosso do Sul, Minas Gerais, Pará, Paraná, Piauí, Rio de Janeiro, Rio Grande do Sul, Rondônia, Roraima, Santa Catarina, São Paulo, Tocantins, certain parts of Bahia and the Iguaçu Falls.
• Depending on individual risk: hepatitis B, rabies, dengue and chikungunya.
• Routine vaccinations: check that you are up to date with the German routine schedule set by STIKO, the Standing Committee on Vaccination. The Foreign Office stresses measles protection because of occasional outbreaks in recent years.

On dengue vaccination, the position in Germany is that STIKO only recommends it for people with a confirmed previous dengue infection. Whether this applies to you, and whether chikungunya vaccination is worthwhile for your trip, is something to settle during a travel health consultation.

Malaria: where the risk lies

According to the Foreign Office and the DTG, malaria risk is present all year and varies widely by region. Around four in five cases are vivax malaria, while just under one in five are the more dangerous falciparum malaria or mixed infections.

In high-risk areas, the Foreign Office considers preventive medication sensible in addition to mosquito protection. For moderate-risk areas more than 48 hours from the nearest facility able to diagnose and treat malaria, it recommends carrying emergency standby medication. Your doctor will decide with you which options are suitable. Our malaria prevention guide explains the basics.

Dengue, Zika and other insect-borne risks

According to the Foreign Office, chikungunya, dengue, Oropouche fever, West Nile fever and Zika can occur throughout the country all year, as can leishmaniasis, particularly in rural areas of the north and north-east. Zika and Oropouche are especially relevant during pregnancy. Protect yourself during the day and at night with long, light-coloured clothing, insect repellent and a bed net. Practical tips are in our guide to dengue and mosquito protection.

Chagas disease is spread by kissing bugs and by contaminated fruit and sugar cane juices that are not industrially produced; the Foreign Office explicitly mentions açaí juice. A bed net helps in simple rural accommodation. Tick-borne spotted fever occurs occasionally in São Paulo state, so check your body carefully after time outdoors.

What depends on your type of trip

Many itineraries combine several of these. Your precautions should be based on the part of the route with the highest risk.

Hygiene, water and animals

According to the Foreign Office, travellers’ diarrhoea and hepatitis A and E also affect visitors. Choose safe drinking water, thoroughly cooked food and good hand hygiene. Avoid home-distilled alcohol of unknown origin, as the Foreign Office warns of methanol poisoning. Because of schistosomiasis, it advises against swimming in freshwater, including rivers. Still or slow-moving water may also be contaminated with rodent urine and transmit leptospirosis. Avoid beaches that are also used by animals.

Rabies is mainly transmitted by dogs. Vaccines and immunoglobulins are usually available in large cities, according to the Foreign Office, although shortages can occur. After a bite or scratch, wash the wound thoroughly with soap and water and seek medical help immediately. Read more in our guide to rabies when travelling. Venomous snakes are found mainly in the Amazon basin.

Medical care in Brazil

Private clinics in large cities generally offer a good standard of care, according to the Foreign Office, but they are expensive. Before admission and treatment they often require a large advance payment in cash or by credit card, regardless of any travel health insurance. The public system is less well equipped on average, waiting times can be long and quality drops sharply in rural areas. Have any planned procedures done in Europe. Pack a travel health kit and your regular medication, and take out insurance that covers medical evacuation.

Timing: when to get advice

Allow a few weeks for your vaccination consultation. STIKO and DTG recommend that travel vaccinations are completed at least two weeks before departure. Our travel vaccine check gives you a first overview, and the travel clinic directory helps you find a practice or yellow fever centre near you. German statutory health insurance does not have to cover vaccinations for private holidays, although some insurers pay for them as a voluntary extra benefit.