Travel vaccinations for India: requirements, advice, malaria and rabies

No vaccination is required for travel from Germany directly to India. The German Federal Foreign Office (Auswärtiges Amt) recommends vaccination against hepatitis A and typhoid for all travellers, along with up-to-date routine vaccinations under the STIKO schedule, Germany’s national immunisation guidance, particularly measles. Depending on how you travel, hepatitis B, rabies, Japanese encephalitis, dengue and chikungunya may be added. Malaria occurs below 2,500 metres throughout the country, but the risk is low in most areas visited by tourists.

Entry rules: yellow fever only for certain routes

According to the WHO, India is not an area with yellow fever transmission. The Federal Foreign Office states that anyone aged nine months or over who arrives from a yellow fever area must show proof of yellow fever vaccination. This can affect travellers who have previously been in parts of Africa or South America. The WHO list also includes transit rules for India. If your route passes through a yellow fever area, check the current requirements before booking and seek advice from an approved vaccination centre. See our guide to yellow fever vaccination.

Recommended vaccinations by type of trip

India stretches from high mountains to tropical coasts, so the risks vary widely. The overview table on this page shows what the Federal Foreign Office recommends for everyone and what applies only to certain trips.

For all travellers

Hepatitis A and typhoid are spread through contaminated food and water. The Federal Foreign Office recommends both for India, with typhoid particularly relevant for longer stays in rural areas. Also check your routine vaccinations against your vaccination record.

Depending on your trip and personal risk

The Federal Foreign Office lists hepatitis B, rabies, Japanese encephalitis, dengue and chikungunya on an individual basis. Japanese encephalitis carries a low transmission risk nationwide, with clusters of brain inflammation in Bihar and Assam. Cholera vaccination is only relevant for people working long term in epidemic areas, for example in healthcare or disaster relief. STIKO currently recommends dengue vaccination only for people aged four and over who have had a laboratory-confirmed dengue infection. Your doctor will advise on what suits your trip. The travel vaccine check gives a first orientation.

Malaria: risk by region and altitude

According to the Federal Foreign Office and the DTG (the German Society for Tropical Medicine), the risk exists all year round and varies considerably:

• High risk: one area of Chhattisgarh below 2,500 metres.
• Moderate risk: further areas in the east and north-east below 2,500 metres.
• Low risk: the rest of the country below 2,500 metres, including New Delhi, Mumbai, Kolkata, Rajasthan and the Andaman and Nicobar Islands.
• Malaria-free: altitudes from 2,500 metres in Himachal Pradesh, Jammu, Kashmir and Sikkim.

In high-risk areas the Federal Foreign Office considers preventive medication sensible in addition to mosquito protection, and for remote moderate-risk areas emergency standby treatment may be recommended. The choice of medication is a matter for your doctor. Our guide to malaria prevention explains more.

Dengue, chikungunya and other risks

Dengue occurs mainly on the coasts but also in cities and at altitudes up to around 1,500 metres. Chikungunya is transmitted particularly during and after the rainy season in coastal areas and the big cities. Leishmaniasis, West Nile fever and Zika also occur. Protect yourself against mosquitoes day and night and sleep under a net. When spending time outdoors in nature, especially in Gujarat, protect yourself against ticks as well.

The Federal Foreign Office also points out:

• Fresh water: avoid swimming and bathing in lakes, rivers and hot springs, where rare but serious amoebic infections and schistosomiasis occur.
• Air pollution: air quality in the major cities is poor, especially in winter, which can worsen respiratory conditions such as asthma.
• Altitude: altitude sickness is possible in the north. Mountain rescues are carried out by the military and can take days to organise.

Rabies and hygiene

There is a high rabies risk nationwide from bites by stray dogs, cats and, less often, monkeys. According to the Federal Foreign Office, the treatment needed after a bite is not assured for unvaccinated travellers outside the large cities, including on trekking routes. For tours away from the major cities in particular, it is worth discussing rabies vaccination before you go. After a bite, wash the wound immediately with soap for at least 15 minutes and seek medical help straight away, see rabies and travel.

Travellers’ diarrhoea is common. Drink water from safe sources, eat cooked food and wash your hands thoroughly. Because of repeated, locally limited outbreaks of Nipah virus in Kerala and West Bengal, the Federal Foreign Office advises avoiding potentially contaminated fruit and palm sap.

Medical care in India

In the large cities, private clinics usually offer a high standard of care, but a substantial deposit is often required before treatment begins. In large parts of the country emergency care is inadequate, and a reliable ambulance service is lacking in many places. The Federal Foreign Office recommends travel health insurance with medical evacuation cover and, for trekking, cover for mountain risks. Pack a well-stocked travel health kit, as resistance to common antibiotics is widespread.

Timeline before departure

According to STIKO and the DTG, travel vaccinations should be completed at least two weeks before departure. As several vaccinations often come together for India, book your consultation early. If you are combining your trip with Nepal or trekking above 2,300 metres, altitude medicine advice is also worthwhile. Practices offering travel medicine are listed in our travel clinics directory.