TRAVEL MEDICINE · PERU & THE ANDES
Peru Travel Vaccines: Yellow Fever, Malaria & Altitude Sickness
What you need depends entirely on your itinerary. Machu Picchu and Cusco are minimal — no yellow fever, no malaria pills. The Amazon is a different story. One fact applies everywhere: Peru does not require proof of any vaccine to enter the country. If your trip covers both the Andes and the jungle, read both sections below.
JUMP TO YOUR TRIP
Andes & Machu Picchu
Cusco Sacred Valley Lake Titicaca Lima, Few shots-but prepare for altitude.
The Amazon
Iquitos Puerto Maldonado. Yellow fever recommended, malaria pills required.
01
Machu Picchu, Cusco & the Andes
Most people who visit Peru stay in the highlands. You need very few shots for this route — but you do need to prepare for the altitude.
Yellow fever — not needed for Machu Picchu or Cusco
NO
You do not need the yellow fever vaccine for Machu Picchu, Cusco, Lima, or Lake Titicaca. Yellow fever spreads through mosquitoes in low, warm jungle areas — not at high altitude.
One thing to know: in 2025 the CDC flagged some lower-elevation areas near Machu Picchu as having minor yellow fever risk. The peak itself and the standard route — train through Aguas Calientes — remain low-risk. If your route passes through lowland jungle on the way in, let us know — your exact itinerary changes the answer.
Altitude sickness: prevention & medication
There is no altitude sickness vaccine. It is not an infection — it's your body reacting to thin air and low oxygen.
11,000 ft
Cusco
12,500 ft
Lake Titicaca
8–12k ft
Sacred Valley
~50%
of travelers feel it
Fly straight into Cusco from sea level and your body has no time to adjust. Symptoms — headache, nausea, fatigue, dizziness — are usually mild and resolve in a day or two.
How to prevent it
• Go up slowly; rest a day or two in Cusco before climbing higher
• Drink plenty of water; skip alcohol your first nights up high
• Each night, don't sleep more than 1,600 ft higher than the night before
We can also prescribe acetazolamide (Diamox) — 125 mg twice a day, starting the day before you go up, through your first two days at altitude. It helps your body adjust faster. You need a prescription, so see us before your trip.
If you have a serious heart or blood condition, talk to a doctor before you go.
Malaria risk: none in the highlands
NO
No malaria risk in Cusco, Machu Picchu, the Sacred Valley, Lake Titicaca, or Lima. Skip the pills for this route.
Traveling to Cusco or Machu Picchu?
Book a pre-travel consultation-we'll confirm what you need and prescribe altitude medication if needed.
02
The Amazon — Iquitos & Puerto Maldonado
If your trip includes Iquitos, Puerto Maldonado, or other jungle destinations, you need more protection.
Yellow fever vaccine for the Amazon
YES
If you're going into the Amazon, get the yellow fever vaccine. Peru had an outbreak in 2025 — 49 cases and 19 deaths — and new cases were reported in Madre de Dios in early 2026.
The vaccine is one shot. It takes 10 days to start working, so get it at least 10 days before you enter the jungle. For most people, one shot protects you for life — no booster needed for a normal trip.
Talk it through with us first if you're pregnant, over 60, breastfeeding, or have a weak immune system — we'll go over the risks together. An egg allergy is not a problem for this vaccine.
Your next country might require it. Ecuador, for example, asks for proof of yellow fever vaccination if you've spent more than 10 days in Peru. If you're continuing on, check its rules.
Malaria medication for the Amazon
REQUIRED
The Amazon has malaria. You'll need preventive medication for jungle destinations like Iquitos or Puerto Maldonado.
We'll help you pick the right one — the most common option is Malarone, and we'll recommend the best fit based on your health and trip details. Keep taking the malaria prevention medication after your last day in the jungle — 7 days for Malarone, up to 4 weeks for some other options
Dengue, Zika & other mosquito risks
The Amazon also has dengue and Zika. There's no routine vaccine for travelers, so the key is avoiding bites: use repellent with DEET, and wear long sleeves and long pants, especially in the daytime.
If you're pregnant, be extra careful — Zika can harm a pregnancy.
Heading to the Amazon?
Book now we stock the yellow fever vaccine and prescribe malaria medication same day.
03
Recommended for all Peru travelers
A few shots make sense no matter where you go in Peru.
Typhoid & Hepatitis A
Both spread through food and water. We recommend both for most Peru travelers, especially outside the big cities. — typhoid vaccine, hepatitis A vaccine
Rabies
Most travelers don't need this. Consider it only for long trips, adventure activities, or time around animals in remote areas. In Peru, bats are the main carriers. — rabies vaccine
Routine vaccines
Make sure you're up to date on MMR (measles, mumps, rubella), Tdap (tetanus), and COVID-19. Measles is rising in many countries, so MMR matters.
04
Frequently asked questions
Do I need a yellow fever vaccine for Peru?
It depends on your itinerary. You do not need it for Lima, Cusco, Machu Picchu, or Lake Titicaca. It is strongly recommended for the Amazon lowlands — including Iquitos, Puerto Maldonado, or the regions of Loreto, Ucayali, or Madre de Dios.
Does Peru require proof of yellow fever to enter?
No. Peru does not require any vaccine to enter. The yellow fever shot is recommended for the Amazon, but it's about your health, not a border rule.
Is there a vaccine for altitude sickness?
No. Altitude sickness isn't an infection. The best prevention is going up slowly. We can also prescribe acetazolamide (Diamox) to help your body adjust.
Do I need malaria pills for Cusco?
No. Malaria risk is only in the Amazon lowlands below 8,200 feet.
How long before my trip should I get vaccinated?
For yellow fever, at least 10 days before you enter the Amazon. For other shots, a few weeks is ideal. The sooner you come in, the better.
Can I get the yellow fever shot if I'm pregnant?
Talk to us first. Pregnancy is a reason to be careful with this vaccine, not an automatic no. We'll weigh your trip and your health together.
How long does yellow fever immunity last?
One shot protects most people for life.
What malaria medication is recommended for the Peruvian Amazon?
The most common option is Malarone. The right choice depends on your health history and trip details. We'll help you decide.
Get your Peru travel vaccines in Midtown Manhattan
Still have questions about your specific itinerary? We handle the whole plan in one visit: confirm exactly what you need, give the shots, write your prescriptions, and provide your yellow fever certificate.
35 W 36th Street, Suite 7E
New York, NY 10018
212.696.5900
This page is general information, not medical advice for your specific trip. Your plan depends on your health and your exact itinerary. See a travel medicine provider before you go.