Travel vaccinations for the USA: requirements, advice and health on the ground

No vaccination is required for travel from Germany directly to the USA. The German Federal Foreign Office (Auswärtiges Amt) recommends hepatitis A vaccination and up-to-date routine vaccinations under the STIKO schedule, Germany’s national immunisation guidance, and particularly stresses measles protection because of current outbreaks. Depending on individual circumstances, dengue, hepatitis B, meningococcal ACWY and rabies may be added. Malaria is not an issue, but protection against mosquitoes and ticks and good travel health insurance are.

Entry rules: no mandatory vaccinations

According to the Federal Foreign Office, no vaccinations are required for direct entry from Germany. The WHO lists the USA neither as a yellow fever risk country nor as requiring a certificate, so yellow fever vaccination is not needed for a trip to the USA alone. If you are combining your trip with Central or South America, check the rules for each country separately, for example for Mexico.

Recommended vaccinations by type of trip

From a travel medicine perspective, the USA is a relatively straightforward destination. Which risks matter depends largely on whether you stay in cities or spend a lot of time outdoors. The overview table on this page summarises the advice, and the breakdown below helps you prepare.

For all travellers

The Federal Foreign Office recommends hepatitis A vaccination, as viral hepatitis A also occurs among travellers to the USA. Routine vaccinations such as tetanus, diphtheria and measles are just as important. Because of current measles outbreaks, the Federal Foreign Office stresses that adequate protection should be in place for you and your children. What STIKO recommends for adults is explained in our guide to routine vaccinations for adults.

Depending on your trip and personal risk

The Federal Foreign Office lists dengue, hepatitis B, meningococcal ACWY and rabies based on individual indication. Whether these apply to you depends on the length of your stay, your accommodation and your activities. A dengue vaccine exists, but STIKO currently recommends it only for people aged four and over who have had a laboratory-confirmed dengue infection in the past. For an initial assessment of your trip, try the travel vaccine check.

Mosquitoes and ticks: dengue, West Nile fever and Lyme disease

The Federal Foreign Office reports no malaria risk for the USA, and the USA is not listed as a malaria area in the 2026 DTG country table. Other diseases spread by mosquitoes and ticks do occur, however:

• Dengue can be transmitted in the southern states and in Puerto Rico, Guam, the US Virgin Islands and American Samoa. The mosquitoes that carry it bite during the day and at dusk.
• West Nile fever is transmitted by mosquitoes during the summer months.
• Eastern equine encephalitis is rare in humans but can be severe.
• Lyme disease is transmitted by ticks, mainly in the northern and eastern states from April to September.

Protect yourself especially during the day and at dusk with repellent and suitable clothing, and check yourself carefully for ticks after spending time outdoors. More tips are in our guide to dengue and mosquito protection.

Animal contact and food

Rabies in the USA is mainly transmitted by foxes, skunks and raccoons. As a rule, avoid contact with wild animals, including in national parks and on campsites. After a bite or scratch, wash the wound immediately with soap and water for at least 15 minutes and seek medical help straight away. Rabies vaccines and immunoglobulins are available in the country, but according to the Federal Foreign Office the immunoglobulin is very expensive. Read more in our guide to rabies when travelling.

Further points from the Federal Foreign Office:

• Hantavirus: it is spread through the droppings and urine of rodents, so avoid contact with rodents and anything they leave behind.
• Avian influenza: avoid contact with birds and poultry, do not consume raw milk or raw milk products, and only eat meat and eggs that are thoroughly heated.
• Venomous snakes: they occur mainly in rural areas. After a bite, seek medical help straight away.

Sun, altitude and water

Intense sunlight can damage skin and eyes, even during short periods outdoors. If you are heading to high altitudes in the Rocky Mountains or the Sierra Nevada, follow the advice on altitude sickness. When swimming or diving, pay attention to warnings from the local authorities.

Medical care and costs

According to the Federal Foreign Office, medical care in the USA is comparable with Germany. Do not underestimate the sometimes long distances to the nearest hospital, though. Treatment is expensive and must be paid in advance or directly, so travel health insurance with sufficient cover and repatriation is essential, and the Federal Foreign Office explicitly recommends medical evacuation cover too. Pack a travel health kit and your regular medication, and if needed ask your doctor for a note in English confirming that you need it for entry.

When to book your consultation

For a city break, a single appointment to catch up on hepatitis A and any missing routine vaccinations is often enough. According to STIKO and the DTG, travel vaccinations should be completed at least two weeks before departure. If you are planning a longer stay, such as studies or an au pair year, book well in advance. You can find a practice with a travel medicine focus near you in our directory of travel clinics.