Vaccinations & Health Rules for Madagascar — German Citizens 2026

Quick Answer: Vaccine Requirements for German Travellers to Madagascar

Yellow fever vaccination is required only if you are arriving from or transiting >12 hours through a country with yellow fever transmission risk—not simply because you're visiting Madagascar, as the country itself has no yellow fever circulation. If you're flying direct from Germany or via non-endemic countries, a yellow fever certificate is not a legal entry requirement, though the CDC does not recommend the vaccine for Madagascar travel on health grounds.

However, malaria prophylaxis is essential: malaria is present throughout Madagascar except in Antananarivo, and chloroquine-resistant parasites are widespread. Hepatitis A, typhoid, and routine vaccines (diphtheria, tetanus, polio, MMR, measles) are also strongly recommended for most travellers.

Plan your vaccinations at least 8 weeks before departure with a travel health clinic, as some vaccines require multiple doses or have spacing requirements.

Yellow Fever Certificate: Entry Rules for German Citizens

When a Yellow Fever Certificate Is Required

Madagascar's entry regulations require proof of yellow fever vaccination (as an International Certificate of Vaccination or Prophylaxis, ICVP) only for travellers aged 9 months and older who are arriving from—or have transited for more than 12 hours through—a country with yellow fever virus transmission risk. Since Germany is not a yellow fever endemic country, German citizens flying directly from Germany do not require a yellow fever certificate.

However, if your itinerary includes a stopover >12 hours in a yellow fever endemic country (such as in West or Central Africa), you will need to present a valid yellow fever certificate at Madagascar immigration, even if you do not leave the airport during the transit.

Certificate Validity & Timing

A yellow fever certificate becomes valid 10 days after vaccination and is valid for life as of 11 July 2016 under WHO International Health Regulations. Booster doses are no longer required by any country. This means a certificate from a previous trip remains valid indefinitely.

If you do need the vaccine, allow at least 10 days between vaccination and travel to Madagascar to ensure protection is effective.

Medical Waivers & Contraindications

If yellow fever vaccination is contraindicated for medical reasons (e.g., severe allergies, immunosuppression, pregnancy), your doctor can issue a medical waiver. However, border authorities may not always honour waivers, and you should take strict mosquito bite precautions in yellow fever risk areas if unvaccinated.

Recommended Vaccinations for Madagascar Travel

The CDC, WHO, and travel health authorities recommend the following vaccinations for German citizens travelling to Madagascar. Schedule these with a travel clinic at least 8 weeks before departure.

Vaccine	Recommendation	Timing & Notes
Hepatitis A	Strongly recommended for most travellers	2-dose series (0 and 6–12 months). Protects against contaminated food/water.
Typhoid	Strongly recommended, especially for rural areas or stays with local families	Single shot (2-year protection) or oral vaccine (5-year protection, requires refrigeration).
Polio (IPV)	Single booster recommended for adults	Madagascar is vulnerable to polio outbreaks; ensure you are up to date.
Rabies	Recommended, especially for longer stays, rural travel, or activities with animal contact	Pre-exposure prophylaxis is 3 doses (0, 7, 21–28 days). Discuss with your doctor based on activities.
Routine: dTP (Diphtheria, Tetanus, Pertussis)	Ensure up to date	Booster every 10 years. Verify your status in your German vaccination record.
Routine: MMR (Measles, Mumps, Rubella)	Ensure up to date	2 doses required; verify in your vaccination record.
Routine: COVID-19	Up-to-date vaccination recommended	Check current entry requirements before travel.
Hepatitis B	Recommended for most travellers	3-dose series (0, 1, 6 months). Consider if you may have exposure to blood or sexual contact.
Chikungunya	Consider for rural or extended travel	An active chikungunya outbreak has been confirmed in Mahajanga, Toamasina, and Antsirabe since mid-2025; mosquito precautions essential.

Vaccination Timeline for German Travellers

• 8 weeks before departure: Book your travel health appointment. Some vaccines (e.g., hepatitis A, typhoid) require 2 doses spaced weeks apart.
• 4–6 weeks before: Receive first doses of multi-dose vaccines.
• 2–4 weeks before: Complete second doses and receive single-dose vaccines (e.g., typhoid shot, yellow fever if required).
• 10 days before: If yellow fever vaccination is required, ensure you've had it at least 10 days prior to departure.

Malaria: Risk Areas, Prophylaxis & Prevention

Who Needs Malaria Prophylaxis?

All travellers to Madagascar except those staying only in Antananarivo (the capital) need malaria chemoprophylaxis. Malaria is present year-round in all regions of Madagascar outside the capital, transmitted by Anopheles mosquitoes. Parasites are resistant to chloroquine, so outdated medications are ineffective.

Recommended Antimalarial Medications

Your travel health doctor will prescribe one of the following based on your itinerary, medical history, and length of stay:

• Atovaquone/proguanil (Malarone): Taken daily with food. Start 1–2 days before entering a malaria area, continue daily during stay, and for 7 days after leaving. Suitable for short trips with frequent activities. Generally well tolerated.
• Doxycycline: Taken daily on an empty stomach (1 hour before or 2 hours after food). Start 1–2 days before, continue during stay, and for 4 weeks after leaving. Cost-effective for longer trips but requires sun protection and stomach precautions.
• Mefloquine: Taken once weekly, starting 1–2 weeks before travel and continuing for 4 weeks after leaving. Suitable for those who cannot tolerate daily medications but has neuropsychiatric side effects in some people.
• Tafenoquine (Krintafel): Single-dose option (taken once before travel, then once weekly or monthly depending on formulation). Requires G6PD deficiency screening before use.

Discuss these options with your doctor 4–6 weeks before travel to allow time for testing (e.g., G6PD screening) if required.

Personal Protection Against Mosquito Bites

Antimalarial medication alone is not sufficient. Combine chemoprophylaxis with aggressive mosquito bite prevention:

• Insect repellent: Use EPA-registered repellents containing DEET (20–30%), picaridin, IR3535, oil of lemon eucalyptus (OLE), or para-menthane-diol (PMD). Apply to exposed skin and clothing.
• Mosquito nets: Sleep under an insecticide-treated bed net, especially in rural areas.
• Clothing: Wear long sleeves and trousers, especially at dawn and dusk when mosquitoes are most active.
• Permethrin treatment: Treat clothing, boots, and gear with permethrin (0.5%) before travel; protection lasts through several washings.
• Air conditioning & screens: Stay in air-conditioned or screened accommodation where possible.

Other Health Risks & Prevention

Plague (Seasonal Risk)

Plague is endemic to Madagascar with seasonal upswings from September through April. There is no vaccine. Prevention relies on avoiding contact with infected animals and flea bites: use insect repellent, avoid dead animals, and seek medical care immediately if you develop fever, swollen lymph nodes, or respiratory symptoms during or after travel.

Water & Food Safety

Tap water in Madagascar is unsafe for drinking. Drink only boiled or bottled water, and avoid ice in drinks. Hepatitis A and typhoid are waterborne/foodborne risks; vaccination and careful food hygiene are essential. Avoid raw vegetables, undercooked meat, and street food unless you are confident in hygiene standards.

Other Mosquito-Borne Diseases

Dengue and chikungunya are present in Madagascar. There is no vaccine for dengue; chikungunya vaccine availability varies. Mosquito bite prevention (above) is your best defence.

Schistosomiasis & Other Parasites

Schistosomiasis (water-borne parasite) is present in Madagascar. Avoid swimming in rivers, lakes, or untreated water sources. Wear shoes in rural areas to prevent hookworm and other soil-transmitted parasites.

Altitude Sickness

If trekking in mountainous regions of Madagascar, altitude sickness is a risk. Ascend gradually, stay hydrated, and consult your doctor about symptoms and acclimatization strategies.

Health Documents & Travel Insurance

What to Carry

Before departure, ensure you have:

• International Certificate of Vaccination or Prophylaxis (ICVP, "yellow WHO card"): Carry the original certificate if you received yellow fever vaccination. Keep a copy with your passport.
• Vaccination record (Impfpass): Bring your German vaccination booklet (Impfpass) or a certified copy showing routine and travel vaccinations.
• Prescription for antimalarial medication: Carry your prescription and the original medication packaging.
• Travel health insurance documentation: Include policy details, emergency contact numbers, and proof of coverage.
• Doctor's letter (if carrying syringes/needles): If you have a chronic condition requiring injections, carry a letter from your doctor explaining your medical needs.

Travel Health Insurance (Highly Recommended)

Madagascar's healthcare system is limited outside Antananarivo; complex surgeries are referred to Mauritius, South Africa, or Réunion. Comprehensive travel health insurance with medical evacuation coverage is essential. Ensure your policy covers:

• Emergency medical treatment and hospitalisation
• Medical evacuation and repatriation to Germany
• Malaria treatment and tropical disease cover
• Pharmacy and doctor visit costs

Verify coverage before departure and keep policy documents accessible.

Medications: What You Can Bring to Madagascar

Prescription Medications

The legal status and availability of medicines in Madagascar differ from Germany. Carry all prescription medications (including antimalarials, insulin, or cardiac drugs) in original packaging with your name clearly marked. Bring more than you think you'll need, as refills may be unavailable. A letter from your German doctor explaining your medical condition and medications is advisable.

Over-the-Counter Medications to Pack

• Traveller's diarrhoea treatment: Oral rehydration salts, loperamide (Imodium), or an antibiotic (e.g., azithromycin, prescribed by your doctor).
• Pain & fever: Paracetamol or ibuprofen
• Antihistamine: For allergies and insect bite itch
• Antacid: For indigestion
• Antibiotic ointment & sterile dressings: For cuts and wounds
• Sunscreen: SPF 30+, especially if taking doxycycline (photosensitivity risk)
• First aid kit: Including sterile syringes and needles (medical supplies are scarce in Madagascar).

Medication Restrictions

Some medications legal in Germany may be prohibited or restricted in Madagascar. Consult your travel clinic or the German embassy in Madagascar before packing unusual medications.

Healthcare Facilities & Emergency Contacts in Madagascar

Medical Care Quality

Comprehensive medical facilities are available only in Antananarivo and a few other major cities, and only at private clinics. Sterile surgical supplies (syringes, needles, sutures) are often in short supply. For any serious illness or injury, evacuation to Mauritius, South Africa, or Réunion may be necessary—which is why travel insurance with medical evacuation is critical.

Emergency Numbers

• Ambulance: Call 117 from a mobile phone or 17 from a landline and request an ambulance.
• Contact your travel insurance provider immediately if you require medical care.

Finding English-Speaking Doctors

The UK Foreign, Commonwealth & Development Office (FCDO) maintains a list of medical providers in Madagascar where some staff speak English. Check the FCDO website or contact your embassy before travel.

Before You Travel: Final Health Checklist

• ☐ Schedule a travel health appointment 8 weeks before departure with a doctor or travel clinic familiar with Madagascar.
• ☐ Review your routine vaccinations: Ensure dTP, MMR, COVID-19, and polio are current.
• ☐ Receive recommended travel vaccines: Hepatitis A, typhoid, rabies (if planning longer stay or animal contact), and yellow fever (if your itinerary includes endemic countries).
• ☐ Obtain antimalarial prescription 4–6 weeks before travel; start prophylaxis as directed (typically 1–2 days before entering a malaria area).
• ☐ Purchase comprehensive travel health insurance with medical evacuation cover.
• ☐ Pack a first aid kit including insect repellent, sunscreen, sterile supplies, and over-the-counter medications.
• ☐ Carry vaccination records: Your ICVP (if yellow fever vaccinated), Impfpass, and a copy of your antimalarial prescription.
• ☐ Check entry requirements: Confirm visa and vaccination documentation on the official Madagascar immigration portal (visa.gov.mg).
• ☐ Register with your embassy: If staying >60 days, register with the German embassy in Madagascar.

Linking Your Safari Plans to Health Preparation

If you're planning a Madagascar safari, your travel itinerary—whether you're visiting national parks in remote areas or staying in Antananarivo—directly affects your health precautions. Rural and forest locations increase malaria and plague risk, so ensure you start antimalarial prophylaxis as soon as you enter a malaria zone and maintain strict mosquito bite prevention. For more on planning your trip, see our complete Madagascar entry requirements guide and Madagascar visa guide for German citizens.

You can compare safari packages and health-aware tour operators on SafariFind, where many providers include health briefings and malaria-safe accommodations in their itineraries.

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Last checked July 2026 — always confirm with official sources before travelling. Health requirements and disease risks change; consult your travel health provider and check the CDC Traveler View for Madagascar and the German Auswärtiges Amt (German Foreign Office) website for the latest guidance.

Frequently Asked Questions

Do German citizens need a yellow fever vaccination to enter Madagascar?

Only if you are arriving from or transiting >12 hours through a country with yellow fever transmission risk. Direct travel from Germany does not require a yellow fever certificate, as Germany is not endemic and Madagascar itself has no yellow fever circulation. However, if your route includes a stopover in West or Central Africa, you will need proof of vaccination.

Is malaria a risk in Madagascar for German travellers?

Yes, malaria is present year-round in all regions of Madagascar except Antananarivo (the capital). All travellers outside the capital require antimalarial prophylaxis. Parasites are resistant to chloroquine, so outdated medications are ineffective. Start prophylaxis 1–2 days before entering a malaria zone and continue for 4–7 days (depending on the drug) after leaving.

What antimalarial medication should I take for Madagascar?

Your travel health doctor will prescribe one of four options based on your itinerary and health: atovaquone/proguanil (Malarone, for short trips), doxycycline (cost-effective for longer stays), mefloquine (weekly dosing), or tafenoquine (single-dose option, requires G6PD screening). Discuss these options 4–6 weeks before travel to allow time for any required testing.

How long before travel should I get vaccinations for Madagascar?

Schedule your travel health appointment at least 8 weeks before departure. Some vaccines (e.g., hepatitis A, rabies) require multiple doses spaced weeks apart. Yellow fever vaccine, if required, must be given at least 10 days before travel to ensure protection.

Which routine vaccinations do I need to check before going to Madagascar?

Ensure you are up to date on dTP (diphtheria, tetanus, pertussis), MMR (measles, mumps, rubella), polio, and COVID-19. Check your German Impfpass (vaccination booklet). A polio booster is recommended, as Madagascar is vulnerable to outbreaks.

Is hepatitis A vaccination required for Madagascar?

Hepatitis A is strongly recommended, especially if you plan to stay with local families, visit rural areas, or eat street food. The vaccine requires 2 doses spaced 6–12 months apart, so start early. Hepatitis A is transmitted through contaminated food and water.

Do I need rabies vaccination for a Madagascar safari?

Rabies vaccination is recommended for longer stays (>3 weeks), rural travel, and activities involving potential animal contact (e.g., wildlife work). Pre-exposure prophylaxis is 3 doses (at 0, 7, and 21–28 days). Discuss with your travel health doctor based on your specific itinerary and activities.

What travel health insurance should I buy for Madagascar?

Comprehensive travel health insurance with medical evacuation coverage is essential, as healthcare outside Antananarivo is limited and serious cases are flown to Mauritius or South Africa. Ensure your policy covers emergency treatment, pharmacy costs, and repatriation to Germany. Check coverage details before departure.

Can I drink tap water in Madagascar?

No, tap water in Madagascar is unsafe. Drink only boiled or bottled water, and avoid ice in drinks. This is why typhoid and hepatitis A vaccinations are recommended—these diseases are transmitted through contaminated water and food.

What should I pack in my first aid kit for Madagascar?

Pack insect repellent (DEET 20–30%), sunscreen (SPF 30+), sterile syringes and needles, antibiotic ointment, dressings, traveller's diarrhoea treatment, antihistamine, pain relief, and antacid. Medical supplies are scarce in Madagascar, so bring more than you think you'll need.

Is there an active chikungunya outbreak in Madagascar?

Yes, an active chikungunya outbreak has been confirmed in Mahajanga, Toamasina, and Antsirabe since mid-2025. There is no vaccine; prevention relies on mosquito bite precautions (insect repellent, nets, long clothing, permethrin-treated gear).

How do I get a yellow fever vaccination certificate for Madagascar?

Visit an authorised travel clinic or yellow fever vaccination centre (in Germany, many travel clinics and certain doctors offer this). You will receive an International Certificate of Vaccination or Prophylaxis (ICVP, the 'yellow WHO card') valid for life. The vaccine must be administered at least 10 days before travel. Keep the original certificate with your passport.