As in my previous question let me start by stating family and I are planning to travel to Peru and Ecuador, we are planning to also visit the Amazon lodge such as this one.

From the US State Department's travel site I gather that we would need a Yellow Fever vaccinations prior to travel but the site also mentioned other diseases that occur there, so my question is from a fairly practical nature:

Besides Yellow Fever what vaccinations are actually good to have current while traveling the Inca Trail and the Amazon?

  • What about none? You won't enjoy such beautiful countries if you think the diseases are running amok. Perhaps in Amazon few precautions should be taken, since it is remote -but I see no problem otherwise. The title is not specific enough-Peru and Ecuadir are big, with jungle, coasts, mountains, islands. I have been to Peru with no medication and "curiously" I survived. Jan 14, 2012 at 3:54
  • I don't think about diseases run amok I just take precautions.
    – Karlson
    Jan 14, 2012 at 4:14
  • Disagree. Almost any health professional will recommend that you get at least some vaccinations for South America, and indeed it is LAW in some countries. Sure the jungle may have more disease from animals than a city block in Lima, but that doesn't mean you won't come into contact with someone who has just been to the jungle - who funnily enough, may be staying in a hostel/hotel with other travellers eg. you!
    – Mark Mayo
    Jan 16, 2012 at 12:51
  • I worried about diseases before I got to South America, now I have been traveling here for 22 months I don't worry at all. I would be more concerned crossing a city street here - lots of locals have accidents with cars, which given how many people drive here is not surprising. I have been nearly run over myself a few times and I always look both ways before crossing! Oct 3, 2012 at 1:37

5 Answers 5


The CDC (Center for Disease Control) has a list and information about health in Peru and health in Ecuador.

You'll want to make sure your MMR, Polio and other regular ones are up to date. Tetanus too, because it's just annoying to have to get in a foreign country if you do injure yourself.

Scroll down the list, and you'll see Hep A, B, Typhoid are also required. Rabies is suggested (although if you get bitten you'll still need another one after) and Yellow Fever is recommended for certain areas, including at altitude (read Inca Trail).

There's currently a focus on measles there, so I'd make extra sure it's up to date.

And of course, find out what type of anti-malaria is appropriate. Remember some brands (in the UK at least) cost 100 times as much (I kid you not), but are only 5% more effective (90 vs 95). Some are more effective against Asian or African variants. Some people react to different ones. So discuss it with your travel doctor first.

On a personal note, take the strongest DEET and anti mosquito/bug spray you've got. At Machu Picchu, I've never been bitten so many times in my life - I had 40-60 bites on each leg alone! Sainsbury supermarket spray was NOT adequate.

Still totally worth it tho ;)


So Rabies is suggested? Before I started traveling I thought I don't hang out with animals I don't need that, in the end I still took it, better safe than sorry.

I was bitten by a street dog in the hills around Cusco (near Machu Picchu). I was just walking down the street when a bunch of them attacked me.

So you need three rabies shots and they are not cheap but I still recommend them in South America.

As Mark said, you still need another shot after you have been bitten, but you have more time to get it, if you have been vaccinated before.


Neither Peru or Ecuador require you to have a Yellow Fever vaccination before entering (see http://www.passporthealthusa.com/vaccinations/yellow-fever/ for a list of countries that do require it such as Bolivia). However there is some Yellow Fever in the Amazon areas of both countries (see map of Yellow Fever infected areas in above link). So if you are planning to go into the jungle, or you might take a side trip to Bolivia, then you might want to get Yellow Fever vaccination before you leave. If you are staying in the highlands then I think it is not so important. I personally also got vaccinated for Yellow Fever, Hep-A, Hep-B, Typhus, Polio booster and Tetanus. I had some reactions for a few days then I was fine. I got some Malaria pills to use if I got symptoms but decided not to take them prophylactically because the side effects were pretty bad.

There are possible adverse reactions and risks to vaccines and malaria pills too, so it makes sense to weigh the risk of getting a disease vs the risk of a reaction. In addition some diseases such as Dengue Fever do not have a vaccine at all. Just like Yellow Fever and Malaria it is carried by some mosquitoes. So a barrier and (strong) insect repellent strategy is a good idea whether or not you decide to get vaccinated. Barrier means wearing long pants, socks, long sleeved shirts with tight wrists and a mosquito net at night.

Staying healthy (ie eat well, sleep well, exercise, avoiding excessive alcohol or drugs, unprotected sex etc) while you are traveling is a good way to keep your immune system up and reduce the risk of getting ill.

I have been traveling in South America for 22 months now and I have not had any issues with all of the diseases mentioned above. So have a great time on your trip!


On NHS Fit for travel we can find the following information about immunisations for:


  • Courses or boosters usually advised: Hepatitis A; Tetanus; Typhoid.
  • Other vaccines to consider: Hepatitis B; Rabies; Yellow Fever.


  • Courses or boosters usually advised: Hepatitis A; Typhoid.
  • Other vaccines to consider: Hepatitis B; Rabies; Tetanus; Yellow Fever.

Usually you can get one combined vaccine preparation for both Hepatitis A virus GBM strain and Salmonella typhi (Ty 2 strain) and separate for Tetanus.


In Peru and Ecuador, also Malaria precautions are essential in some areas. So please consider suitable antimalarial tablets, if travelling to high risk malarious areas, remote from medical facilities, carrying emergency malaria standby treatment may be considered. Malaria is a serious and sometimes fatal disease transmitted by mosquitoes and causes symptoms that typically include fever, fatigue, vomiting, headaches (sometimes muscle pains, diarrhoea, generally feeling unwell) and in severe cases it can cause yellow skin, seizures, coma or death.

The risks to health whilst travelling will vary between individuals and many issues need to be taken into account, e.g. activities abroad, length of stay and general health of the traveller. So it is recommended that you consult with your General Practitioner or Practice Nurse 6-8 weeks in advance of travel. They will assess your particular health risks before recommending vaccines and /or antimalarial tablets.

In Peru, Malaria risk throughout the year. Risk is present in rural areas below 2000m. Risk is highest in the department of Loreto in the Amazon. Risk is lower in other areas and low to no risk in areas West of the Andes, except the district of Piura, and at altitude.

In Ecuador, Malaria is present throughout the year below 1500m. There is moderate risk in coastal provinces and no risk in Guayanquil, Quito, other cities in the inter-Andean region and the Galapagos islands.

For full list of high risk areas, please check Peru and Ecuador Malaria Maps at NHS site.

See also:

  • Malaria Travel Health Advice at Fit For Travel (NHS) including country specific malaria information and malaria maps.
  • Malaria and Travelers at Centers for Disease Control and Prevention (CDC) to find out whether malaria is a problem in the country where you will be traveling.

I have no idea and try to wrap my head around it.

My internal operating system is wired in a way that word "may" means "whatever".

However the word "may" is constantly abused ("calls may be recorded", "you may be liable to fine") that at some point I treat "may" as "must"

Some notable sources I was able to find

Get vaccines or medicines you may need

You may need certain vaccinations before traveling to Peru

Visit your health professional at least 4 to 6 weeks before your trip to check whether you need any vaccination

Confirm primary courses and boosters are up to date as recommended for life in Britain - including for example, vaccines required for occupational risk of exposure, lifestyle risks and underlying medical conditions.

Courses or boosters usually advised: Hepatitis A; Tetanus; Typhoid.

Other vaccines to consider: Rabies; Yellow Fever.

No yellow fever vaccination certificate required for this country.

There are no certificate requirements under International Health Regulations (2005).

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