Travel vaccinations for South Africa: requirements, recommendations and malaria in the Kruger area

South Africa requires no vaccinations if you arrive directly from Germany. As a travel vaccination, the German Federal Foreign Office (Auswärtiges Amt) mainly recommends hepatitis A, with hepatitis B and rabies added for longer stays or particular exposure. Malaria only occurs in the north and north east, most intensely in the Kruger area between September and May. Cape Town, the Garden Route and the rest of the south are malaria-free.

Entry rules: yellow fever and transit

According to the Foreign Office, there are no mandatory vaccinations for direct arrival from Germany. South Africa itself is not a yellow fever country. Proof is required, however, if you arrive from a yellow fever country, and also if you spent more than 12 hours in transit there. The Foreign Office gives connections in Nairobi or Addis Ababa as examples. Because flights can be delayed and transit times cannot always be verified, it recommends vaccination even for shorter transits through such a country.

So if you fly via East Africa or combine South Africa with Kenya, discuss yellow fever vaccination early. The Foreign Office notes that a single vaccination is now accepted as lifelong proof for international travel. In Germany it is only given at approved yellow fever vaccination centres.

Recommended vaccinations according to the Foreign Office

The table at the top of this page summarises the classification. In context:

• All travellers: hepatitis A.
• Long stays or particular exposure: hepatitis B and rabies. The Foreign Office gives self-drive travellers camping, contact with wild animals and animal welfare project work as examples.
• Cholera: according to the Foreign Office only very rarely indicated, for example when working in a hospital with cholera patients.
• Routine vaccinations: check that you are up to date with the STIKO schedule, the official German vaccination calendar. Our guide to routine vaccinations for adults explains which ones apply.

Compared with many long-haul destinations, the vaccination effort for South Africa is modest. That makes it all the more worth looking at your route, because the differences between Cape Town and the Lowveld in the north east are considerable.

Malaria: where and when the risk exists

According to the Foreign Office and the DTG, malaria risk depends on region and season. More than 99 per cent of cases are falciparum malaria.

In risk areas, protect yourself consistently against mosquito bites, especially at dusk and at night, using repellent, long clothing and a bed net. For high-risk areas the Foreign Office also considers preventive medication useful. For moderate-risk areas more than 48 hours away from a facility able to diagnose malaria, it advises carrying medication for emergency standby treatment. Which approach suits your trip is something to decide with your doctor. Our guide to malaria prevention explains the background.

If you develop a fever after a trip to the north east, even months later, have malaria ruled out straight away and mention your journey.

What depends on your type of trip

If you combine South Africa with Namibia, go through both countries together during your consultation.

HIV, water, bilharzia and sun

According to the Foreign Office, HIV is the biggest health problem in South Africa and is very widespread among adults. Condoms protect during sexual contact. Tuberculosis is mainly relevant for travellers in healthcare settings or during longer stays in crowded housing.

Diarrhoeal illness is among the most common travel complaints. The Foreign Office advises drinking only water from a safe source, never tap water, and paying attention to food and hand hygiene. Bilharzia (schistosomiasis) can be transmitted in fresh water in Limpopo, Mpumalanga, KwaZulu-Natal and in the Eastern Cape near Port Elizabeth, so do not swim in open fresh water there.

South Africa lies in a zone of increased UV radiation. Sun protection with a hat and high-factor sunscreen is important, even on coasts with a cool sea breeze.

Medical care in South Africa

The Foreign Office rates medical care as good overall. Private hospitals in the large cities are of European standard, state hospitals lag behind and care in rural areas is weaker. Payment upfront is generally required for treatment, sometimes in substantial amounts. Travel health insurance with repatriation cover is therefore strongly advised.

Timing and costs

Plan your travel health consultation a few weeks before departure. STIKO and DTG recommend completing travel vaccinations at least two weeks before you leave. You can find a suitable practice in Germany in our directory of travel clinics, and the travel vaccine check gives a first overview. What German statutory health insurers cover for private trips is explained in our guide to travel vaccination costs.