Travel vaccinations for Peru: yellow fever, recommended vaccines, malaria and altitude

Peru does not require any vaccination for travellers arriving directly from Germany. The German Federal Foreign Office (Auswärtiges Amt) recommends hepatitis A for all travellers and, for areas below 2,300 metres in many regions east of the Andes, yellow fever as well. On classic highland routes around Cusco, Machu Picchu and Lake Titicaca, altitude and hygiene are the main concerns. Malaria is only relevant in the Amazon lowlands.

Entry rules: yellow fever proof and onward travel

If you fly straight from Germany to Peru, you do not need to show proof of vaccination. According to the Foreign Office, however, a third country may ask for a yellow fever certificate if you arrive there from Peru. If you are combining Peru with Brazil or Colombia, for example, check the entry rules of every country on your route.

In Germany, yellow fever vaccination is only available at approved yellow fever vaccination centres. Under the WHO International Health Regulations, the certificate is valid from the tenth day after vaccination and then for life. Find out more in our guide to yellow fever vaccination.

Yellow fever: which regions the Foreign Office covers

In Peru, altitude is the main factor in whether yellow fever vaccination makes sense. The Foreign Office recommends it for everyone aged nine months or over travelling to areas below 2,300 metres in these regions: Amazonas, Loreto, Madre de Dios, San Martín, Ucayali, Puno, Cusco, Junín, Pasco, Huánuco, the far north of Apurímac and Huancavelica, north-eastern Áncash, eastern La Libertad, northern and eastern Cajamarca, northern and north-eastern Ayacucho and eastern Piura.

It is not generally recommended west of the Andes, for example in Tumbes, western and central Lambayeque and Cajamarca, and western Piura. Above 2,300 metres, the Foreign Office does not recommend yellow fever vaccination. Because regions such as Cusco and Puno include both highlands and lower valleys, bring your exact route, with the altitude of each stop, to your consultation.

Other recommended vaccinations

• For all travellers: hepatitis A.
• 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 specifically highlights adequate measles protection.

Rabies deserves special attention in Peru: according to the Foreign Office, vaccines and immunoglobulins are not available in the country, or only to a very limited extent. If you are staying longer, spending a lot of time outdoors or likely to have contact with animals, weigh up vaccination before you travel with particular care. STIKO only recommends dengue vaccination for people with a confirmed previous dengue infection.

Malaria: lowlands only

According to the Foreign Office and the DTG, malaria risk is present all year and varies by region. About 82 per cent of cases are vivax malaria and 18 per cent the more dangerous falciparum malaria, mostly in Loreto and Amazonas.

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 malaria, it recommends emergency standby medication. Discuss suitable options with a doctor. Our malaria prevention guide covers the basics.

Chikungunya, dengue, leishmaniasis, Oropouche fever and Zika can also occur. Protect yourself against mosquito bites by day and at night and use a bed net; see our guide to dengue and mosquito protection for practical tips. Chagas disease is spread by kissing bugs in basic accommodation and by fruit and sugar cane juices that are not industrially produced.

Altitude sickness: the underestimated risk

Altitude sickness, known locally as soroche, can develop above about 2,500 metres if you ascend too quickly, and it is occasionally life-threatening. According to the Foreign Office, it often affects tourists who fly straight to Cusco or Puno, and it can strike at any age. Warning signs include poor sleep, headache, dizziness, vomiting and increasing breathlessness. If symptoms do not ease after a rest or a night’s sleep, descend below 2,000 metres. The Foreign Office notes that coca tea offers no reliable protection, and most medicines used against altitude sickness need a prescription. Build in days for acclimatisation and discuss any pre-existing conditions with a doctor before you go.

What depends on your type of trip

Hygiene, animals and local medical care

According to the Foreign Office, travellers’ diarrhoea and hepatitis A and E are common among visitors too. Drink only water from safe sources and eat thoroughly cooked food. Avoid contact with dogs and other animals, and with still water that may be contaminated with rodent urine. After a bite, wash the wound thoroughly with soap and seek medical help straight away.

Private healthcare in Lima is broadly satisfactory, according to the Foreign Office. In rural areas quality can drop drastically, and even in Cusco the facilities are often insufficient for serious illness, so a transfer to Lima may be needed. Take out insurance that covers medical evacuation and pack a well-stocked travel health kit with your regular medication.

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 lists practices and yellow fever centres across Germany.