Vaccinations for Madagascar: Full Recommended Schedule 2026

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Madagascar has no compulsory vaccinations for arrivals from non-yellow-fever countries — but the CDC, WHO and most travel medicine experts strongly recommend several. This guide walks through the routine and travel-specific schedule, what each disease actually looks like in Madagascar, and how to time everything.

Routine Vaccines: Confirm Before You Plan Anything

Before any travel-specific vaccine, make sure your routine adult vaccinations are current. These are: MMR (measles, mumps, rubella) — at least one dose in adulthood, two for those born after 1970 without childhood records; measles outbreaks have hit Madagascar repeatedly. Tdap or DTaP (diphtheria, tetanus, pertussis) — booster every 10 years; the tetanus risk in Madagascar is real, particularly with rural cuts or animal bites. Polio — one-time adult booster after the childhood series for travel to Madagascar (CDC recommendation due to occasional vaccine-derived poliovirus circulation in the region).

Varicella (chickenpox) — if you didn’t have chickenpox as a child and weren’t vaccinated, get the two-dose series before travel. Influenza — annual flu shot before any international travel, especially during outbreaks. COVID-19 — current vaccination status is recommended for general health protection though no longer required for entry. Get all routine catch-ups done at the same visit as your travel-specific vaccines to save time and copays. Plan your full preparation timeline using our Madagascar trip planning checklist.

Travel Vaccines Strongly Recommended for Madagascar

Hepatitis A is the single most important travel vaccine for Madagascar. Transmitted via contaminated food and water, it can incapacitate you for weeks. Two doses 6 months apart give lifelong protection; even a single first dose gives ~95% protection within 2 weeks. Get this no matter how short your trip. Typhoid — bacterial illness transmitted similarly to hepatitis A. Two forms: injectable (single shot, 2-year protection) or oral capsules (4 doses, 5-year protection). Inject if your departure is under 2 weeks away.

Hepatitis B — blood and body fluid transmission, including from medical procedures with unsterile equipment. Three-dose series; the standard series takes 6 months, the accelerated takes 3 weeks. Recommended for any trip longer than 2 weeks, anyone visiting medical facilities, getting a tattoo, or engaging in intimate contact. Rabies (pre-exposure) — three-dose series over 21–28 days. Strongly recommended if you are trekking remotely, working with animals, or staying in rural areas more than a few days. Madagascar has dog rabies; bites in rural areas may be hours from post-exposure treatment. The pre-exposure series buys you time and reduces the post-exposure protocol. Pack appropriate gear: see our Madagascar wildlife packing list.

Yellow Fever: When You Actually Need It

Madagascar does NOT have endemic yellow fever, and the country does not require yellow fever vaccination from travellers arriving direct from non-endemic countries (USA, Canada, UK, most of Europe, Australia). You DO need yellow fever vaccination if you are transiting through or arriving from any country with risk of yellow fever transmission — most of sub-Saharan Africa including Kenya, Ethiopia, Tanzania (mainland), Senegal, and most West African nations.

Key implications: if your routing is Europe → Madagascar direct, no yellow fever required. If your routing is Europe → Nairobi → Antananarivo, you need a yellow fever certificate (transit over 12 hours triggers it in some interpretations; safer to vaccinate regardless if Nairobi transit). The vaccine is a single dose with lifelong protection per current WHO guidance. Cost in Europe/North America is $150–250. The International Certificate of Vaccination (yellow card) must be carried with your passport — Madagascar border officials may ask, especially if your inbound flight came from Africa. For visit-timing context including airline routing, see our Madagascar best time to visit guide.

Flight delayed or cancelled? Connecting through Paris, Nairobi, or Addis Ababa is common for Madagascar. Check your claim free on AirAdvisor — EU connection delays may entitle you to up to €600.

Timeline, Cost and Where to Get Vaccinated

Start 6–8 weeks before departure. Some vaccines (rabies series, hepatitis B accelerated) need 3 weeks minimum. Yellow fever needs at least 10 days before entry. If you have less than 4 weeks, prioritise hepatitis A (single dose works), typhoid injectable (single shot), and yellow fever if needed. Skip the rabies series unless you can compress to the 3-week accelerated schedule.

Cost estimates (2026): Hepatitis A — $80–150 per dose; Typhoid injectable — $80–110; Typhoid oral — $80–100; Hepatitis B series — $150–250 total; Rabies pre-exposure series — $250–400 total (often the most expensive item); Yellow fever — $150–250. Total bill for a complete schedule including rabies: $700–1,200. Without rabies: $400–700. Where to get vaccinated: in the US, CVS Minute Clinic and Passport Health offer travel vaccines; in the UK, NHS Travel Clinics (some vaccines free, others paid) and private clinics like MASTA; in France, centres de vaccinations internationales (notably Institut Pasteur Paris); in Canada, public health travel clinics and private travel medicine specialists. Always carry your vaccination certificate in printed form plus an offline phone photo. Pair preparation with our Madagascar budget guide to plan the vaccine line item into total trip costs.

Frequently Asked Questions

Is rabies vaccination really worth $300+ for Madagascar?

If you are doing serious trekking in national parks (Andasibe, Tsingy, Andringitra), staying with rural homestays, working with animals, or visiting remote areas more than a day from a major hospital — yes. Madagascar has dog rabies and post-exposure human rabies immunoglobulin is often unavailable locally. Pre-exposure significantly improves your post-bite options.

What if I cannot do the rabies series in time?

Compress to the 3-week accelerated schedule (days 0, 7, 21) if at least 3 weeks remain before departure. If less, skip rabies, plan to wash any animal bite immediately with soap and water for 15 minutes, and head to Antananarivo for post-exposure treatment as fast as possible. Discuss with a travel medicine specialist.

Do I need a yellow fever certificate if I have a 4-hour layover in Addis Ababa?

Strict interpretation: yes if the airport transit lasts more than 12 hours; some immigration officers ask regardless of layover length. Many travellers vaccinate to avoid any risk of border refusal. The lifetime single-dose vaccine is the simplest insurance against this question.

Vaccinations for Madagascar are a one-time investment that protects you against the most common preventable travel illnesses. Start 6–8 weeks before departure, get hepatitis A and typhoid at minimum, and add rabies if your itinerary includes serious remote travel. Cover the rest with insurance: Get SafetyWing before you fly — from $1.82/day. For adventure-heavy itineraries, World Nomads adds trekking and diving cover; medical evacuation alone runs $30,000–$80,000 from Madagascar.