Travel health · Guatemala
Antigua, Lake Atitlán, Tikal and a line of volcanoes you can walk up. Which of those you have booked decides almost everything on this page.
The short version
Most travellers to Guatemala need 3 vaccines, and three to five weeks is enough time to do it properly.
Leaving sooner? Most of it can still be done — we prioritise what matters for your route. Nobody gets turned away for booking late.
Recommended for essentially everyone going to Guatemala.
Food and water, and the one vaccine nobody argues about. CDC recommends it for unvaccinated travellers one year old or older going to Guatemala; the Government of Canada recommends vaccination for all travellers to areas where hepatitis A is present.
Any time before you fly. One dose covers the trip; a second, six months later, covers decades.
Also food and water — and the vaccine where the two sources part company. CDC recommends it for most travellers to Guatemala, especially those staying with friends or relatives or visiting smaller cities and rural areas. The Government of Canada says there is a risk of typhoid in Guatemala but that the risk is low for most travellers, and that a vaccine may be recommended for some. We show you both rather than split the difference.
At least two weeks ahead. There is an injection, and there are oral capsules you finish over a week.
Tetanus, measles-mumps-rubella, polio, diphtheria, chickenpox. CDC asks every traveller to be current before every trip and asks all international travellers to be fully vaccinated against measles. Tetanus is the one that has usually lapsed, and it matters more than usual on a trip involving volcanic rock and long days on foot.
Tetanus if it has been more than ten years — which for most adults it has.
The honest answer to “am I too late?” depends on the date. Put yours in and we’ll work backwards. Nothing is sent anywhere.
Worth a conversation — the answer changes with where you’re going and what you’ll be doing.
The full list for Guatemala. Most people need the first two or three; the rest depend on where you are going and for how long.
Spread through contaminated food and water. CDC recommends it for unvaccinated travellers one year old or older going to Guatemala, and adds that infants 6 to 11 months old should also be vaccinated, with that dose not counting towards the routine two-dose series. The Government of Canada recommends vaccination for all travellers to areas where hepatitis A is present. The most useful single vaccine for this trip.
Also food and water. CDC recommends it for most travellers to Guatemala, especially those staying with friends or relatives or visiting smaller cities or rural areas. The Government of Canada calls the risk low for most travellers and says the vaccine may be recommended for some, depending on risk. Available here as an injection or as oral capsules taken over a week. See the note above for how we handle the difference.
CDC asks travellers to be up to date on all routine vaccines before every trip, and asks all international travellers to be fully vaccinated against measles with MMR, including an early dose for infants aged 6 to 11 months. The Government of Canada asks the same. Tetanus is the one people have let lapse.
Spread through blood and body fluids, including unplanned medical or dental care, tattooing and piercing. CDC recommends it for unvaccinated travellers younger than 60 travelling to Guatemala, and says unvaccinated travellers 60 and older may get vaccinated. The Government of Canada recommends hepatitis B vaccination for all travellers, to every destination. Many Canadians already have it from the school programme, so we check the record rather than assume.
CDC says all eligible travellers should be up to date with their COVID-19 vaccines, and the Government of Canada asks you to discuss it with a healthcare provider before travelling. Easy to do on the same visit if you are due.
CDC says dogs infected with rabies are sometimes found in Guatemala and that rabies is also present in bats, and frames pre-exposure vaccination around whether your activities raise the chance of animal contact and whether you could get prompt post-exposure treatment. The Government of Canada goes further, calling rabies common in this destination, naming veterinarians and wildlife workers, children, adventure travellers and cave explorers among those at higher risk, and warning that treatment to prevent rabies may be limited or not available so you may need to travel elsewhere for it. Caves, volcano huts, long rural stays and small children are what move this from “no” to “let us talk about it”.
CDC says all travellers should take steps to prevent mosquito bites and that chikungunya vaccination is generally not recommended for Guatemala. The Government of Canada says there is a risk of chikungunya in the country, varying by season, year, region and elevation, and notes a vaccine is approved in Canada which you should weigh against your age and itinerary. A conversation, not a default.
Not for Guatemala itself: CDC says the vaccine is not recommended, and the Government of Canada says there is no risk of yellow fever in the country and that vaccination is not recommended. But the entry rule is stricter than most people expect. CDC says direct travel from North America needs nothing, while travellers arriving from a country with risk of yellow fever transmission must show proof from one year of age — and that this includes airport transits or layovers longer than twelve hours in such a country. The Government of Canada puts it the same way: proof is required if you are coming from, or have transited through an airport in, a country where yellow fever occurs. If Guatemala is one leg of a bigger trip — Panama, Colombia, Brazil, Peru — bring the whole itinerary and we will check it against the rule. The certificate becomes valid ten days after the dose, so it is the one that cannot be left to the last week.
Honest about the risks, and specific about what prevents each one.
Named by both sources. The Government of Canada notes the mosquitoes that carry it typically bite in the daytime, particularly around sunrise and sunset, that risk varies with season, year, region and elevation, and that dengue can become severe and be fatal.
Prevention No vaccine or medication to prevent it is available in Canada, so repellent through the day is the whole strategy. Screened or air-conditioned rooms; long, loose, tightly woven clothing.
A risk in Guatemala according to both sources. Spread by mosquito bite, also sexually transmitted, and it can cause serious birth defects.
Prevention Bite avoidance, plus condoms or avoiding sexual contact, particularly in pregnancy. If you are pregnant or planning to be, the Government of Canada asks you to discuss the trip with a healthcare provider first and says you may choose to postpone. Tell us before you book, not after.
The Government of Canada says some Guatemalan volcanoes are at high altitude with sub-zero temperatures at night, that warm and waterproof clothing is essential, that local tour companies might underestimate the risk of hypothermia, and that there is no mountain rescue service in the country. It asks travellers to know the symptoms of altitude sickness, dehydration and heatstroke, all of which it says can be fatal.
Prevention Go up slowly, drink more than feels necessary, carry real layers rather than one fleece, and turn around if someone is unwell — there is no helicopter coming. Tell us if you have a heart or lung condition and an overnight hike is booked.
Both are on CDC’s Guatemala list, and both on Canada’s. Chagas comes from triatomine bugs, which the Government of Canada notes are active at night; cutaneous and mucocutaneous leishmaniasis come from sand fly bites, most active between sunset and sunrise in rural and forested areas. Canada says the risk of each is generally low for most travellers.
Prevention Bite avoidance after dark, and a net if you are sleeping in poorly constructed or unscreened rural housing. There is no vaccine for either.
Both appear on CDC’s Guatemala list. Leptospirosis comes from water, mud or food contaminated with animal urine, including swimming or wading in fresh water and contact with floodwater; melioidosis from contact with contaminated fresh water, mud or soil, especially after heavy rain. Guatemala’s rainy season runs mid-May to mid-November, and the Government of Canada says flash floods and landslides are common in it.
Prevention Avoid floodwater and muddy water after heavy rain, cover cuts and grazes before entering fresh water, and do not swallow river or pool water. Semuc Champey and the rivers are fresh water.
Both on CDC’s risk list for Guatemala — hantavirus from the urine, droppings or saliva of infected rodents, tuberculosis through the air from someone infectious. Neither changes what a typical trip needs, but the whole list belongs on the page rather than the convenient half of it.
Prevention Avoid rodents and places their waste builds up, including caves; avoid close contact with people who are unwell.
The reason the first two vaccines on this page are the first two. The Government of Canada’s rule is boil it, cook it, peel it, or leave it, and it asks you not to swallow water when swimming, showering or bathing, and to keep fresh water out of your eyes, mouth and nose after heavy rain. Travellers’ diarrhoea is the most common illness travellers get anywhere.
Prevention Bottled or treated water, ice only from safe water, hot food served hot, fruit you peel yourself. Rehydration sachets in the bag — fluids are the treatment.
The Government of Canada says road conditions vary, that secondary and rural roads can be hazardous because of poor lighting, missing signs, unmarked speed bumps, animals and narrow winding mountain roads, and that driving in the rainy season brings flooding, mudslides and rockslides. It says drink-driving is common. Roadblocks — both roadwork and illegal — are frequent in several departments and can cause substantial delays. CDC names motor vehicle crashes among the main causes of death for travellers abroad.
Prevention No night driving. Avoid the chicken buses. Use hotel-associated taxis, yellow cabs or a ride-sharing app rather than white taxis, and skip the tuk-tuks. Build slack into travel days so a roadblock does not become a night drive.
The Government of Canada notes Guatemala sits in an active seismic zone where earthquakes and tsunamis can occur, that a tsunami can arrive within minutes of a nearby quake, and that there are four active volcanoes where eruptions may happen at any time and tremors sometimes lead to evacuations.
Prevention On the coast, find out the tsunami evacuation route on day one. Inland, follow local authorities and monitor local media; falling ash can also close the airport, which is a travel-insurance question as much as a health one.
Prevented with tablets rather than a vaccine, and only needed for some routes — which is why the answer depends on your itinerary.
CDC puts transmission primarily in five departments: Alta Verapaz, Baja Verapaz, Escuintla, Izabal and Petén, with a few cases reported in other departments. It states specifically that there is no malaria transmission in the cities of Antigua or Guatemala City, and none at Lake Atitlán — the three places most Guatemala itineraries are built around. Tikal is in Petén, Semuc Champey is in Alta Verapaz, and Río Dulce and Livingston are in Izabal, so those legs sit inside the risk area. The Government of Canada says only that there is a risk of malaria in certain areas or at certain times of year and that antimalarial medication may be recommended depending on your itinerary — the same message, less specific.
For the five departments CDC lists atovaquone-proguanil, chloroquine, doxycycline, mefloquine, primaquine or tafenoquine. For other areas with reported transmission it recommends no chemoprophylaxis at all — insect bite precautions and mosquito avoidance only. The wide drug list is not an accident: CDC records drug resistance in Guatemala as none, and about 99 per cent of cases as Plasmodium vivax, which is why chloroquine is still an option here when it is not in much of the world. Which one suits you depends on your dates, your other medicines, pregnancy, and the rest of your route. Whatever we choose, the part people get wrong is stopping too early after they get home — some of these have to be continued for weeks after the last day of exposure.
The things that prevent most travel illness are not medical.
This is unusually helpful and worth reading carefully. CDC puts Guatemala’s malaria transmission primarily in five departments — Alta Verapaz, Baja Verapaz, Escuintla, Izabal and Petén — with a few cases reported elsewhere. It then says explicitly that there is no malaria transmission in the cities of Antigua or Guatemala City, and none at Lake Atitlán. For a great many Calgary trips, that is the whole itinerary: fly into Guatemala City, base in Antigua, spend a few days on the lake, go home. No tablets. Add Tikal — which is in Petén — and the answer changes, because Petén is one of the five departments where CDC recommends taking prescription medicine. Semuc Champey is in Alta Verapaz, and Río Dulce and Livingston are in Izabal, so the same applies there. This is exactly why we ask for your route instead of your destination.
CDC lists drug resistance in Guatemala as none, and the species split as roughly 99 per cent Plasmodium vivax and 1 per cent Plasmodium falciparum. In plain terms: chloroquine still works here, so it stays on the list of options alongside atovaquone-proguanil, doxycycline, mefloquine, primaquine and tafenoquine. That matters practically — chloroquine is a weekly tablet rather than a daily one and is usually inexpensive, which suits a two-week trip and suits some people who cannot take doxycycline. It is not automatically the right choice; the right choice depends on your dates, your other medicines, whether you are pregnant, and what else is on your route. But in a lot of the world that option no longer exists, and in Guatemala it does.
Its Guatemala page says outdoor activities including hiking, climbing volcanoes, zip-lining, diving and whitewater rafting can be dangerous; that tour operators may not meet Canadian safety standards; that some volcanoes are at high altitude with sub-zero temperatures at night, so warm and waterproof clothing is essential; that local tour companies might underestimate the risk of hypothermia; and — the line that should decide how you book — that there is no mountain rescue service in Guatemala. It also asks travellers to know the symptoms of altitude sickness, dehydration and heatstroke, all of which it says can be fatal. If an overnight volcano hike is on your list, that is a conversation to have with us as well as with the tour company: what to carry, how to pace the ascent, and what to do if someone in your group starts feeling unwell at altitude.
Those are the actual words, and they point in different directions. CDC lists typhoid for most travellers to Guatemala and singles out people staying with friends or relatives and people visiting smaller cities and rural areas. The Government of Canada says there is a risk of typhoid in this destination but that the risk is low for most travellers, that people visiting friends or relatives and people with weakened immune systems are more likely to become seriously ill, and that the vaccine may be recommended for some travellers depending on their risk. Where our pharmacist tends to land: for a hotel-based week in Antigua, nearer the Canadian wording; for a longer trip, a homestay, a Spanish school placement, street food as the point of the trip, or anything in the highlands and Petén, nearer CDC. You will get the reasoning, not just the recommendation.
The Government of Canada’s overall level for Guatemala is “Exercise a high degree of caution”, because of high levels of crime, roadblocks and demonstrations throughout the country, with regional advisories to avoid non-essential travel to several zones of Guatemala City, some municipalities in Guatemala and Escuintla departments, and a list of named border crossings. It says roadblocks are common in Alta Verapaz, Escuintla, Huehuetenango, Petén, Quiché and San Marcos and can cause substantial delays, and that illegal roadblocks also occur, including on the roads to the airport. Its transport advice is specific: avoid the recycled-school-bus “chicken buses”, which it describes as mechanically unreliable and frequently involved in serious accidents and armed robberies; use hotel taxis or yellow cabs rather than white ones; and avoid tuk-tuks. It also flags drink spiking as a problem in tourist areas, especially Antigua. This is a safety question rather than a vaccine one, and it changes — read it in full on travel.gc.ca before you book.
Most people booking a travel consult with us are sorting out a household, not just themselves. A few things are different for children.
Bring the whole household to the same consultation. We review each person’s records separately but plan the trip as one, which usually means fewer visits and no repeated explanations. Tell us how many people when you book so we set aside the time.
CDC recommends it for unvaccinated travellers aged one year and over. Infants aged 6 to 11 months can have a travel dose, which does not count towards the routine two-dose series and is repeated later. The same applies to measles: CDC asks for an early MMR dose for infants aged 6 to 11 months travelling internationally.
If Tikal or Semuc Champey is on your itinerary, children need protection too — and the choice of tablet is narrower for them, with doses worked out by weight rather than age. Bring your children’s current weights to the appointment and we will sort a plan that is actually swallowable, which matters more than people expect on day four.
The Government of Canada lists children among those at higher risk of rabies and asks parents to supervise them closely around animals, because they are more likely to reach out and less likely to mention a scratch. It also says treatment to prevent rabies may be limited or not available in Guatemala. Wash anything that breaks the skin for about fifteen minutes with soap and clean water and get medical care the same day.
Any immunisation records you can find, for each traveller. Alberta records we can often look up; out-of-province and overseas records we cannot. A photo of a yellow card is plenty.
For most trips: hepatitis A, typhoid and your routine vaccines brought up to date, with hepatitis B worth checking. CDC lists hepatitis A and typhoid under most travellers for Guatemala; the Government of Canada recommends hepatitis A for all travellers to affected areas and hepatitis B for all travellers, and describes the typhoid risk as low for most travellers. Malaria tablets apply to five departments rather than to the country, and rabies depends on what you are doing. Yellow fever is not recommended for Guatemala itself.
No. CDC states specifically that there is no malaria transmission in the cities of Antigua or Guatemala City, and none at Lake Atitlán. It places transmission primarily in the departments of Alta Verapaz, Baja Verapaz, Escuintla, Izabal and Petén. Mosquito precautions still matter everywhere, because dengue, Zika and chikungunya are all on both sources’ lists for Guatemala and none of them is prevented by malaria tablets.
Tikal is in Petén, which is one of the five departments where CDC recommends taking prescription medicine to prevent malaria. So yes, that leg changes the answer. The same goes for Semuc Champey in Alta Verapaz and Río Dulce and Livingston in Izabal. Tell us how many nights you will spend there and when, and we will work out whether tablets make sense and which one fits your trip.
It is on CDC’s list for the five risk departments, alongside atovaquone-proguanil, doxycycline, mefloquine, primaquine and tafenoquine — because CDC records drug resistance in Guatemala as none and about 99 per cent of cases as Plasmodium vivax. That makes Guatemala one of the places where a weekly, inexpensive tablet is still a genuine option. Whether it is the right one for you depends on your other medicines, your dates, whether you are pregnant, and where else you are going. That is what the appointment is for.
Not if you are flying from Canada. Both sources say there is no yellow fever risk in Guatemala and that vaccination is not recommended for the destination itself. But proof is required if you arrive from — or have transited an airport in — a country where yellow fever occurs, and CDC notes that this includes airport transits or layovers longer than twelve hours, from one year of age. So if Guatemala follows Panama, Colombia, Brazil or Peru on your route, bring the whole itinerary. The certificate only becomes valid ten days after the dose, so it is not a last-week job.
The Government of Canada says some Guatemalan volcanoes are at high altitude with sub-zero temperatures at night, that warm and waterproof clothing is essential, that tour companies might underestimate the risk of hypothermia, and that there is no mountain rescue service in Guatemala. It also asks travellers to know the symptoms of altitude sickness, dehydration and heatstroke, which it says can be fatal. Practically: real layers rather than one fleece, go up slowly, drink more than you think you need, and be willing to turn back. If you have a heart or lung condition, tell us before you book the hike.
The Government of Canada advises a high degree of caution in Guatemala because of high levels of crime, roadblocks and demonstrations, with regional advisories to avoid non-essential travel to several zones of Guatemala City, certain municipalities in Guatemala and Escuintla departments, and a list of named border crossings. It also warns about chicken buses, white taxis, tuk-tuks and drink spiking in tourist areas including Antigua. Most visits pass without incident; read the current advisory in full on travel.gc.ca before you book, because it changes.
Nothing. The travel consultation is free — a full itinerary review, every recommended vaccine discussed, and advice for your particular trip. You pay only for the vaccines actually given, and for any malaria tablets you decide to take. We tell you the price of each before you agree to it, and some are covered by private plans.
Bring your travel dates. A pharmacist will go through what you need for Guatemala, give what can be given that day, and book anything that needs a second dose. No doctor referral, no wait list.
Written from current CDC and Government of Canada guidance, checked 31 July 2026. Advice for your particular trip comes from our pharmacist, in person.
Imagine Health Pharmacy & Travel Clinic — #4120, 15 Sunpark Plaza SE, Calgary, Alberta. In Sunpark Plaza, off Macleod Trail, serving Sundance, Midnapore, Shawnessy, Chaparral and the rest of south Calgary.
No doctor’s referral is needed. In Alberta a pharmacist can assess you, prescribe what your trip needs and give the vaccines in the same visit — so for most travellers this is one appointment, not a clinic queue and then a pharmacy.
The vaccine guidance on this page follows the official recommendations below, read and applied by a pharmacist. Where the two differ we say so rather than pick one.
Checked against both sources on 31 July 2026. Official advice changes — if your trip is months away, check again or ask us.
