Which vaccinations do you need for East Africa?

Yellow fever is the vaccination with a legal requirement attached: Uganda and Rwanda require a valid international certificate from arriving travellers, and Kenya and Tanzania require one from travellers arriving from or transiting a country with a risk of transmission, which includes Uganda and Rwanda. Everything else is a medical recommendation rather than an entry condition, and it is made by a doctor who knows your history, not by a tour operator. In practice most travellers to this region are advised to be up to date on routine immunisations and to consider hepatitis A and typhoid, with tetanus, hepatitis B, rabies, meningitis and cholera discussed depending on the trip. Malaria is not a vaccination question at all for most travellers and is handled with prescribed tablets. Book a travel clinic appointment six to eight weeks before you fly, because some courses need more than one dose.

Who actually requires a yellow fever certificate?

Two practical consequences follow. First, on any multi-country trip in this region you will need the certificate, because moving from Uganda or Rwanda into Kenya or Tanzania triggers the transit rule. Second, carry the physical yellow card, not a photograph of it. Border officials ask for the document.

The certificate becomes valid ten days after vaccination, so this is not something to do the week before you fly. Under current International Health Regulations a single dose is treated as valid for life, and older certificates showing a ten-year expiry are still accepted, but if yours predates that change ask your clinic to confirm the position for the countries on your itinerary.

If you cannot be vaccinated for a genuine medical reason, ask your doctor for an exemption letter on headed paper. Acceptance is at the discretion of the officer at the border, so travel with the letter and expect questions.

What else is usually recommended?

This is a general list of what travel clinics commonly discuss for this region. It is not advice for you personally, and a clinic will change it based on your itinerary, your age, your medical history and how long you are staying.

• Routine immunisations. Measles, mumps and rubella, diphtheria, polio and tetanus brought up to date. Measles in particular is often overlooked in adults.
• Hepatitis A. Commonly recommended, food and water borne.
• Typhoid. Commonly recommended, particularly for longer trips or where you will eat outside hotels and camps.
• Hepatitis B. Often discussed for longer stays or where medical treatment might be needed.
• Rabies. Worth discussing seriously. Bats, dogs and monkeys are all vectors, and post-exposure treatment is not quickly available in remote areas. Pre-exposure vaccination does not remove the need for treatment after a bite, but it buys time and simplifies what is needed.
• Meningococcal meningitis. Discussed for some itineraries and seasons.
• Cholera. Occasionally advised depending on current outbreaks and where you are going.

What about malaria?

Almost all of the safari region is a malaria area, including Bwindi, the Serengeti, the Masai Mara and the Ugandan savannah parks. Prophylaxis is prescribed and the common options each have different dosing schedules, different side effect profiles and different suitability for children and for pregnancy. That is a conversation with a clinic, not a decision to make from an article.

The tablets are only half of it. Bites are prevented by covering arms and legs from late afternoon, using a repellent containing DEET on exposed skin, and sleeping under the net your camp provides. The mosquito that carries malaria bites from dusk to dawn, which is exactly when you are sitting outside at the fire.

Learn the symptoms, because this is the one that matters after you get home. Malaria presents like flu: fever, headache, aching, sometimes sickness. It can appear up to a year after you return. If you develop a fever within twelve months of an African trip, tell the doctor you have been to a malaria area and ask specifically for a malaria test.

When should I see a travel clinic?

Six to eight weeks before departure. Some courses need multiple doses spaced weeks apart, yellow fever needs ten days to become valid, and rabies pre-exposure is a short course rather than a single injection.

Take your itinerary with you, including the specific parks and any nights outside main towns. A clinic advises differently for two nights in Kigali than for three weeks moving through rural Uganda.

If you have left it late, go anyway. Something is better than nothing, and a clinic will tell you what can still be done usefully in the time available.

What else keeps people well out here?

• Water. Filtered or bottled only, including for brushing teeth. Every camp we use provides safe refills, so bring a bottle.
• Tsetse flies. Present in parts of the region. Their bite hurts, they are attracted to dark blue and black, and repellent barely deters them. Wear neutral colours and keep the window up through infested woodland.
• Sun and altitude. Bwindi, Volcanoes and Ngorongoro all sit high enough that the sun burns faster than the temperature suggests, and mild altitude effects on the first day are normal.
• Do not swim in fresh water unless your guide confirms it is safe. Bilharzia is present in parts of Lake Victoria and in slow rivers, and hippo and crocodile are present in many of the places that look inviting.
• Bring a written prescription for any regular medication, and keep it in its original labelled packaging in your hand luggage.

Do I need insurance as well?

Yes, and comprehensive travel insurance including emergency air evacuation is a condition of travelling with us. The reason is specific: good hospitals in this region are in the capitals, and if something serious happens in a park you are being flown, not driven. Check that your policy covers medical evacuation, repatriation, and any activity endorsement your trip requires, and carry the policy number and the twenty four hour assistance number with you rather than in an email you cannot reach.

Nothing on this page is medical advice. It is a planning summary written by a tour operator so you know what to ask. Requirements and recommendations change, so confirm the current position with a travel clinic and with the official government travel advice for your own country before you fly.