Travel health · Nepal
Everest Base Camp, the Annapurna Circuit, Kathmandu and Pokhara. There is no malaria on the classic treks — the thing to plan for is how you would get back down, and who pays for the helicopter.
The short version
Most travellers to Nepal need 4 vaccines, and six 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 Nepal.
Not a vaccine, and first on the list anyway. The Government of Canada notes many popular trekking trails ascend higher than 5,500 metres and tells travellers to know the symptoms of high-altitude illness, which can be fatal. It also says rescues from remote areas can be hindered by helicopter operators not being paid immediately, by insurance companies not responding, and by there being no regular phone service on much of the trail. Descending is the treatment; in Nepal descending is also a logistics problem.
Sort the itinerary and the insurance before you pay for the trek. Altitude medication is prescribable by a pharmacist in Alberta — we will work out whether your ascent needs it.
Food and water, and both sources agree without qualification: CDC for unvaccinated travellers aged one and over going to Nepal, the Government of Canada for all travellers to areas where hepatitis A is present. Teahouse food on a trail is exactly the setting it exists for.
Any time before you fly. One dose covers the trip; a second, six months later, covers decades.
One of the few places both sources say the same thing plainly. CDC recommends it for most travellers, especially anyone staying with friends or relatives or visiting smaller cities and rural areas; the Government of Canada says a vaccine is available and is recommended for most travellers to Nepal.
At least two weeks before departure. The oral capsules take a week to finish.
The Government of Canada recommends hepatitis B for all travellers; CDC for unvaccinated travellers younger than 60, adding that those 60 and over may still get vaccinated. Hepatitis B is a blood and bodily fluid infection, which means unplanned medical care — and the same source says facilities outside the Kathmandu Valley and Pokhara do not meet the standards you would expect in Canada. Routine cover matters too: CDC asks all international travellers to be fully vaccinated against measles and currently carries a global measles notice.
Tetanus if it has been more than ten years. Hepatitis B runs over months, but faster schedules exist.
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 Nepal. 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 aged one year and over going to Nepal; the Government of Canada for all travellers to areas where hepatitis A is present. One of the few points where the two need no reconciling.
Bacterial infection from contaminated food and water. CDC recommends it for most travellers to Nepal, particularly those staying with friends or relatives or visiting smaller cities and rural areas; the Government of Canada says a vaccine is available and is recommended for most travellers to this destination. Injection or oral capsules; the capsules take a week to finish.
Spread through blood and bodily fluids — medical or dental care, tattoos, piercings, unplanned injuries. The Government of Canada recommends it for all travellers; CDC for unvaccinated travellers younger than 60, noting that those 60 and over may still get vaccinated. Weigh it against the note that facilities outside the Kathmandu Valley and Pokhara do not meet Canadian standards, and that serious cases are often evacuated to Bangkok, New Delhi or Singapore.
CDC asks travellers to be up to date on routine vaccines before every trip — chickenpox, DTaP/Tdap/Td, influenza, MMR, polio and shingles — and asks all international travellers to be fully vaccinated against measles, with a global measles travel notice currently in place. Tetanus is the one that lapses quietly, and a trek is exactly where a cut happens.
CDC advises all eligible travellers to be up to date with their COVID-19 vaccines. The Government of Canada describes vaccination as one of the most important ways to protect yourself from serious complications.
CDC states that dogs infected with rabies are commonly found in Nepal, and frames pre-exposure vaccination around whether you will be doing occupational or recreational activities that raise the chance of contact with a potentially rabid animal. The Government of Canada notes rabies is present and carried by dogs and some wildlife including bats, and says to talk to a health care professional about vaccination. The deciding factor for most trekkers is not the odds of a bite but how long it would take to reach treatment. This is a course of doses rather than a single shot, so it needs lead time.
The two sources read very differently here, and we would rather show you that than split the difference. CDC recommends vaccination for travellers moving to an area with Japanese encephalitis or spending a month or more there, and says to consider it for shorter stays where activities raise the risk — visiting rural areas, hiking or camping, or staying somewhere without air conditioning, screens or bed nets. The Government of Canada says risk is very low for most travellers and that those at relatively higher risk may want to consider vaccination. Read CDC’s activity list next to a teahouse trek through farmland and you can see why this needs a conversation rather than a rule. It is given as a course, so it is the item on this page that needs the most notice.
CDC states that active cholera transmission is widespread in Nepal but that cholera is rare in travellers, and says vaccination may be considered for children and adults travelling to areas of active transmission. The Government of Canada says vaccination may be recommended for high-risk travellers. For most tourist itineraries this comes down to food and water precautions rather than a vaccine.
CDC says chikungunya vaccination is generally not recommended for Nepal, though a traveller may consider it. The Government of Canada notes chikungunya is spread by infected mosquitoes and causes fever and joint pain. Mosquito precautions carry this one, and they mostly matter in the lowlands rather than up on the trail.
Not recommended for Nepal itself — CDC does not recommend the vaccine for the destination. It only becomes relevant as an entry rule: the Government of Canada notes proof of vaccination is required if you are coming from, or have transited through an airport in, a country where yellow fever occurs. Flights from Calgary usually route through Europe, the Gulf or Asia, none of which triggers it. If Nepal is one leg of a longer trip, bring the whole itinerary and we will check.
Honest about the risks, and specific about what prevents each one.
The Government of Canada notes many popular trekking trails ascend higher than 5,500 metres and tells travellers to know the symptoms of high-altitude illness, dehydration and heatstroke, which can be fatal. Walking up over days is genuinely better than flying into height — but Nepal’s trails keep climbing long past the point where anyone stops being at risk.
Prevention Build rest days into the itinerary rather than hoping for them, and know before you leave which village you would drop to from each night’s stop. Descend when symptoms worsen; that is the treatment that always works. Altitude medication is prescribable by a pharmacist in Alberta — bring your day-by-day plan and we will work through it.
The Government of Canada says evacuations and rescues from remote areas are available but can be hindered by the lack of immediate payment to helicopter rescue providers, by no response from the traveller’s insurance company, and by limited access to regular phone service in many trekking areas. It also documents helicopter rescue and insurance scams — unnecessary evacuations, pressure to be evacuated without a medical assessment, falsified paperwork and inflated billing.
Prevention Insurance that names high-altitude trekking and medical evacuation, bought before you pay for the trek. Registered, reputable operators, and no unusually cheap packages. Policy number and emergency line saved offline where a companion can find them.
The Government of Canada states that outside the Kathmandu Valley and Pokhara, medical services and facilities do not meet standards you might expect in Canada, that most hospitals require up-front payment or confirmation of insurance before treating you, and that medical evacuation to Bangkok, New Delhi or Singapore is often necessary for serious conditions.
Prevention Carry enough of your own medication for the whole trip plus a margin, in labelled packaging, in hand luggage. A written list of what you take and why. Know that a card is not always accepted as payment when it matters.
CDC states that dogs infected with rabies are commonly found in Nepal. The Government of Canada adds that rabies is spread mainly through bites but also through scratches, and that it is carried by some wildlife including bats.
Prevention Do not touch dogs, monkeys or any animal, however friendly. If you are bitten or scratched, wash the wound with soap and clean water for about 15 minutes and get to medical care — do not wait it out. Pre-exposure vaccination is worth discussing if you will be far from a hospital.
The Government of Canada calls it the most common illness affecting travellers, with fever, nausea, vomiting and stomach pain alongside the obvious. On a trek it is not only miserable — dehydration at altitude makes everything else harder.
Prevention Boil it, cook it, peel it, or leave it. Treated or bottled water including for teeth, no ice you did not see made. Rehydration salts weigh nothing and we can send you with a standby antibiotic where appropriate.
The Government of Canada names dengue, which can lead to severe dengue and can be fatal, and chikungunya. CDC also names leishmaniasis, spread by sand fly bite, and Japanese encephalitis by mosquito. These are lowland and warm-season concerns rather than high-trail ones.
Prevention Repellent by day and at dusk, long sleeves, and screens or nets in Kathmandu, Chitwan and the Terai. There is no vaccine for dengue or leishmaniasis available here, so bite prevention is the whole strategy.
The Government of Canada notes the monsoon runs June to September, that seasonal flooding hampers overland travel and reduces essential services, and that roads may become impassable due to mudslides and landslides. It also notes Nepal sits in an active seismic zone with a continued risk of earthquakes, aftershocks and landslides, and that avalanches in the mountains may be fatal. CDC names motor vehicle crashes the number one killer of healthy travellers abroad.
Prevention Build slack into the schedule — a missed connection is better than a night drive on a wet mountain road. Reputable operators over the cheapest option, and a plan for what happens if the road closes.
CDC lists leptospirosis from contaminated water and soil including floodwater, tuberculosis spread through the air from an infectious person, and hantavirus from rodents and their droppings. The Government of Canada notes human cases of avian influenza have been reported in Nepal. None of these changes the plan for most travellers, but they are on the sources and so they are on this page.
Prevention Avoid wading in floodwater, keep away from rodents, live poultry and bird markets, and do not handle sick or dead animals.
Prevented with tablets rather than a vaccine, and only needed for some routes — which is why the answer depends on your itinerary.
CDC puts malaria transmission in Sudurpashchim and Karnali provinces in areas below about 2,000 metres, with rare cases elsewhere in the country below that same elevation. It states there is NO malaria transmission in Kathmandu, in Pokhara, or on typical Himalayan treks. The Government of Canada is far less specific — it says only that there is a risk in certain areas and at certain times of year, and that medication may be recommended depending on your itinerary and season. We use CDC’s geography because it is the one that actually names places.
For the far western lowlands below 2,000 metres, CDC lists atovaquone-proguanil, doxycycline, mefloquine and tafenoquine. Most cases in Nepal are P. vivax, with fewer than one in ten being P. falciparum. For a Kathmandu–Pokhara–Annapurna or Everest Base Camp itinerary none of this applies, and we will tell you that rather than sell you tablets you do not need.
The things that prevent most travel illness are not medical.
People arrive at this page expecting Peru’s version of altitude: fly into a high city, feel awful for a day. Nepal is a different shape. You walk up over days, which is the acclimatisation everyone recommends — and then you keep walking up. The Government of Canada notes many popular trekking trails ascend higher than 5,500 metres and warns that high-altitude illness can be fatal. The treatment that always works is to go down, and that is where Nepal gets specific: the same source says evacuations and rescues from remote areas can be hindered by the lack of immediate payment to helicopter rescue providers, by no response from the traveller’s insurance company, and by limited access to regular phone service in many trekking areas. Plan the descent before you need it. Know which day of the itinerary is the highest, where the nearest lower village is, and what your policy actually says. Altitude medication is prescribable by a pharmacist in Alberta and we will talk through whether your ascent calls for it — but no tablet substitutes for a plan to lose elevation.
The Government of Canada states there have been documented cases of helicopter rescue and insurance scams in Nepal, involving unnecessary evacuations, pressure to be evacuated without a medical assessment, falsified medical or evacuation documents, and inflated billing to travellers and insurance companies. Its own advice is direct: deal only with registered and reputable helicopter companies and trekking agencies, avoid trekking packages that look unusually inexpensive, and choose insurance that covers high-altitude trekking and medical evacuation. It also notes that most hospitals require up-front payment or confirmation of insurance coverage before treating you, and that medical evacuation to Bangkok, New Delhi or Singapore is often necessary for serious conditions. A standard holiday policy that excludes trekking above a certain altitude is worse than useless here, because you will not find out until the worst possible moment.
CDC is unusually specific for Nepal: malaria transmission is in Sudurpashchim and Karnali provinces below about 2,000 metres, with rare cases elsewhere in the country below that same elevation — and it states there is no transmission in Kathmandu, in Pokhara, or on typical Himalayan treks. The Government of Canada is much vaguer, saying only that there is a risk in certain areas and at certain times of year and that medication may be recommended depending on your itinerary and season. Where one source is precise and the other general, we use the precise one and tell you that is what we did. In practice: a Kathmandu–Pokhara–Annapurna or Everest itinerary needs no tablets, and we will say so rather than sell you some. The far western lowlands are a different conversation.
CDC states plainly that dogs infected with rabies are commonly found in Nepal, and the Government of Canada notes rabies is present and carried by dogs and some wildlife including bats. Rabies is essentially always fatal once symptoms start and always preventable if treatment starts promptly — which is the whole issue on a trek. Post-exposure treatment is a hospital errand, and on the trail you may be several days’ walk from one. Pre-exposure vaccination does not remove the need for treatment after a bite; it buys time and simplifies what you need when you get there. If you are bitten or scratched, wash the wound with soap and clean water — the Government of Canada says for about 15 minutes — and get to medical care rather than waiting to see how it looks.
People ask us about Kathmandu’s air. Neither CDC’s Nepal page nor the Government of Canada’s raises air quality, so we are not going to quote you a number we cannot source. What we will do is practical: if you use an inhaler or have any lung condition, bring more than the trip strictly needs, keep it in your hand luggage, and tell us before you go so the supply is sorted here rather than there. The second is timing — the Government of Canada notes the monsoon runs June to September, that seasonal flooding hampers overland travel, and that roads may become impassable from mudslides and landslides. That is not a vaccine question, but it changes how far you are from a pharmacy on any given day, which is the question this whole page is really about.
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.
Children get altitude illness too, and they are less able to describe what they are feeling — a quiet, off-colour child high on a trail deserves attention rather than a nap. The Government of Canada says high-altitude illness can be fatal and that trails commonly go above 5,500 metres, so know the symptoms yourself and be willing to turn a family itinerary around. Descending is the treatment for a child as much as for an adult.
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 schedule and is repeated later.
CDC states that dogs infected with rabies are commonly found in Nepal. Small children approach animals, are less likely to mention a scratch, and are more often bitten on the face or hands. Talk it through per child rather than per family, and teach the rule before you land: nobody touches an animal, however friendly it looks.
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.
No. CDC states there is no malaria transmission in Kathmandu, in Pokhara, or on typical Himalayan treks. The risk it does describe is in Sudurpashchim and Karnali provinces below about 2,000 metres, with rare cases elsewhere below that elevation. The Government of Canada only says there is a risk in certain areas at certain times of year, which is why people arrive confused. For the standard trekking itinerary the answer is no, and we would rather say that than sell you a prescription.
The Government of Canada notes many popular trekking trails ascend higher than 5,500 metres and warns that high-altitude illness can be fatal. Walking up over days is much better than flying into height, which is why Nepal treats people better than a fly-in destination does — but the trails keep climbing well past the height at which anyone is safe by default. The part worth planning is the descent: know the highest night on your itinerary and where you would drop to from each stop, because going down is the treatment that always works.
Altitude medication is prescribable by a pharmacist in Alberta, so yes — but whether you need it depends on your day-by-day ascent, your other medications and your history, which is exactly what the appointment is for. Bring the itinerary with the elevations on it. No tablet replaces rest days and a descent plan.
Two things a standard policy often excludes: high-altitude trekking at the elevation you will really reach, and medical evacuation — including out of the country, since the Government of Canada notes serious cases often need evacuation to Bangkok, New Delhi or Singapore. The same source says rescues can be held up when helicopter operators are not paid immediately or when insurers do not respond, and it documents rescue and insurance scams involving unnecessary evacuations and inflated billing. Read the exclusions before you pay for the trek, and save the policy number and emergency line offline where a companion can find them.
The two sources genuinely differ, and we will show you both rather than average them. CDC recommends it for people moving to an area with Japanese encephalitis or spending a month or more there, and says to consider it for shorter trips involving rural areas, hiking or camping, or accommodation without air conditioning, screens or bed nets. The Government of Canada says the risk is very low for most travellers and that those at relatively higher risk may want to consider it. A three-week teahouse trek through farmland sits awkwardly between those two descriptions, which is why it is a conversation. It also takes the most lead time of anything on this page, so raise it early.
Not coming from Canada. CDC does not recommend yellow fever vaccination for Nepal itself. The only way it applies is the entry rule: proof is required if you are arriving from, or have transited through an airport in, a country where yellow fever occurs. Ordinary routings from Calgary through Europe, the Gulf or Asia do not trigger it. If Nepal is one stop on a longer trip, bring the full itinerary and we will check the whole route.
Wash the wound with soap and clean water — the Government of Canada says for about 15 minutes — and get to medical care rather than waiting to see how it looks. CDC states that dogs infected with rabies are commonly found in Nepal, and rabies is preventable if treatment starts promptly and not treatable once symptoms begin. Pre-exposure vaccination does not remove the need for treatment after a bite, but it buys time and simplifies what you need, which matters when the nearest hospital is several days’ walk away. Worth discussing before you go if your route is remote.
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.
Bring your travel dates. A pharmacist will go through what you need for Nepal, 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.
