cdc travel website indonesia

• Travel Advisories |
• Contact Us |
• MyTravelGov |

Find U.S. Embassies & Consulates

Travel.state.gov, congressional liaison, special issuance agency, u.s. passports, international travel, intercountry adoption, international parental child abduction, records and authentications, popular links, travel advisories, mytravelgov, stay connected, legal resources, legal information, info for u.s. law enforcement, replace or certify documents.

Before You Go

Learn About Your Destination

While Abroad

Emergencies

Share this page:

Travel Advisory July 24, 2023

Indonesia - level 2: exercise increased caution.

Reissued with obsolete COVID-19 page links removed.

Exercise increased caution in Indonesia due to  terrorism and natural disasters.  Some areas have increased risk.  Read the entire Travel Advisory.

Do Not travel to:

• The provinces of Central Papua (Papua Tengah) and Highland Papua (Papua Pegunungan) due to civil unrest.

Terrorists continue plotting possible attacks in Indonesia. Terrorists may attack with little or no warning, targeting police stations, places of worship, hotels, bars, nightclubs, markets/shopping malls, and restaurants.

Natural disasters such as earthquakes, tsunamis or volcanic eruptions may result in disruptions to transportation, infrastructure, sanitation, and the availability of health services.

Demonstrations occur frequently and have the potential to become violent.  Avoid demonstrations and crowds. 

Indonesia’s revised criminal code, which takes effect January 2026, includes penalties for defamation, blasphemy, cohabitation, and sex outside of marriage. It is unclear how Indonesian authorities will implement the revised criminal code.

Read the  country information page  for additional information on travel to Indonesia.  

If you decide to travel to Indonesia:

• Monitor local media for breaking events and be prepared to adjust your plans. 
• Visit the websites for  Badan Geologi  (Indonesian Geological Agency, Indonesian language only) for the latest information from the Government of Indonesia on current natural disasters.
• Review the  CDC’s suggestions on how to prepare for natural disasters.
• Be aware of your personal safety and security at all times. 
• Enroll in the  Smart Traveler Enrollment Program  ( STEP ) to receive alerts and make it easier to locate you in an emergency.
• Ensure your passport is valid for at least six months beyond your intended stay.
• Follow the Department of State Facebook  and Twitter .  Follow the U.S. Embassy Jakarta on Facebook , Instagram , and Twitter .
• Review the Country Security Report  for Indonesia.
• Prepare a contingency plan for emergency situations. Review the  Traveler’s Checklist .

Central Papua and Highland Papua– Level 4: Do Not Travel

In Central Papua and Highland Papua, violent demonstrations and conflict could result in injury or death to U.S. citizens. Avoid demonstrations and crowds. Armed separatists may kidnap foreign nationals.

The U.S. government has limited ability to provide emergency services to U.S. citizens in Central Papua and Highland Papua as U.S. government employees must obtain special authorization before traveling to those areas.

Embassy Messages

View Alerts and Messages Archive

Quick Facts

Six months beyond arrival date. Indonesia does not accept the 12-page U.S. emergency passport for entry into Indonesia.

Two blank visa pages required for entry stamp

Yes, Visa or Visa on Arrival

100,000,000 Indonesian rupia (approx. $7,000 USD)

Embassies and Consulates

U.s. embassy jakarta.

Jl. Medan Merdeka Selatan No. 3 - 5 Jakarta 10110, Indonesia Telephone: +(62)(21) 5083-1000 Emergency After-Hours Telephone: +(62)(21) 5083-1000 ext. 0 (operator) Email:  [email protected]

U.S. Consulate General Surabaya Jl. Citra Raya Niaga No. 2 Surabaya 60217 Indonesia Telephone: +(62)(31) 297-5300 Emergency After-Hours Telephone: +(62)(811) 334-183 Email:  [email protected]

U.S. Consular Agency Bali Jalan Hayam Wuruk 310, Denpasar, Bali Telephone: +(62)(361) 233-605 Emergency After-Hours Telephone: Please contact the U.S. Consulate in Surabaya:+(62)(811) 334-183 Email:  [email protected]

American Consulate Medan, Sumatra Uni Plaza Building 4th Floor (West Tower) Jl. Let. Jend. MT Haryono A-1 Medan 20231, Indonesia Telephone: +(62)(61) 451-9000 Emergency After-Hours Telephone: +(62)(61) 451-9000 Email:  [email protected]

The U.S. Consulate in Medan provides only emergency assistance to U.S. citizens and does not offer routine consular services.

Destination Description

See the Department of State’s Fact Sheet on Indonesia for information on U.S.- Indonesia relations.

Entry, Exit and Visa Requirements

Entry Requirements:  To enter Indonesia, your passport must have at least two blank pages and be valid for at least six months beyond the date of your arrival in Indonesia. If your passport does not meet these requirements, you will be denied entry into Indonesia. The Government of Indonesia will not admit travelers holding the 12-page U.S. emergency passport, issued by U.S. embassies and consulates overseas.

Visa-on-Arrival:  If you meet the requirements, you can apply for a visa on arrival at some international airports, seaports, or land crossings. To apply for the visa on arrival, you must have an ordinary (non-emergency) passport with at least 6 months of validity from the date you plan to enter and the date you plan to leave Indonesia and a return or onward flight booking to another country. There is a 500,000 Indonesian Rupiah fee (about $35). The visa on arrival is valid for up to 30 days. You may extend a Visa-on-Arrival once at the immigration office one week before it expires for an additional 30 days for a maximum of 30 additional days, for another 500,000 Rupiah.

• Official visit or government duties;
• Business meeting;
• Procurement of goods;
• Official meeting; or

Electronic Visa-On-Arrival:  You may also apply for an electronic Visa on Arrival (e-VOA) in advance if you are entering Indonesia at Soekarno-Hatta International Airport in Jakarta or Ngurah Rai International Airport in Bali. Check the e-VOA requirements from Indonesian Immigration before applying. To apply for an e-VOA see  https://molina.imigrasi.go.id/ .

Visa:  Travel for more than 30 days and travel for non-VOA purposes, including employment and journalism, requires that the appropriate visa be obtained from an Indonesian embassy or consulate before arrival. If you are traveling on an emergency passport, you must obtain a visa before arrival in Indonesia.

If you overstay your visa, you are subject to a fine of 1 million Indonesian rupiah (about $70 USD at current exchange rates; fees may change at any time) per day and may be detained and deported. U.S. citizens have been jailed for visa overstays or entering the country on the wrong visa class for their purpose of travel . Travelers coming to Indonesia for non-tourism purposes are strongly encouraged to consult Indonesian Immigration’s website. Travelers should generally carry a copy of their passport with them whenever possible to establish their identity and proof of Indonesian visa.

You must exit Indonesia using the same passport that you used to enter.  If this passport is replaced for any reason before you depart Indonesia, you must apply with Immigration to obtain a “special pass” (exit permit) in your new passport prior to departing.

Dual-Nationality:  Indonesia has laws that prohibit Indonesian citizens from holding additional nationalities. If you are an Indonesian with dual nationality, you could be compelled to renounce your Indonesian nationality through a formal act of renunciation. Please research Indonesian nationality laws and consult with a local attorney regarding any specific circumstance.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Indonesia. The Government of Indonesia screens incoming passengers in response to reported outbreaks of pandemic illnesses.

Find information on dual nationality , prevention of international child abduction , and customs regulations on our websites.

Safety and Security

Terrorism:  Terrorist groups and those inspired by such organizations are intent on attacking U.S. citizens abroad. Terrorists are increasingly using less sophisticated methods of attack – including knives, firearms, and vehicles – to target crowds. Frequently, their aim is unprotected or vulnerable targets, such as:

• High-profile public events (sporting contests, political rallies, demonstrations, holiday events, celebratory gatherings, etc.)
• Hotels, clubs, and restaurants frequented by tourists
• Places of worship
• Shopping malls and markets
• Public transportation systems (including subways, buses, trains, and scheduled commercial flights)

Extremists in Indonesia aspire to carry out violent attacks against Indonesian and foreign targets, and police have arrested more than 1,200 individuals on terrorism-related charges since 2018. Extremists may target both official and private establishments, including government offices, hotels, bars, nightclubs, shopping areas, restaurants, and places of worship. Be aware of your personal safety and security at all times.

Recent incidents of extremist violence include a December 2022 suicide bombing at a police station in Bandung, West Java that killed one police officer, a March 2021 bomb attack against a church in Makassar, South Sulawesi which injured 20 civilians, and May 2018 bomb attacks against three churches in Surabaya, East Java which killed 15 civilians and injured 50.

Demonstrations are very common in Jakarta, Surabaya, and other large cities, but less common in Bali. You should avoid demonstrations and other mass gatherings, since even those intended to be peaceful can become violent. U.S. citizens have been detained for participating in protests.  Demonstrations may become more frequent ahead of the Indonesian general elections scheduled for February 2024.

Currently, travel by U.S. government personnel to the provinces of Central Papua (Papua Tengah) and Highland Papua (Papua Pegunungan) is restricted to mission-essential travel that is approved in advance by the Embassy. Papuan separatists have kidnapped foreigners in the past and a New Zealand national was kidnapped by a separatist group in Nduga Regency in February 2023.

For more information, see our Terrorism page.

Crime:   In the last year several American citizens were victims of violent and serious crimes in Indonesia, particularly in Bali. As with any major tourist destination, U.S. citizens traveling in Indonesia are especially encouraged to always remain vigilant of their surroundings and read the following advisories carefully. Take sensible measures to protect yourself and your belongings.  Closely monitor bags and luggage and carry only essential items. Take particular care of your passport and bank cards and avoid traveling alone.

Police presence and responsiveness is less than it is in the United States, making it more difficult to report crimes quickly and receive police attention. U.S. citizens often cite language barriers as a major hindrance when reporting crimes.

Pickpocketing, sexual assault, vehicle theft, armed car-jacking, snatch and grab robberies of cell phones and purses, and residential break-ins are common. Avoid traveling to isolated areas late at night. Be aware of your surroundings, particularly vehicles or individuals that might be following you.

Use a reputable taxi company or hire a taxi either at a major hotel or shopping center and ensure the driver’s identity card is visible. If you are booking a car via a mobile app, always ensure that the driver is the same as the person on the app, share your journey with a friend via the in-app option, and know the contact information for the app’s security center. Be aware of drivers falsely claiming to be registered with online ride hailing apps.

Credit card fraud is a common problem in Indonesia. Criminals have “skimmed” credit/debit cards to access and drain bank accounts. Use an ATM in a secure location, such as a major bank branch, and check the machine for evidence of tampering. Monitor your account statements regularly.

Tourists and Indonesians have suffered from serious illness and have even died from "drink-spiking” and drink poisoning incidents, particularly in clubs and nightspots in urban and tourist areas. There have been reports of sexual assaults and drink spiking in Bali, Lombok, and the Gili Islands.  Make sure drinks are prepared in your sight and be careful about accepting drinks from strangers at clubs and parties or leaving drinks unattended. Tourists have also been robbed after taking visitors to their hotel rooms, and in some cases have found that their drinks were spiked. There have also been deaths and serious illnesses caused by drinking alcoholic drinks contaminated with methanol. These cases have occurred in bars, shops, and hotels in popular tourist areas like Bali, Lombok, the Gili Islands, and Sumatra.

Sexual Assault:  Women travelling alone may be subject to harassment and verbal abuse. Sexual assault, harassment, and rape occur. To minimize the risk, avoid travelling alone, especially at night; remain particularly vigilant in less populous areas; and be careful when dealing with strangers or recent acquaintances. Never leave food or drinks unattended or in the care of strangers. Be wary of accepting snacks, beverages, gum, or cigarettes from new acquaintances. These items may contain drugs that could put you at risk of sexual assault and robbery. Local authorities may not respond adequately to reports of sexual violence and harassment. If you are the victim of a sexual assault, you should report it immediately to local authorities and to the U.S. Embassy or U.S. Consulate General.  

Demonstrations  occur frequently. They may take place in response to political or economic issues, on politically significant holidays, and during international events. 

• Demonstrations can be unpredictable. Avoid areas around protests and demonstrations. 
• Past demonstrations have turned violent.
• Check local media for updates and traffic advisories.
• Participating in demonstrations on a tourist visa can lead to deportation.

International Financial Scams:  See the  Department of State  and the  FBI  pages for information.

Internet romance and financial scams occur in Indonesia. Scams are often initiated through Internet postings/profiles or by unsolicited emails and letters. Scammers almost always pose as U.S. citizens who have no one else to turn to for help. Common scams include:

• Romance/Online dating
• Money transfers
• Lucrative sales
• Gold purchase
• Contracts with promises of large commissions
• Grandparent/Relative targeting
• Free Trip/Luggage
• Inheritance notices
• Work permits/job offers
• Bank overpayments

Victims of Crime:

Sexual assault:  U.S. citizen victims of sexual assault should seek prompt medical assistance, contact the Embassy or nearest Consulate, and call the local police at 112. For a criminal investigation to be initiated by the police, the victim must make a full statement to the local police, in person.  Remember that local authorities are responsible for investigating and prosecuting crime. U.S. citizen victims of sexual assault may choose to be accompanied by a translator.

See our webpage on help for U.S. victims of crime overseas .

• Help you find appropriate medical care
• Assist you in reporting a crime to the police
• Contact relatives or friends with your written consent
• Explain the local criminal justice process in general terms
• Provide a list of local attorneys
• Provide our information on victim’s compensation programs in the U.S.
• Provide an emergency loan for repatriation to the United States and/or limited medical support in cases of destitution. Follow this link for more information
• Help you find accommodation and arrange flights home
• Replace a stolen or lost passport

Domestic Violence:  U.S. citizen victims of domestic violence are encouraged to contact the Embassy for assistance.

Tourism: The tourism and recreational activity industries are unevenly regulated, and safety inspections for equipment and facilities do not commonly occur. Hazardous areas/activities are not always identified with appropriate signage, and staff may not be trained or certified either by the host government or by recognized authorities in the field.  Water sports, especially diving, can be hazardous in Indonesia with operators lightly regulated and hyperbaric chambers available only in Bali and Ambon.  Traffic is hazardous in Indonesia and U.S. citizens are frequently injured while riding rented motorbikes. Wearing a helmet is required by law. In the event of an injury, appropriate medical treatment is typically available only in/near major cities, and only basic stabilization may be available. Serious injuries require medical evacuation to another country. First responders are generally unable to provide urgent medical treatment or to access areas outside of major cities. Boat and ferry incidents are frequent; vessels rarely carry appropriate sizes and numbers of safety vests; passengers are encouraged to bring their own. U.S. citizens are strongly encouraged to purchase medical evacuation insurance. See our webpage for more information on insurance providers for overseas coverage ( http://travel.state.gov/content/passports/en/go/health/insurance-providers.html ).

Please note:   The U.S. Embassy and Consulates do not pay the medical expenses of private U.S. citizens in Indonesia. It is the traveler’s responsibility to ensure adequate medical insurance coverage or funds for medical expenses.

Local Laws & Special Circumstances

Criminal Penalties:  You are subject to Indonesian laws. If you violate local laws, even unknowingly, you may be expelled, arrested, or imprisoned. Criminal cases can take months or even years to resolve, and suspects can be held without charges for up to 60 days, and in many cases longer. Indonesia‘s revised criminal code, which takes effect January 2026, includes penalties for defamation, blasphemy, cohabitation, and sex outside of marriage. Enroll in the Smart Traveler Enrollment Program (STEP) to stay up-to-date.

If you are convicted of possession, use, or trafficking of illegal drugs in Indonesia, you may be subject to heavy fines, long jail sentences, and even the death penalty. Some prescription medications that are available in the United States are illegal in Indonesia. Some drugs used to treat attention deficit hyperactivity disorder (ADHD) are illegal in Indonesia. Marijuana, Cannabis, hash, “edibles,” and products containing CBD or THC remain illegal in Indonesia, including for medicinal purposes. A medical prescription does not make it legal. If you take such products to Indonesia or purchase or use them in Indonesia, you can be arrested and face imprisonment, fines, deportation, or the death penalty. Illegal drug convictions often result in lengthy prison sentences, even at the simple possession level. Indonesian prison conditions are harsh and do not meet U.S. standards. Many prisons are overcrowded and provide minimal services. The costs of basic services, including healthcare, often must be borne by the prisoner.

Individuals establishing a business or practicing a profession that requires additional permits or licensing should seek information from the competent local authorities prior to practicing or operating a business.

Furthermore, some laws are also prosecutable in the United States regardless of local law. For examples, see our website on crimes against minors abroad and the Department of Justice website.

Arrest Notification:  If you are arrested or detained, ask police or prison officials to notify the U.S. Embassy immediately. See our webpage for further information.

Counterfeit and Pirated Goods:  Although counterfeit and pirated goods are prevalent in many countries, they may still be illegal according to local laws. You may also pay fines or have to give them up if you bring them back to the United States. See the U.S. Department of Justice website for more information.

Faith-Based Travelers:  See the following webpages for details:

• Faith-Based Travel Information
• nternational Religious Freedom Report – see country reports
• Human Rights Report – see country reports
• Hajj Fact Sheet for Travelers
• Best Practices for Volunteering Abroad

LGBTQI+ Travelers:  LGBTQI+ status or conduct is not illegal, but local authorities sometimes take legal action against, or tolerate harassment of people engaging in LGBTQI+ relationships or openly expressing LGBTQI+ identity. Some local governments have passed laws criminalizing LGBTQI+ relationships. Same-sex marriages or civil unions recognized as valid in other countries are not legally recognized in Indonesia. The Indonesian Parliament revised the criminal code to include penalties for cohabitation and sex outside of marriage. These revisions, however, will not come into force until January 2026, and how they will be implemented is unclear.

See our LGBTQI+ Travel Information page and section 6 of our Human Rights report for further details .

Sharia Law:   Sharia law is enforced in Aceh province and may exist unofficially or through local legislation in other areas. The law is intended for Muslims and should not apply to non-Muslims or foreign visitors. You should be respectful of local traditions, mindful of social norms, and seek guidance from local police if confronted by Sharia authorities. 

Earthquakes and Tsunamis:  There are approximately 4,000 earthquakes per year in Indonesia, or more than 10 per day on average. While most earthquakes are mild, some cause significant destruction and can trigger tsunamis. Tsunami warning systems may not be operable, or reports of tremors and tsunamis may be delayed. Local construction standards are lower than in the United States, and many structures including hotels and malls are prone to damage or collapse in an earthquake. Access to disaster-affected areas is often difficult and assistance from the U.S. Embassy may be limited.

If a major earthquake or landslide occurs close to shore, you should follow the instructions of local authorities, bearing in mind that a tsunami could arrive within minutes. The Indonesia Tsunami Early Warning Centre issues tsunami warnings when a potential tsunami with significant impact is imminent or expected.

Volcanoes:  There are 127 active volcanoes in Indonesia. Eruptions frequently cause travel delays, displace local populations, and disrupt economic activities. 

Environmental Quality:  Air quality in Indonesia’s major cities can range from "unhealthy for sensitive groups" to "unhealthy." Current air quality data for Jakarta can be found on the Embassy’s  Air Quality  page. Tap water is not potable throughout Indonesia and should not be consumed. 

Mountain Hiking:  When hiking in mountainous areas, obtain current information on local conditions, travel with a reputable guide, have overseas medical insurance, and carry a local mobile phone. Never go hiking or climbing alone. Particularly dangerous trails may not be clearly labeled as such. Hikers on Puncak Jaya in Papua should have realistic primary and backup plans for climbing down the mountain. Tour operators have abandoned climbers. Taking shortcuts through private property is considered trespassing and is not a safe or legal alternative to a proper plan. If possible, ensure your hiking plans are registered and known to local authorities and/or tourism operators, as this helps identify your presence in these areas in the event of an emergency. 

Dual Nationality:  Indonesian law does not recognize dual nationality for adults over 18 years of age. U.S. citizens who are also Indonesian nationals may be required to renounce their Indonesian citizenship and may also be deported.  Please visit our Dual Nationality page .

Travelers with Disabilities:  Persons with disabilities will face severe difficulties in Indonesia as most public places and transportation facilities do not accommodate disabled people. The law in Indonesia prohibits discrimination against persons with mental and physical disabilities, but the law is seldom enforced. Social acceptance of persons with disabilities in public is not as prevalent as in the United States. Expect accessibility to be extremely limited in public transportation, lodging, communication/information, and general infrastructure.

Students:  See our Students Abroad page and FBI travel tips .

Women Travelers:   Women traveling alone may be subject to harassment and verbal abuse. Sexual assault, harassment, and rape occur. To minimize the risk, avoid travelling alone, especially at night; remain particularly vigilant in less populous areas; and be careful when dealing with strangers or recent acquaintances. Never leave food or drinks unattended or in the care of strangers. Be wary of accepting snacks, beverages, gum, or cigarettes from new acquaintances. These items may contain drugs that could put you at risk of sexual assault and robbery. While domestic violence is illegal in Indonesia, these laws are rarely enforced. Local authorities may not respond adequately to reports of sexual violence and harassment. If you are the victim of a sexual assault, you should report it immediately to local authorities and to the U.S. Embassy or U.S. Consulate General and seek medical attention. See our travel tips for Women Travelers .

The Government of Indonesia requires all non-Indonesian citizens entering the country to be fully vaccinated against COVID-19. 

Medical Care:  For emergency services in Indonesia dial 112.

Sanitation and health care conditions in Indonesia are far below U.S. standards. Routine medical care is available in all major cities, although most expatriates leave the country for all but the most basic medical procedures. Physicians and hospitals often expect payment or sizable deposits before providing medical care, even in emergency and/or life-threatening situations. See our  Embassy's  website for a list of English-speaking doctors and hospitals, but keep in mind that even in large cities the quality of English-speaking medical personnel will vary and there are often communication difficulties. In remote areas there may be no English-speaking medical personnel. Psychological and psychiatric services are limited, even in the larger cities, with hospital-based care only available through government institutions.

Ambulance services are not widely available, and training and availability of emergency responders may be below U.S. standards. Ambulances are not staffed with trained paramedics and often have little or no medical equipment. Injured or seriously ill travelers may prefer to take a taxi or private vehicle to the nearest major hospital rather than wait for an ambulance.

We do not pay medical bills.  Be aware that U.S. Medicare/Medicaid does not apply overseas. Most hospitals and doctors overseas do not accept U.S. health insurance.

Medical Insurance:   Make sure your health insurance plan provides coverage overseas. Most care providers overseas only accept cash payments. See our webpage for more information on insurance providers for overseas coverage. Visit the U.S. Centers for Disease Control and Prevention for more information on type of insurance you should consider before you travel overseas.

We strongly recommend supplemental insurance to cover medical evacuation, which can exceed over $100,000 per person.

Always carry your prescription medication in original packaging, along with your doctor’s prescription.  Be aware that Indonesian authorities may consider some prescription drugs as illegal narcotics. The Indonesian government does not publish a list of which pharmaceuticals are considered contraband, and these decisions may be arbitrary.

U.S. citizens are advised against mailing or shipping by courier any medications to Indonesia. Indonesian authorities pay close attention to packages containing pharmaceuticals and may detain or arrest recipients of both prescription and over the counter medications. Even if a medication is legal or has been prescribed in the United States, it may be considered an illegal narcotic in Indonesia. U.S. citizens are advised to only hand carry prescription medications into the country, in the original packaging with a copy of any prescription. The U.S. Embassy and Consulates cannot assist you with the importation and/or release of medications.  

Marijuana, Cannabis, hash, “edibles,” and products containing CBD or THC remain illegal in Indonesia, including for medicinal purposes.  A medical prescription does not make it legal.

Local pharmacies carry a range of products of variable quality, availability, and cost. Counterfeit pharmaceuticals are a significant risk; patronize only reputable pharmacies. Malaria, dengue, Japanese encephalitis, and  Zika virus  are mosquito borne diseases in Indonesia.  Prevention of mosquito bites  is strongly encouraged; malaria preventive medication is needed in some areas. Pregnant women should be aware that Indonesia is a  CDC Zika risk area  and that Zika can be spread by mosquitos as well as  sexual contact . Diarrheal diseases are very common throughout Indonesia and  food and water precautions  are recommended. Rabies is prevalent in animals and animal contact should be avoided.

Vaccinations:  Be up-to-date on all vaccinations recommended by the U.S. Centers for Disease Control and Prevention.

Further health information:

• World Health Organization
• U.S. Centers for Disease Control and Prevention (CDC)

Air Quality:  Visit AirNow Department of State for information on air quality at U.S. Embassies and Consulates. See the OPTIONAL stock language below for additional suggestions.

The U.S. Embassy maintains a list of doctors and hospitals. We do not endorse or recommend any specific medical provider or clinic.

Medical Tourism and Elective Surgery

• Visit the U.S. Centers for Disease Control and Prevention website for information on Medical Tourism, the risks of medical tourism, and what you can do to prepare before traveling to Indonesia.
• We strongly recommend supplemental insurance  to cover medical evacuation in the event of unforeseen medical complications.
• Your legal options in case of malpractice are very limited in Indonesia.

Pharmaceuticals

• Exercise caution when purchasing medication overseas.  Pharmaceuticals, both over the counter and requiring prescription in the United States, are often readily available for purchase with little controls. Counterfeit medication is common and may prove to be ineffective, the wrong strength, or contain dangerous ingredients.  Medication should be purchased in consultation with a medical professional and from reputable establishments.
• U.S. Customs and Border Protection and the Food and Drug Administration are responsible for rules governing the transport of medication back to the United States. Medication purchased abroad must meet their requirements to be legally brought back into the United States. Medication should be for personal use and must be approved for usage in the United States. Please visit the U.S. Customs and Border Protection and the Food and Drug Administration websites for more information.

Water Quality

• Tap water is not potable. Bottled water and beverages are generally safe, although you should be aware that many restaurants and hotels serve tap water unless bottled water is specifically requested. Be aware that ice for drinks may be made using tap water.

Adventure Travel

• Visit the U.S. Centers for Disease Control and Prevention website for more information about Adventure Travel .

General Health Language

The following diseases are prevalent:

• Tuberculosis
• Chikungunya
• Use the U.S. Centers for Disease Control and Prevention recommended mosquito repellents and sleep under insecticide-impregnated mosquito nets. Chemoprophylaxis is recommended for all travelers even for short stays.
• Visit the U.S. Centers for Disease Control and Prevention website for more information about Resources for Travelers regarding specific issues in Indonesia.

Air Quality

• Air pollution is a significant problem in several major cities in Indonesia. Consider the impact smog and heavy particulate pollution may have on you and consult your doctor before traveling if necessary. People at the greatest risk from particle pollution exposure include:
• Infants, children, and teens
• People over 65 years of age
• People with lung disease such as asthma and chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema
• People with heart disease or diabetes
• People who work or are active outdoors

Travel and Transportation

Road Conditions and Safety:  Traffic in Indonesia is hazardous, congested, and undisciplined. Traffic signals are frequently ignored and often in disrepair. Motor vehicles share the roads with other forms of transportation such as pedicabs and pushcarts. Buses and trucks are often dangerously overloaded and travel at high speeds. Accidents between a car and a motorcycle are viewed as the fault of the driver of the car. Consider these risks before driving your own vehicle, especially if you are unaccustomed to Indonesian road conditions.  When an accident results in personal injury, Indonesian law requires both drivers to await the arrival of a police officer to report the accident.

Public Transportation:   Air, ferry, and road accidents that result in fatalities, injuries, and significant damage are common. While all forms of transportation are regulated in Indonesia, oversight is spotty, maintenance may not be properly performed, and rescue and emergency capacity are limited. Indonesia has experienced several fatal plane crashes and non-fatal runway overruns in recent years. Also in recent years, several ferry accidents and a train collision resulted in dozens of fatalities and even more injuries because of over-crowding and unsafe conditions.

See our  Road Safety page  for more information. Also, visit  Indonesia's national tourist office  online for road safety information.

Aviation Safety Oversight: The U.S. Federal Aviation Administration (FAA) has assessed the government of Indonesia’s Civil Aviation Authority as being in compliance with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Indonesia’s air carrier operations.  Further information may be found on the FAA’s safety assessment page .

Since 2014, several private pilots have inadvertently crossed into Indonesian airspace and have been detained and paid heavy fines. If you intend to fly on private aircraft through Indonesian airspace, get clearances from Indonesian aviation authorities before you depart. 

Maritime Safety and Security:   Inter-island travel by boat or ferry can be dangerous: storms can appear quickly, vessels may be over-crowded and lack basic safety equipment, and safety standards vary. Ferries have sunk, resulting in loss of life. The Indonesian Search and Rescue Agency records boat and ferry accidents resulting in injuries and deaths yearly. Boats and ferries used in tourism or general transportation frequently break down, stranding passengers or capsizing; not all boats are equipped with adequate life vests. Make sure you are satisfied with safety equipment and life jackets before travelling. 

Piracy:  Maritime piracy and other related crimes in and around Indonesian waters continue. Recent reports include thefts of valuables or cargo from boats that are in port and out at sea. Before traveling by sea, especially in the Strait of Malacca between Riau Province and Singapore, and in the waters north of Sulawesi and Kalimantan, review the current security situation with local authorities. Be vigilant, reduce opportunities for theft, establish secure areas on board, and report all incidents to the coastal and flag state authorities.

Maritime Travel:  Mariners planning travel to Indonesia should also check for U.S. maritime advisories and alerts on the  Maritime Administration website . Information may also be posted to the websites of the  U.S. Coast Guard  and the  National Geospace Intelligence Agency  (select “broadcast warnings”).

In recent years, private vessels have inadvertently anchored in Indonesian waters, especially near Singapore, and have been detained and paid heavy fines.

For additional travel information

• Enroll in the  Smart Traveler Enrollment Program (STEP)  to receive security messages and make it easier to locate you in an emergency.
• Call us in Washington, D.C. at 1-888-407-4747 (toll-free in the United States and Canada) or 1-202-501-4444 (from all other countries) from 8:00 a.m. to 8:00 p.m., Eastern Standard Time, Monday through Friday (except U.S. federal holidays).
• See the  State Department’s travel website  for the  Worldwide Caution  and  Travel Advisories .
• Follow us on X (formerly known as "Twitter") and Facebook .
• See  traveling safely abroad  for useful travel tips.

Review information about International Parental Child Abduction in Indonesia . For additional IPCA-related information, please see the International Child Abduction Prevention and Return Act ( ICAPRA ) report.

Travel Advisory Levels

Assistance for u.s. citizens, indonesia map, learn about your destination, enroll in step.

Subscribe to get up-to-date safety and security information and help us reach you in an emergency abroad.

Recommended Web Browsers: Microsoft Edge or Google Chrome.

Make two copies of all of your travel documents in case of emergency, and leave one with a trusted friend or relative.

Afghanistan

Antigua and Barbuda

Bonaire, Sint Eustatius, and Saba

Bosnia and Herzegovina

British Virgin Islands

Burkina Faso

Burma (Myanmar)

Cayman Islands

Central African Republic

Cote d Ivoire

Czech Republic

Democratic Republic of the Congo

Dominican Republic

El Salvador

Equatorial Guinea

Eswatini (Swaziland)

Falkland Islands

France (includes Monaco)

French Guiana

French Polynesia

French West Indies

Guadeloupe, Martinique, Saint Martin, and Saint Barthélemy (French West Indies)

Guinea-Bissau

Isle of Man

Israel, The West Bank and Gaza

Liechtenstein

Marshall Islands

Netherlands

New Caledonia

New Zealand

North Korea (Democratic People's Republic of Korea)

Papua New Guinea

Philippines

Republic of North Macedonia

Republic of the Congo

Saint Kitts and Nevis

Saint Lucia

Saint Vincent and the Grenadines

Sao Tome and Principe

Saudi Arabia

Sierra Leone

Sint Maarten

Solomon Islands

South Africa

South Korea

South Sudan

Switzerland

The Bahamas

Timor-Leste

Trinidad and Tobago

Turkmenistan

Turks and Caicos Islands

United Arab Emirates

United Kingdom

Vatican City (Holy See)

External Link

You are about to leave travel.state.gov for an external website that is not maintained by the U.S. Department of State.

Links to external websites are provided as a convenience and should not be construed as an endorsement by the U.S. Department of State of the views or products contained therein. If you wish to remain on travel.state.gov, click the "cancel" message.

You are about to visit:

Cookies on GOV.UK

We use some essential cookies to make this website work.

We’d like to set additional cookies to understand how you use GOV.UK, remember your settings and improve government services.

We also use cookies set by other sites to help us deliver content from their services.

You have accepted additional cookies. You can change your cookie settings at any time.

You have rejected additional cookies. You can change your cookie settings at any time.

Before you travel check that:

• your destination can provide the healthcare you may need
• you have appropriate travel insurance for local treatment or unexpected medical evacuation

This is particularly important if you have a health condition or are pregnant.

Emergency medical number

Call 118 and ask for an ambulance. 

Contact your insurance company quickly if you’re referred to a medical facility for treatment.

Vaccine recommendations and health risks   

At least 8 weeks before your trip:

• check the latest vaccine recommendations for Indonesia
• see where to get vaccines and whether you have to pay on the NHS travel vaccinations page

See what health risks you’ll face in Indonesia , including:

• poor air quality

Air pollution

Air quality in Indonesia’s major cities can reach levels classed as ‘unhealthy for sensitive groups’ or ‘unhealthy’. You can check current air quality data for Jakarta on the  Air Quality Index website .

Ash plumes from volcanoes can have an impact on health, particularly for anyone with pre-existing respiratory conditions. If you’re affected, get advice on how to prepare and cope with ash fall . 

During the dry season from May to November, widespread wildfires cause smoke haze, which drifts across parts of Indonesia, particularly Riau Islands, central Sumatra and Kalimantan. The haze can cause disruption to local and regional air travel, and the air pollution has an impact on public health. Keep up to date with local information and seek medical advice on appropriate precautions. A regional haze map is available from the  Singapore Meteorological Service .

Tap water is not safe to drink in Indonesia.

Altitude sickness

Altitude sickness is a risk in parts of Indonesia. Read more about altitude sickness on TravelHealthPro . 

 There are many street dogs in Bali and elsewhere, and monkeys around temples and tourist areas. Rabies exists in both wild and domestic animals, including pets. Seek immediate medical assistance if you’re bitten or scratched.

 Medication

The legal status and regulation of some medicines prescribed or bought in the UK can be different in other countries.

TravelHealthPro explains best practice when travelling with medicines .

Healthcare in Indonesia

The standard of local medical care can be poor and some medical tests cannot be performed reliably. Psychological and psychiatric services are also limited.

Good medical care can be expensive. In remote areas, you may not be able to get treatment for serious injuries or illness. Medical evacuation can cost tens of thousands of pounds. Make sure you have adequate travel health insurance and accessible funds to cover the cost of any medical treatment abroad and repatriation.

FCDO has a list of  medical providers in Indonesia where some staff will speak English.

See guidance on healthcare if you’re living in Indonesia .

Travel and mental health

Read  FCDO guidance on travel and mental health . There is also  guidance on TravelHealthPro .

Related content

Is this page useful.

• Yes this page is useful
• No this page is not useful

Help us improve GOV.UK

Don’t include personal or financial information like your National Insurance number or credit card details.

To help us improve GOV.UK, we’d like to know more about your visit today. Please fill in this survey (opens in a new tab) .

• Skip to main content
• Keyboard shortcuts for audio player

Bali reopens to foreign travelers as COVID-19 surge subsides

The Associated Press

A beach vendor sets chairs as he waits for customers in Kuta beach in Bali, Indonesia, on Thursday. The Indonesian resort island of Bali welcomed international travelers to its shops and white-sand beaches for the first time in more than a year Thursday - if they're vaccinated, test negative, hail from certain countries, quarantine and heed restrictions in public. Firdia Lisnawati/AP hide caption

A beach vendor sets chairs as he waits for customers in Kuta beach in Bali, Indonesia, on Thursday. The Indonesian resort island of Bali welcomed international travelers to its shops and white-sand beaches for the first time in more than a year Thursday - if they're vaccinated, test negative, hail from certain countries, quarantine and heed restrictions in public.

DENPASAR, Indonesia — The Indonesian resort island of Bali reopened for international travelers to visit its shops and white-sand beaches for the first time in more than a year Thursday — if they're vaccinated, test negative, hail from certain countries, quarantine and heed restrictions in public.

However, foreign visitors may be slow to arrive. No international flights to Bali were scheduled on the first day of the reopening and a tourism official forecast travel would pick up in November.

Bali's airport will welcome new foreign arrivals from 19 countries that meet World Health Organization's criteria such as having their COVID-19 cases under control, Luhut Binsar Pandjaitan, the government minister who leads the COVID-19 response in Java and Bali, said in a statement late Wednesday.

He said all international flight passengers must have proof they've been vaccinated two times, test negative for the coronavirus upon arrival in Bali and undergo a 5-day quarantine at designated hotels at their own expense. They'll also have to follow stringent rules at hotels, in restaurants and on beaches.

"We have to do this with caution because we need to stay alert," Pandjaitan said.

President Joko Widodo credited Bali's high vaccination rate for the decision to reopen. The country's COVID-19 caseload has also declined considerably; Indonesia has had around 1,000 cases a day in the past week after peaking around 56,000 daily in July.

Tourism is the main source of income on the idyllic "island of the gods" that is home to more than 4 million people, who are mainly Hindu in the mostly Muslim archipelago nation. Bali's tourist areas were deserted two decades ago after visitors were scared off by deadly terror attacks that targeted foreigners, but the island has worked to overcome that image.

More than 6 million foreigners arrived in Bali each year prior to the pandemic.

Foreign tourist arrivals dropped six-fold from 6.2 million in 2019 to only 1 million in 2020, while 92,000 people employed in tourism lost their jobs and the average room occupancy rate of classified hotels in Bali was below 20%. Statistics Indonesia data showed the island's economy contracted 9.31% year-on-year last year.

After closing the island to all visitors early in the pandemic, Bali reopened to Indonesians from other parts of the country in the middle of last year. That helped the island's gross domestic product grow a modest 2.83% in the second quarter this year, ending five consecutive quarters of contraction.

An airport worker marks queue line for the reopening of International Ngurah Rai Airport in Bali, Indonesia, Thursday. Firdia Lisnawati/AP hide caption

An airport worker marks queue line for the reopening of International Ngurah Rai Airport in Bali, Indonesia, Thursday.

The July surge , fueled by the delta variant, again totally emptied the island's normally bustling beaches and streets. Authorities restricted public activities, closed the airport and shuttered all shops, bars, sit-down restaurants, tourist attraction spots and many other places on the island. It reopened to domestic travelers in August.

Sang Putu Wibawa, the general manager at Bali's Tandjung Sari Hotel, said only two of its 40 rooms were occupied on average and he hoped the reopening would help the occupancy rate back to normal.

"We have been waiting for this moment for so long," he said. "This outbreak has hammered the local economy ... we are very excited to welcome foreign guests by observing health protocols."

Widodo said deciding to reopen Bali was based on its high vaccination rate as well as wanting to revive its economy. He said more than 80% of the Bali population has been fully vaccinated.

"Based on this situation, I am optimistic and we have decided to reopen international flights to Bali," Widodo wrote in his official Instagram on Saturday.

Overall, 59.4 million of Indonesia's 270 million people are fully vaccinated and another 43.2 million are partially vaccinated. Indonesia has confirmed more than 4.2 million cases and 142,811 deaths from COVID-19, the most in Southeast Asia.

Tourists from 19 countries are now able to visit the Bali and Riau islands provinces — Saudi Arabia, United Arab Emirates, New Zealand, Kuwait, Bahrain, Qatar, China, India, Japan, South Korea, Liechtenstein, Italy, France, Portugal, Spain, Sweden, Poland, Hungary, and Norway.

The tight timing is one reasons tourists were not immediately arriving, said Putu Astawa, head of the Bali Tourism Office

Airlines need time to schedule flights to Bali, while tourists need time to arrange travel documents such as tickets, insurance and virus tests as well as their five-day quarantine accommodations.

He predicted new visitors would start coming in early November.

The Embassy of The Republic of Indonesia in Berlin

• Layanan WNI
• Our Embassy
• Consular Service
• Honorary Consul
• Visit B211A
• Diplomatic/Service visa
• Visa on Arrival (VoA)
• Calling Visa
• Visa Exemption
• Invest in Indonesia
• Trade with Indonesia
• Wonderful Indonesia
• Information
• Tips and tricks
• Testimonials

Current Health Regulations at Entry

The Minister of Foreign Affairs of the Republic of Indonesia informs the following updates on the policies of the Republic of Indonesia concerning the Circular Letter of the COVID-19 Task Force Number 1 Year 2023 concerning Health Protocols During the Transformational Period of Endemic on Corona Virus Disease 2019 (Covid19), as follows:

• With the enactment of the Circular Letter of the COVID-19 Task Force No. 1 of 2023, the Circular Letter of COVID-19 Task Force No. 24 and 25 of 2022 are revoked and declared no longer valid.
• All document requirements for arrival and domestic travel in the Territory of the Republic of Indonesia which include the obligation to download and use the SATUSEHAT application and show a second dose of the COVID-19 vaccine certificate are no longer required.

See the following original document (Indonesia and English) here

Search Smartraveller

Latest update

Exercise a high degree of caution in Indonesia overall due to security risks.

Higher levels apply in some areas.

Indonesia (PDF 699.19 KB)

Asia (PDF 2.29 MB)

Local emergency contacts

Fire services, ambulance and rescue services, medical emergencies.

Call 110 or 112.

Tourist Police, Bali

Call (+0361) 759 687.

Tourist Police, Jakarta

Call (+201) 526 4073.

Advice levels

Exercise a high degree of caution in Indonesia overall.

Reconsider your need to travel to the provinces of Papua (Papua), Papua Highlands (Papua Pegunungan), Central Papua (Papua Tengah) and South Papua (Papua Selatan).

Reconsider your need to travel  to the provinces of Papua, Papua Pegunungan, Papua Tengah and Papua Selatan due to the risk of serious security incidents or demonstrations that may turn violent.

• There's an ongoing risk of terrorist attack in Indonesia. Be alert to possible threats. Take official warnings seriously and follow the advice of local authorities. Popular tourist areas may be the target of terrorist attacks.
• Public protests and events that draw large groups of people occur regularly and can turn violent with little notice. Expect traffic delays and restricted access to locations if there are protests. Avoid protests and demonstrations and monitor local media for the latest updates.
• There's been tension, including demonstrations and violence, in towns within the provinces of Papua,   Papua Pegunungan, Papua Tengah and Papua Selatan in recent years. Armed groups have stated that they're targeting foreigners, including Australians. Our ability to provide consular support in these provinces is limited. Armed groups have killed a foreign pilot and shot at aircraft, including commercial planes, in remote airports in Papua Pegunungan and Papua Tengah provinces.
• Many of Indonesia's volcanoes are active and can erupt without warning. Adhere to exclusion zones around volcanoes, which can change at short notice, and follow the advice of local authorities. Domestic and international flights can be disrupted. Monitor Indonesia's  Volcano Observatory Notice  for the latest volcanic activity (Bahasa Indonesia and English),  Global Disaster Alert and Coordination System  and the  Volcanic Ash Advisory Centre  for updates. 
• Petty and violent crime occurs in Indonesia. Opportunistic crime, such as pickpocketing occurs. Drinks may be spiked or mixed with toxic substances. Crimes involving taxis and taxi drivers occur. Solo women are at higher risk. Be alert in taxis, public transport, crowds, bars and nightclubs.
• Legal disputes over real estate are common, including in Bali. Before entering into an agreement or providing financial details, do your research and get legal advice.
• Natural disasters such as severe weather, floods, landslides, earthquakes, volcanic eruptions and tsunamis occur regularly. Weather conditions can change quickly during the wet season (October – April). Regularly check weather reports, monitor media and speak to your travel provider before continuing with planned activities. Follow the advice of local authorities.
• When undertaking adventure activities, ensure that functioning safety equipment is available, that you have travel insurance and that your policy covers you for these activities.

Full travel advice: Safety

• Before entering Indonesia, you need to complete an electronic health declaration form called the SATUSEHAT Health Pass . You can complete the form online before you check-in for your flight to Indonesia. After completing the form, a barcode containing your health and travel history will appear. Indonesian authorities will scan the barcode on arrival in Indonesia. Save your barcode, or bring a printed copy with you to ensure authorities can scan it on arrival. If you have Mpox symptoms you may be referred to a hospital for treatment on arrival.  
• The standard of medical facilities in Indonesia is generally lower than in Australia. Many regional hospitals only provide basic facilities.
• Some medications, including prescription medications, drugs for attention deficit hyperactivity disorder (ADHD), all cannabis-based products including medicinal cannabis, cannabis-based oils and creams, hemp-based products, CBD, THC, hash and edibles, are illegal in Indonesia. Harsh penalties, such as arrest and jail time, can apply even if you have a prescription. Make sure your  medication is legal in Indonesia .
• Purchasing prescription medication online or over the counter in Indonesia without an Indonesian prescription is illegal. Ensure you provide a valid prescription from an Indonesian doctor before purchasing prescription medication and confirm that it's accepted by the seller before your purchase.

Full travel advice: Health

• Indonesia has revised its criminal code, which includes penalties for cohabitation and sex outside of marriage. These revisions will not come into force until January 2026.
• Penalties for drug offences include heavy fines, long prison sentences and the death penalty. Police target tourist destinations. 
• Some medications are illegal in Indonesia. Harsh penalties can apply even if you have a prescription. It is also illegal to purchase prescription medications online or over the counter without an Indonesian prescription. Ensure you have a valid Indonesian prescription. See ' Health '.

The death penalty exists for some crimes in Indonesia.

• Standards of dress and behaviour are conservative in many parts of Indonesia. Learn about local customs. Take care not to offend.
• Aceh province upholds aspects of sharia law. Sharia law applies to everyone, including travellers. Inform yourself about the laws, and be careful not to offend or break local laws. If in doubt, seek local advice.

Full travel advice: Local laws

• Before entering Indonesia, you need to complete an electronic health declaration form called the SATUSEHAT Health Pass . You can complete the form online before you check-in for your flight to Indonesia. After completing the form, a barcode containing your health and travel history will appear. Indonesian authorities will scan the barcode on arrival in Indonesia. Save your barcode, or bring a printed copy with you to ensure authorities can scan it on arrival. If you have Mpox symptoms you may be referred to a hospital for treatment on arrival (See 'Health').
• The Bali Provincial Government has introduced a tourist levy of IDR 150,000 per person to foreign tourists entering Bali. The tourist levy is separate from the e-Visa on Arrival or the Visa on Arrival. Cashless payments can be made online prior to travel or on arrival at designated payment counters at Bali's airport and seaport. See the  Bali Provincial Government's  official website and  FAQs  for further information.
• If you're travelling to Indonesia for tourism, official government duties or business meetings, you can  apply for an e-Visa on Arrival (e-VOA)  online at least 48 hours before your travel to Indonesia. This also applies if you're transiting through Indonesia at international airports, seaports and land crossings. You can get a Visa on Arrival (VOA) at some international airports, seaports or land crossings.
• To apply for the e-VOA or VOA, you must have an ordinary (non-emergency) passport with at least 6 months of validity from the date you plan to enter (we also recommend having at least 6 months of passport validity from the date you plan to leave Indonesia, to avoid any issues for your departure or onward travel) and a return or onward flight booking to another country.
• You may need to apply for a visa in advance to enter Indonesia for purposes not covered by the e-VOA or VOA. Check the latest entry requirements with your travel provider or an  Embassy or Consulate of Indonesia  before travel. Entry, exit and transit conditions can change at short notice, including to Bali and Jakarta by air, land or sea. Contact your travel provider and monitor media for the latest updates. 
• You'll be required to complete an  e-customs declaration  for arrival. You can complete this within 3 days of departure to Indonesia.

Full travel advice: Travel

Local contacts

• The Consular Services Charter tells you what the Australian Government can and can't do to help when you're overseas.
• For consular help, contact the Australian Embassy, Jakarta , the Australian Consulate-General, Bali , the Australian Consulate-General, Makassar or the Australian Consulate-General, Surabaya .
• To stay up to date with local information, follow the Embassy's social media accounts.

Full travel advice: Local contacts

Full advice

The terrorist threat in Indonesia is ongoing. Attacks could happen anywhere and anytime. This includes places that foreigners visit.

Be alert to possible threats. Take official warnings seriously and follow the advice of local authorities. Remain respectful of religious and local customs.

Indonesian authorities continue to investigate and disrupt terrorist groups in Indonesia, including Bali.

Terrorist attacks are motivated by extreme beliefs. Both local grievances as well as events in other parts of the world could motivate extremists in Indonesia towards violence.

Recent terrorist attacks

In December 2022, an explosion occurred at a police station in Bandung, Jawa Barat, killing 2 and injuring 11.

In March 2021, 2 suicide bombers attacked a church in Makassar, injuring dozens.

In the past, police have said that terrorist suspects remain at large and may seek Western targets.

Indonesian security agencies continue to conduct operations against terrorist groups.

Terrorists in Indonesia may carry out small-scale violent attacks with little or no warning.

Be alert in places of worship, especially during periods of religious significance.

Terrorists have targeted places of worship in:

As well as places of worship, other possible targets by terrorists include:

• Indonesian government facilities, premises and symbols associated with the Indonesian Government
• police stations and checkpoints
• bars, nightclubs, cafes and restaurants
• cinemas and theatres
• shopping centres, public transport and transport hubs
• airports and airlines
• clubs, including sporting clubs
• tourist areas and attractions, tour buses and tour groups
• outdoor recreation events

Supporters have committed additional acts of violence in response to high-profile extremists being detained or killed.

To protect yourself during a terrorist attack:

• leave the area as soon as it's safe
• follow the advice of local authorities
• don't gather in a group after an attack
• don't gather in a group if you're evacuated from a building

Security remains at a high level at:

• the Australian Embassy in Jakarta
• the Consulates-General in Bali, Makassar and Surabaya

More information:

Civil unrest and political tension

Most events are announced before they happen; however, protests may occur with little or no notice.

Protests and events are often held near major government buildings and embassies in Jakarta, including the Australian Embassy.

Protests may also occur at any of Australia's Consulates-General in Surabaya, Bali and Makassar, at government buildings, or the offices of international organisations in Indonesia.

You can expect traffic delays and restricted access to locations if there are protests.

Phone or email ahead for an appointment before going to the Embassy or the Consulates-General (see  Local contacts ).

Demonstrations and acts of violence can happen when courts try and sentence extremists.

Conflict between different communities can sometimes occur, including in the provinces of Papua, Papua Pegunungan, Papua Tengah and Papua Selatan. Our ability to provide consular support in these provinces is limited.

Local violence can also be directed at minority groups in other parts of Indonesia, including in Java.

If you're found to endanger security or public order, you may be prosecuted under Indonesia's Immigration laws, which may result in imprisonment or deportation.

To protect yourself from possible violence:

• avoid protests and demonstrations
• monitor local media for the latest security updates
• plan your activities to avoid potential unrest on significant dates
• be prepared to change your travel plans
• Demonstrations and civil unrest

Armed conflict

The provinces of Papua, Papua Pegunungan, Papua Tengah and Papua Selatan experience regular violent clashes involving armed groups, civilians, Indonesian police, and the military. Armed groups have stated that they are targeting foreigners, including Australians. Our ability to provide consular support in these provinces is limited.

Many people have been killed and injured in clashes. This includes members of security forces, armed groups and civilians. Violent attacks have occurred in several areas of these provinces, including in and around Jayapura. There's a risk of more attacks.

In February 2023, a riot broke out in Wamena, Papua Pegunungan, when a crowd attacked Indonesian security personnel following the arrest of two people accused of child kidnapping. 12 civilians and rioters were killed.

Violent attacks have occurred around the Freeport Mine in Papua Tengah.

Armed groups have:

• killed a New Zealand helicopter pilot in Mimika, Papua Tengah
• taken a New Zealand pilot hostage in Paro, Papua Pegunungan
• shot at aircraft, including commercial planes, at Beoga airport in Papua Tengah province and Nop Goliat Dekai airport in Papua Pegunungan province
• killed people in attacks, including one Australian
• attacked vehicles using the road between Grasberg and Timika
• killed people in violent attacks in Puncak Jaya District, Papua Tengah
• more attacks are possible and could target infrastructure and national institutions.

A range of crimes, including violent crime, occur in Indonesia. Crimes can happen in popular tourist locations in Bali.

To protect yourself from crime:

• be aware of your surroundings
• be alert in crowds
• understand the potential crime risks

Theft, robbery  and bag and phone snatching have occurred. These crimes can sometimes involve violence. Opportunistic crime such as pickpocketing occurs.

Be careful of thieves:

• on motorcycles targeting pedestrians
• in upmarket shopping malls
• in crowded public transport
• at traffic lights targeting people in stopped cars
• at bars and nightclubs
• when entering accommodation, including villas in Bali

Keep bags and valuables out of sight in vehicles.

If you're travelling on foot, walk:

• on footpaths
• away from the curb
• with your bag held away from traffic

Sexual assault

If you're a victim of sexual assault :

• get immediate medical assistance. If you have any doubts about seeking medical assistance after a sexual assault, contact your nearest Australian Embassy or Consulate in Indonesia (see  Local contacts ) as quickly as possible.
• make a full statement to local police, in person, so they can conduct a criminal investigation. You may wish to seek consular help before you visit the police station. Contact your nearest Australian Embassy or Consulate (see  Local contacts ).

Local police can only investigate a crime after you've left Indonesia if you've reported it.

Your sworn statement, or statements by witnesses, can be used as evidence in criminal court proceedings.

You don't always need to be in Indonesia for trial. Neither do witnesses who live outside of Indonesia.

Counselling support

Should you wish to speak to a counsellor, you can call the 24-hour Consular Emergency Centre on +61 2 6261 3305 or contact your nearest Australian Embassy or Consulate (see  Local contacts ). They can connect you to counselling hotlines and services.

• Reducing the risk of sexual assault

Bars and nightclubs

Be alert in bars and nightclubs. Drink-spiking and snatching of valuables may occur if you're not alert.

Drinks may be contaminated with drugs or toxic substances. See  Health .

Don't leave your food or drinks unattended.

Never accept drinks, food, gum, cigarettes, vapes or e-cigarettes from people you've just met.

• Partying safely

Credit card and ATM fraud

Credit card, online banking and ATM fraud occurs in Indonesia.

Check your bank statements.

Make sure your bank doesn't block your cards. Tell your bank you'll be visiting Indonesia.

Never let your card out of your sight. This includes when you pay in restaurants.

Shield your PIN from sight.

Some vendors install hidden cameras and use card skimmers.

Don’t click on unknown links in WhatsApp or mobile phone text messages, particularly if your phone is linked to mobile banking.

Use ATMs at controlled and secure places, such as:

• shopping centres

Scams and confidence tricks

Beware of scams and confidence tricks.

Only exchange money at authorised money changers. Authorised money changers can also be found on the  Bali Foreign Exchange website . Unauthorised money changers have been known to scam foreign tourists in Bali and elsewhere.

All types of gambling are illegal in Indonesia.

Australians have lost large sums of money in card game scams run by organised gambling gangs, particularly in Bali. See Local laws

Some tourists have been robbed or planted with drugs after taking new acquaintances back to their hotel rooms. In some cases, their drinks were spiked.

Legal disputes over the purchase of real estate are common, including in Bali, involving:

• holiday clubs and resorts
• timeshare schemes

Before entering into an agreement or providing financial details:

• thoroughly research the proposal
• get legal advice and know your rights, especially before you sign any documents

Using taxis

Only use licensed official metered taxis. Crimes involving unregistered taxis include:

• taxis departing before the passenger can take their baggage from the vehicle
• taxi drivers robbing or temporarily holding passengers, including in urban areas
• taxi drivers forcing passengers to withdraw money at ATMs before releasing them

Lone female travellers are at higher risk of crime.

If you're in an incident involving a taxi, leave the taxi and the immediate area if it's safe to do so.

To protect yourself from overcharging and scams:

• only travel in licensed taxis with signage, a "taxi" roof sign and meters working
• ensure the driver's identification card is visible
• book via your phone, on an official taxi company mobile app, from inside an airport, or at stands at major hotels

See Travel .

Cyber security

You may be at risk of cyber-based threats during overseas travel to any country. Digital identity theft is a growing concern. Your devices and personal data can be compromised, especially if you're connecting to Wi-Fi, using or connecting to shared or public computers, or to Bluetooth.

Social media can also be risky in destinations where there are social or political tensions, or laws that may seem unreasonable by Australian standards. Travellers have been arrested for things they have said on social media. Don't comment on local or political events on your social media.

• Cyber security when travelling overseas

Kidnapping  occurs across the world with political, ideological and criminal motives. Foreigners, including Australians, have been kidnapped overseas while travelling. Kidnaps can happen anywhere, anytime, including destinations that are typically at lower risk. 

On 5 August, a New Zealand helicopter pilot was killed by an armed group in Alama District, Mimika Regency, Papua Tengah. In February 2023, a New Zealand pilot was taken hostage by an armed group in Paro, Papua Pegunungan.

The Australian Government's longstanding policy is that it doesn't make payments or concessions to kidnappers.

Adventure activities

Many businesses don't follow safety and maintenance standards. This includes transport and tour operators, water sports providers, hotels, restaurants and shops.

It may affect adventure activities, such as:

• bungee jumping
• scuba diving and snorkelling 
• chairlift or gondola rides

In the past, Australians have been seriously injured or died while participating in adventure activities. If you require intensive care medical treatment, emergency surgery or medical evacuation. The Australian Government won't pay for these costs.

If you plan to do an adventure activity :

• check if your travel insurance policy covers it
• ask about safety, search and rescue procedures
• ask about and insist on minimum safety requirements
• always use available safety gear, such as life jackets or seatbelts
• check with your travel provider on vessel capacity limits before embarking on sea, land or air travel
• check weather and ocean conditions, and whether the vessel has had any mechanical issues, on the day and before continuing with water activities or sea travel
• check where the nearest medical facilities are

If proper safety equipment isn't available or you're unsure of the provider's safety or maintenance procedures, use another provider.

Trekking and climbing

Some mountain treks suit only experienced climbers. Travel with a guide and check the level of difficulty beforehand.

Many trekking options may be on or around an active volcano. Many of Indonesia's volcanoes are active and can erupt without warning. Volcanic and seismic activity may continue for some time. Adhere to exclusion zones around volcanoes, which can change at short notice, and follow the advice of local authorities. If you're planning to travel to an area near an active volcano, check with local authorities before climbing and check:

• Bureau of Meteorology  Volcanic Ash Advisory Centre  
• MAGMA Indonesia  (Bahasa Indonesia) for daily updates on status and alert levels
• National Disaster Management Authority (BNPB)  (Bahasa Indonesia)
• Global Disaster Alert and Coordination System

Swimming safety

People have drowned in coastal areas, including in Bali, due to rough seas, strong currents, or from swimming, snorkelling or scuba diving in areas where there is frequent passage of boats, resulting in collisions.

Local beach rescue services may not be of the same standard as in Australia.

Saltwater crocodiles are in rivers throughout Indonesia. Avoid swimming around river estuaries and seek local advice in other locations. 

If you plan to spend time in or on the water:

• regularly check weather reports as sea conditions can change rapidly
• take warnings seriously
• check media and local sources for information about potential dangers
• speak to your travel provider about safety equipment and weather conditions before continuing with planned activities
• take a friend or family member with you when you undertake swimming or water activities
• be careful when swimming, snorkelling or scuba diving near motor-powered boats or where there is frequent passage of boats
• ensure you have travel insurance and that your policy covers you for planned activities

Ensure you have travel insurance and that your policy covers you for planned activities.

Climate and natural disasters

Indonesia experiences natural disasters and severe weather , including:

• landslides and mudslides
• volcanic eruptions
• earthquakes
• storms resulting in turbulent sea conditions
• tsunamis and high wave events

If there's a natural disaster or severe weather:

• always carry your passport in a waterproof bag
• keep in contact with family and friends
• check the media and local sources for information
• don't undertake sea, land or air travel if it's not safe to do so
• Indonesian Meteorology, Climatology and Geophysics Agency (BMKG)  (English and Bahasa Indonesia)
• BMKG Multi-Hazard Early Warning System app  (English and Bahasa Indonesia) 

Floods and mudslides

Floods , landslides and mudslides occur regularly during the wet season from October to April, with some severe events resulting in injury, displacement, death or damaged infrastructure.

Heavy rains can cause significant flooding in urban areas, including the greater Jakarta region, causing disruption to transportation. Monitor the local media for updates.

Walking and driving in flooded areas can be dangerous. Flood waters may hide uncovered drainage ditches.

Volcanic activity may escalate with little or no notice, leading to flight disruptions and airport closures, including in surrounding provinces. Contact your airline for the latest flight information. 

There are 147 volcanoes in Indonesia. 76 of them are active volcanoes and could erupt at any time.

Volcanic alert levels and exclusion zones may rise quickly. You may be ordered to evacuate at short notice. Volcanic activity can disrupt domestic and international flights. There are 4 volcano alert levels in Indonesia; 1 - normal, 2 - advisory, 3 - watch, 4 - warning.

Before you travel to areas that are prone to volcanic activity, monitor media and ensure you read the Indonesian Government's latest advice on current volcanic activity, including:

• Volcanic Activity Report  by Indonesia's Multiplatform Application for Geohazard Mitigation and Assessment (MAGMA) (Bahasa Indonesia)
• Volcano Activity and Observatory Notices  (English and Bahasa Indonesia)
• MAGMA Indonesia Map of Latest Volcano Levels and Climate Information  (Bahasa Indonesia)
• Bureau of Meteorology's  Volcanic Ash Advisory Centre

If there's volcanic activity:

• avoid the area
• take official warnings seriously and adhere to exclusion zones
• follow the instructions and advice of local authorities
• follow evacuation orders
• read our advice on Volcanic eruptions while travelling

Volcanic ash can cause breathing difficulties. The risk is higher for people with chronic respiratory illnesses, including:

Recent and frequent volcanic activity has included:

• Mount Ile Lewetolok in East Nusa Tenggara (Nusa Tenggara Timur)
• Mount Lewotobi Laki Laki in East Flores Regency, Nusa Tenggara Timur
• Mount Marapi in West Sumatra
• Mount Anak Krakatau, to the south of Sumatra
• Mount Merapi, near Yogyakarta
• Mt Dukono in North Sulawesi
• Mount Semeru, near Malang, East Java
• Mount Agung in Bali
• Mount Sinabung in North Sumatra

Some trekking routes are on or near active volcanoes, including Mount Agung and Mount Batur in Bali, Mount Marapi in West Sumatra, Mount Merapi near Yogyakarta, Mount Rinjani in Lombok, Mount Bromo and Mount Ijen in East Java. See 'Trekking and climbing'.

If you're planning to travel to an area near an active volcano, make sure you have comprehensive travel insurance and check if any restrictions apply.

If a volcanic eruption occurs:

• make a backup plan in case you're affected
• contact your airline or travel insurer to confirm flight schedules and get help
• keep in touch with family and friends
• Learn more about  volcanic eruptions  (Geoscience Australia)
• See practical advice and information about  volcanic eruptions  (US CDC)
• See worldwide  volcanic activity reports  in real-time (GDACS)

Earthquakes

Indonesia is in an active earthquake region. It has a high level of earthquake activity, that sometimes triggers tsunamis.

There are approximately 4,000 earthquakes across Indonesia every year. Around 70 to 100 of these are over 5.5 magnitude.

Earthquakes can cause death, injury and significant damage to infrastructure.

Strong earthquakes can occur anywhere in Indonesia. They are less common in Kalimantan and south-west Sulawesi.

To stay safe during an earthquake:

• know the emergency plans at your accommodation
• take precautions to avoid exposure to debris and hazardous materials, including asbestos
• MAGMA Indonesia  (Bahasa Indonesia)
• Indonesia's Meteorology, Climatology and Geophysics Agency  (Bahasa Indonesia) or BMKG Multi-Hazard Early Warning System app (English and Indonesia)
• Indonesia's Centre for Volcanology and Geological Disaster Mitigation  (Bahasa Indonesia)
• US Federal Emergency Management Agency advice on what to do before, during and after an earthquake  (English)

Forest fires and smoke haze

During the dry season in April to November, widespread forest fires can cause smoke haze resulting in poor air quality across parts of Indonesia, particularly the Riau Islands, central Sumatra and Kalimantan.

Smoke haze could affect your health and travel plans.

Keep up to date with local information and seek medical advice on appropriate precautions.

• ASEAN Regional Haze Situation
• Smartraveller advice on Bushfires

Tsunamis and high wave events

The Indian and Pacific Oceans experience more frequent, large and destructive tsunamis than other parts of the world.

There are many large earthquakes along major tectonic plate boundaries and ocean trenches.

High wave events can happen throughout coastal regions and between islands. They're caused by strong weather conditions and storms.

If you plan to surf, undertake water activities or travel by sea, check local conditions regularly.

If there’s a tsunami or high wave event: 

• don't travel by sea if it's not safe to do so
• Indonesia Tsunami Early Warning Centre  issues warnings when a potential tsunami with significant impact is expected
• Indonesia's Meteorology, Climatology and Geophysics Agency  with the latest list of earthquakes with a magnitude greater than 5.0 on the Richter scale (Bahasa Indonesia) or  BMKG Multi-Hazard Early Warning System app  (English and Bahasa Indonesia)
• US Federal Emergency Management Agency page  on what to do before, during and after an earthquake

Piracy occurs in the coastal areas of Indonesia.

The  International Maritime Bureau (IMB)  issues weekly piracy reports.

If you decide to travel by boat in these regions:

• check  IMB piracy  reports
• get local advice
• arrange security measures
• Travelling by boat
• Going on a cruise
• International Maritime Bureau

Travel insurance

Get comprehensive travel insurance before you leave. 

Your policy needs to cover all overseas medical costs, including emergency treatment and medical evacuation. The Australian Government won't pay for these costs.

If you can't afford travel insurance, you can't afford to travel. This applies to everyone, no matter how healthy and fit you are.

If you're not insured, you may have to pay many thousands of dollars up-front for medical care.

Before you travel, confirm:

• what activities and care your policy covers
• that your insurance covers you for the whole time you'll be away, including on all forms of transport you plan to take
• whether it covers medical evacuation in the event of hospitalisation or injury
• any exclusions to your policy

Physical and mental health

Consider your physical and mental health before you travel, especially if you have an existing medical condition. 

See your doctor or travel clinic to:

• have a basic health check-up
• ask if your travel plans may affect your health
• plan any vaccinations you need

Do this at least 8 weeks before you leave.

If you have immediate concerns for your welfare or the welfare of another Australian, call the 24-hour Consular Emergency Centre on +61 2 6261 3305 or contact your  nearest Australian Embassy, High Commission or Consulate  to discuss counselling hotlines and services available in your location.

• General health advice
• Healthy holiday tips  (Healthdirect Australia)

Not all medication available over the counter or by prescription in Australia is available in other countries. Some may even be considered illegal or a controlled substance, even if prescribed by an Australian doctor.

Some drugs used to treat attention deficit hyperactivity disorder (ADHD) are illegal in Indonesia.

If you plan to bring over-the-counter or prescription medication, check if it's legal in Indonesia by contacting the  Indonesian Embassy in Canberra  well in advance of your planned travel. Take enough legal medicine for your trip and carry it in its original packaging. Purchasing prescription medication online in Indonesia without an Indonesian prescription is illegal. Ensure you provide a valid prescription from an Indonesian doctor before purchasing prescription medication and confirm that it's accepted by the seller prior to your purchase.

Carry a copy of your prescription and a letter from your doctor stating:

• what the medicine is
• your required dosage
• that it's for medical treatment or use

If you're caught with illegal medicine, you could face detention, fines or harsher penalties. You could face charges even if an Australian doctor prescribed the medication.

Ask the Indonesian Embassy in Canberra for advice before you travel.

Medicinal cannabis and cannabis-based products

Cannabis-based products such as cannabis oil and creams, hemp, CBD, THC, hash and edibles remain illegal in Indonesia, including for medicinal purposes. A medical prescription does not make it legal. If you take such products to Indonesia or purchase or use them in Indonesia, you can be arrested and face imprisonment, fines, deportation or the death penalty.

• Medications

Health Risks

To prevent the entry of new variants of Mpox to Indonesia, all travellers arriving at international ports in Indonesia need to complete an electronic health declaration form called the SATUSEHAT Health Pass. 

You can complete the form online before you check-in for your flight to Indonesia. After completing the form, a barcode containing your health and travel history will appear. Indonesian authorities will scan the barcode on arrival in Indonesia. Save your barcode or bring a printed copy with you, to ensure authorities can scan it on arrival. If you have Mpox symptoms you may be referred to a hospital for treatment on arrival. 

• SATUSEHAT Health Pass

Critical care for Australians who become seriously ill, including in Bali, is significantly below the standard available in Australia. Medical evacuation may not be possible.

The Australian Government cannot guarantee your access to hospitals and other health services in Indonesia. 

Medical evacuation to Australia for medical conditions, is possible but is very expensive and may not be covered by travel insurance. Check your policy before you travel.

Ban on sale of liquid/syrup medication

The Indonesian Ministry of Health (MoH) has advised local health workers and pharmacists to stop selling liquid/syrup medication, including commonly used medications containing paracetamol and cough syrups. MoH and the Indonesian Paediatrician Association (IDAI) received reports of a sharp increase in cases of Atypical Progressive Acute Kidney Injury (AKI) in children , especially under the age of 5 years.

Insect-borne illnesses

Insect-borne illnesses are common throughout the year.

To protect yourself from disease:

• research your destination
• ask locals for advice
• make sure your accommodation is mosquito-proof
• use insect repellent
• wear long, loose, light-coloured clothing

Dengue  occurs throughout Indonesia, including Bali, Jakarta and other major cities.

Dengue is common during the rainy season.

Australian health authorities have reported an increase in dengue infections in people returning from Bali in recent years.

Consult your travel doctor for further information on available vaccines and their suitability for your individual circumstances.

Zika virus  can occur in Indonesia.

Protect yourself from mosquito bites.

The  Australian Department of Health and Aged Care  advises pregnant women to:

• discuss any travel plans with their doctor
• consider deferring non-essential travel to affected areas

Malaria , including chloroquine-resistant strains, is widespread in rural areas, particularly in the provinces of Papua, Papua Pegunungan, Papua Tengah, Papua Selatan, Papua Barat Daya, Papua Barat, Maluku and Nusa Tenggara Timur. There is no malaria transmission in Jakarta.

• Consider taking medicine to prevent malaria.

Japanese encephalitis and filariasis

Japanese encephalitis  and  filariasis  occur in Indonesia, especially in rural agricultural areas.

Japanese encephalitis has been present in Australian travellers returning from Indonesia, including Bali.

Vaccination is recommended for certain groups of travellers. 

• Infectious diseases

Drink poisoning

People have been poisoned by alcoholic drinks contaminated with harmful substances, including methanol and arak (a traditional rice-based spirit). Locals and foreigners, including Australians, have died or become seriously ill from poisoned drinks.

Cases of drink poisoning have been reported in Bali and Lombok.

Contaminated drinks have included:

• local spirits
• spirit-based drinks, such as cocktails
• brand name alcohol

To protect yourself from drink poisoning:

• consider the risks when drinking alcoholic beverages
• be careful drinking cocktails and drinks made with spirits
• drink only at reputable licensed premises
• avoid home-made alcoholic drinks

Labels on bottles aren't always accurate.

Symptoms of methanol poisoning can be similar to drinking too much. However, they are usually stronger.

Symptoms of methanol poisoning include:

• vision problems

Vision problems may include:

• blindness, blurred or snowfield vision
• changes in colour perception
• difficulty looking at bright lights
• dilated pupils
• flashes of light
• tunnel vision

If you suspect that you or someone you're travelling with may have been poisoned, act quickly. Urgent medical attention could save your life or save you from permanent disability.

Report suspected cases of methanol poisoning to the Indonesian police.

Magic mushrooms

Don't consume magic mushrooms. They're illegal.

Australians have become sick or injured after taking magic mushrooms.

Australians have been in trouble with local police after taking magic mushrooms, particularly in Bali.

Magic mushrooms can cause major health problems, including:

• erratic behaviour
• severe hallucinations

Rabies is a risk throughout Indonesia, especially in:

• Nusa Tenggara Timur, including Labuan Bajo
• South Sulawesi
• West Kalimantan
• Nias, off the west coast of Sumatra

To protect yourself from rabies:

• avoid direct contact with dogs
• don't feed or pat animals
• avoid contact with other animals, including bats and monkeys.

Talk to your doctor about getting a pre-exposure rabies vaccination. 

If bitten or scratched by an animal:

• immediately use soap and water to wash the wound thoroughly for 15 minutes
• seek urgent medical attention.

Rabies treatment in Indonesia may be limited, including the rabies vaccine and immunoglobulin availability. If you're bitten, you may need to return to Australia or travel to another country for immediate treatment.

You're at risk of contracting rabies if you visit a market where live animals and fresh food are sold because:

• live rabies-positive dogs may be present
• rabies-positive dog meat may be sold as food

Selling dog meat for human consumption is a breach of government disease control regulations.

Avoid contact with monkeys, even in places where you're encouraged to interact with them. This includes:

• popular markets
• tourist destinations
• sanctuaries

Legionnaires' disease

Cases of Legionnaires' disease have been reported in people who have travelled to Bali. Travellers who are unwell with flu-like symptoms within 10 days of returning from Bali are advised to consult their GPs.

• Legionnaires' disease warning for Bali travellers  (Western Australian Government Department of Health) 
• Legionnaires’ disease  (Better Health Channel, Victorian Government Department of Health)
• Legionnaires' disease  (World Health Organization)

Cases of poliovirus (type 1) have been reported in the provinces of Papua, Papua Pegunungan, Papua Tengah and Papua Selatan. Poliovirus (type 2) cases have been reported in the provinces of Aceh, East, West and Central Java. There may be unreported cases in other provinces in Indonesia.

Ensure that you're vaccinated against polio.

• Factsheet on poliovirus types  (World Health Organization)
• Health emergencies information for Indonesia  (World Health Organization)

Periodic outbreaks of measles continue to be reported in Indonesia, including Bali.

You need 2 doses of vaccine 4 weeks apart to be fully vaccinated against measles.

If you have symptoms of measles, seek medical attention.

Measles is highly infectious. Call before attending a healthcare facility.

Nipah Virus and Yellow Fever

There are no cases of  Nipah virus  or  Yellow Fever  in Indonesia. You may be temperature checked on arrival at international and domestic airports. If you have fever symptoms, you may be referred to the airport clinic for further tests and asked to seek medical treatment. See your doctor or travel clinic before you travel to plan any vaccinations you need.

HIV/AIDS is a risk for travellers. Take steps to reduce your risk of exposure to the virus.

Other health risks

Waterborne, foodborne, parasitic and other infectious diseases are widespread. These include:

• tuberculosis

Serious outbreaks sometimes occur.

To protect yourself from illness:

• boil drinking water or drink bottled water
• avoid ice cubes
• avoid raw food, such as salads

To minimise the risk of food poisoning, only eat meat from reputable suppliers.

Seek urgent medical attention if you suspect food poisoning or have a fever or diarrhoea.

Seafood toxins

You can become sick from naturally occurring seafood toxins, including:

• ciguatera fish poisoning
• scombroid (histamine fish poisoning)
• toxins in shellfish

Avoid temporary black henna tattoos. The dye often causes serious skin reactions.

Before you get any tattoo, check the hygiene and safety of your tattoo provider.

Medical care

Medical facilities.

The standard of medical facilities in Indonesia is generally lower than Australia. Many regional hospitals only provide basic facilities.

Hospitals expect families to provide support to patients, including all financial support.

Psychiatric and psychological services are limited in Indonesia. Hospital staff may use physical restraints on patients.

When diving in Indonesia, there is a risk that you may experience decompression illness. An illness may occur when a diver ascends to the water surface too quickly and may have severe consequences. Understand the risks before you dive. 

Decompression chambers are available in various areas, including the following locations:

• Bali's Sanglah General Hospital
• Siloam Hospital in Labuan Bajo
• Hospitals in Jakarta, Balikpapan, Bintan, Medan, Makassar, Raja Ampat (Waisai), Maluku, Tual and Manado near popular dive sites 

Before admitting patients, hospitals usually need:

• guarantee of payment from the patient or their next of kin (family or friend)
• confirmation of medical insurance
• deposit payment 

There's no reciprocal healthcare agreement between Australia and Indonesia. 

The Australian Government cannot provide guarantee of payment, confirmation of medical insurance or a deposit payment for services.

If you become seriously ill or injured, you may need to be evacuated to a place with better care. Medical evacuation can be very expensive. Check your insurance policy before you travel. The Australian Government won't pay for these costs. It's best to check with your travel provider on the location and functionality of decompression chambers and other medical facilities available in the area before undertaking remote travel.

You're subject to all local laws and penalties, including those that may appear harsh by Australian standards. Research local laws before travelling.

Indonesian Parliament has passed revisions to its criminal code, which includes penalties for cohabitation and sex outside of marriage. These revisions will not come into force until January 2026.

Indonesia has signed into law revisions to the Electronic and Information Transactions Law (ITE Law). Tough penalties apply for defamation, hate speech, spreading hoaxes and uploading immoral content to the Internet. The law applies both within and outside Indonesia.

If you're arrested or jailed, the Australian Government will do what it can to help you under our Consular Services Charter . But we can't get you out of trouble or out of jail.

• Arrested or jailed

Penalties for drug offences are severe. They include the death penalty.

You may face heavy fines or jail for consuming or possessing even small amounts of drugs, including marijuana. Cannabis-based products such as cannabis oil and cream, hemp, CBD, THC, hash and edibles remain illegal in Indonesia, including for medicinal purposes. A medical prescription does not make it legal. If you take such products to Indonesia or purchase or use them in Indonesia, you can be arrested and face imprisonment, fines, deportation or the death penalty.

Some prescription medications that are available in Australia are illegal in Indonesia. Purchasing prescription medication online or over the counter in Indonesia without an Indonesian prescription is illegal. Ensure you provide a valid prescription from an Indonesian doctor before purchasing prescription medication and confirm that it's accepted by the seller before your purchase.

Magic mushrooms are illegal. Indonesian police work to prevent their distribution.

Police target illegal drug use and possession across Indonesia. Police often target popular places and venues in Bali, Lombok and Jakarta.

• Carrying or using drugs

Local labour laws can change at short notice. This can affect expatriate workers.

Under Indonesian law, you must always carry identification. For example, your:

• Australian passport; and
• Resident's Stay Permit (if applicable)

Gambling is illegal.

Property laws are strict, seek legal advice before acquiring property in Indonesia.

It's sometimes illegal to take photographs in Indonesia. Obey signs banning photography. If in doubt, get advice from local officials. See Safety .

Australian laws

Some Australian criminal laws still apply when you're overseas. If you break these laws, you may face prosecution in Australia.

• Staying within the law and respecting customs

Local customs

Standards of dress and behaviour are conservative in many parts of Indonesia. Take care not to offend.

Find out what customs apply at your destination.

If in doubt, seek local advice.

LGBTQIA+ information

Same-sex relationships are legal in Indonesia, except in the province of Aceh. Same-sex relationships in Aceh may attract corporal punishment. Visible displays of same sex relationships could draw unwanted attention.

Some laws and regulations can be applied in a way that discriminates against the LGBTI community, including for pornography and prostitution.

• Advice for LGBTQIA+ travellers

The Islamic holiday month of Ramadan  is observed in Indonesia. Respect religious and cultural customs and laws at this time.

During Ramadan, eating, drinking and smoking may be illegal in public during this time. If you're not fasting, avoid these activities around people who are. Seek local advice to avoid offence and follow the advice of local authorities.

Explore our Ramadan page to learn more, including dates for Ramadan.

Aceh is governed as a special territory, not a province, and has a degree of special autonomy.

Some aspects of sharia law are upheld. This includes regulations and punishments that don't apply in other parts of Indonesia.

Local sharia police enforce sharia law.

Sharia law applies to anyone in Aceh, including:

• foreigners (expats and travellers)
• non-Muslims

Sharia law doesn't allow:

• drinking alcohol
• prostitution
• same-sex relationships
• extra-marital sex
• co-habitation before marriage

It also requires a conservative standard of dress.

Learn about the laws in Aceh. If in doubt, seek local advice.

Dual citizenship

Indonesia doesn't allow dual nationality for adults, and you may be prosecuted by Immigration authorities should you be found to hold valid passports of two nationalities. If you entered Indonesia on your non-Australian citizenship passport, Indonesian Immigration will require you to exit Indonesia on that nationality's passport.

A child of Indonesian and Australian parents can maintain citizenship of both countries until the age of 18 years. Before a dual Australian-Indonesian citizen minor travels from Indonesia, additional identity documentation may be required from Indonesian Immigration. Check with Indonesian Immigration or the  Indonesian Embassy in Canberra  well in advance of your planned travel.

• Embassy and Consulate of Indonesia
• Information on limited dual citizenship
• Dual nationals

Visas and border measures

Every country or territory decides who can enter or leave through its borders. For specific information about the evidence you'll need to enter a foreign destination, check with the nearest embassy, consulate or immigration department of the destination you're entering. 

Travel to Bali

The Bali Provincial Government has introduced a new tourist levy of IDR 150,000 per person to foreign tourists entering Bali. The tourist levy is separate from the e-Visa on Arrival or the Visa on Arrival. Cashless payments can be made online prior to travel or on arrival at designated payment counters at Bali's airport and seaport. Exemption from payment of the levy applies to transit passengers and certain visa holders. See the Bali Provincial Government's  official website and FAQs for further information.

e-Visa on Arrival and Visa on Arrival

You can  apply for an e-Visa on Arrival (e-VOA)  no later than 48 hours prior to travelling to Indonesia if you are travelling for tourism, business meetings, purchasing goods or transiting only. Check the e-VOA requirements from Indonesian Immigration before applying.

You can still apply for a regular Visa on Arrival (VOA) at certain international airports, seaports and land crossings, including Jakarta, Bali, Surabaya, Makassar, Lombok, Batam, Medan, Manado, Aceh, Padang, Tanjung Pinang and Yogyakarta, if you do not apply for an e-VOA at least 48 hours in advance of your travel to Indonesia.

The e-VOA or VOA can be used for tourism, official government duties, business meetings, or to transit through Indonesia. You cannot transit in Indonesia without an e-VOA or VOA.

Additional requirements apply if you are travelling on government duties.

For the latest list of entry points for the e-VOA or VOA, refer to the  Directorate General of Immigration's list of land border crossings, international airports, and international seaports .

The e-VOA and VOA cost IDR 500,000 (approximately $A 50), with the e-VOA charging a small online processing fee.

For the VOA, some airports, including Jakarta's international airport, are only accepting cash payment. Card payment facilities are available at Bali's international airport. ATM facilities may be in high demand. Be prepared to pay in cash if required. 

The visa is valid for a 30 day stay and can be extended once (for a maximum of 30 days) by applying at an immigration office within Indonesia. Ensure you extend your visa within the initial 30 days to avoid an overstay fine and deportation.

To apply for a regular VOA, you must show:

• your ordinary (non-emergency) passport with at least 6 months of validity from the date you plan to enter (we also recommend having at least 6 months passport validity from the date you plan to leave Indonesia, to avoid any issues for your departure or onward travel) 
• a return flight booking to Australia or onward flight booking to another country

Contact your travel agent, airline, or your nearest  Embassy or Consulate of Indonesia  for details.

Other visas

If you're entering Indonesia from a port or airport that does not issue a visa on arrival, or you're visiting Indonesia for a purpose not allowed under the e-VOA or VOA conditions, you must apply for a visa in advance of travel. Check the  Indonesian Immigration  website for further information, or contact your nearest  Embassy or Consulate of Indonesia .

Overstaying your permit may result in fines, detention and/or deportation.

• check your visa and permit, and contact the Directorate General of Immigration (DGI) for advice specific to your needs
• if you use an agent to extend your visa or stay permit, use only reputable companies
• if you have specific enquiries on visas or stay permits, contact DGI's Customer Service team via WhatsApp on +62 821 1295 3298

Entry and exit conditions can change at short notice. Contact the nearest Embassy or Consulate for details about visas, currency, customs and entry rules.

You can't work or conduct research in Indonesia unless you have the appropriate visa. Fines of IDR1,000,000 (approx. $A 100) per day apply for the maximum 60 day overstay period.

If you breach Indonesian immigration regulations, you may face:

• deportation
• re-entry bans

You may not be allowed to enter Indonesia if you have a criminal record. This is regardless of how long ago the offence took place. If you're concerned, contact an Embassy or Consulate of Indonesia before you travel.

Indonesian Immigration and visa decisions are final. The Australian Government can't help you.

• Embassy or Consulate of Indonesia

Border measures

To prevent the entry of new variants of Mpox to Indonesia, all travellers arriving at international ports in Indonesia need to complete an electronic health declaration form called the SATUSEHAT Health Pass . 

You can complete the form online before you check-in for your flight to Indonesia. After completing the form, a barcode containing your health and travel history will appear. Indonesian authorities will scan the barcode on arrival in Indonesia. Save your barcode or bring a printed copy with you, to ensure authorities can scan it on arrival. If you have Mpox symptoms you may be referred to a hospital for treatment on arrival.  

You'll be required to complete an  e-customs declaration for arrival . You can complete this within 3 days of departure to Indonesia.

Check entry requirements with your travel provider or the nearest  Embassy or Consulate of Indonesia  before you travel.

Other formalities

If you're staying in a private residence, including private Airbnb, not a hotel, register when you arrive with both:

• the local Rukun Tetangga Office
• local police

If you plan to be in Indonesia for more than 30 days:

• register with the local immigration office
• make sure you have the right visa
• Embassy of Indonesia in Canberra

Indonesia won't let you enter unless your passport is valid for 6 months after you plan to leave Indonesia. This can apply even if you're just transiting or stopping over. You can end up stranded or returned back to your previous port overseas at your own cost, if your passport is not valid for more than 6 months from the date you enter and the date you plan to leave Indonesia.

Indonesia does not accept entry with an emergency passport, even if it is valid for more than 6 months. Ensure you enter Indonesia on a valid ordinary, official, or diplomatic passport.

Some foreign governments and airlines apply these rules inconsistently. Travellers can receive conflicting advice from different sources.

The Australian Government does not set these rules. Check your passport's expiry date before you travel. If you're not sure it'll be valid for long enough, consider getting a new passport .

Lost or stolen passport

Your passport is a valuable document. It's attractive to people who may try to use your identity to commit crimes.

Some people may try to trick you into giving them your passport. Always keep it in a safe place.

If your passport is lost or stolen, tell the Australian Government as soon as possible:

• In Australia, contact the Australian Passport Information Service .
• If you're overseas, contact the nearest Australian Embassy, Consulate or High Commission.

Damaged Passports

Indonesian authorities have strict standards for damaged passports, and travellers have been refused entry into Indonesia with a damaged passport. Normal wear and tear, including water damage, minor tears or rips to the pages, can be considered damaged. 

It's important that:

• there are no tears or cuts in the passport pages, especially the photo page
• everything on the photo page is legible and clear
• there are no marks across your photo or in the Machine Readable Zone (MRZ) on the photo page
• no pages have been removed
• there is no alteration or tampering

If you're not sure about the condition of your passport, call the Australian Passport Office on 131 232 or contact your nearest  Australian embassy or consulate overseas . We may need to see your passport to assess it.

• Passport Services  
• Damaged and faulty passports  
• Using and protecting your passport  

Passport with ‘X’ gender identifier

Although Australian passports comply with international standards for sex and gender, we can’t guarantee that a passport showing 'X' in the sex field will be accepted for entry or transit by another country. Contact the nearest embassy, high commission or consulate of your destination  before you arrive at the border to confirm if authorities will accept passports with 'X' gender markers.

More information: 

• LGBTQIA+ travellers

The local currency is the Indonesian Rupiah (IDR). Only exchange money at authorised money changers. Unauthorised money changers have been known to scam foreign tourists in Bali and elsewhere.

Declare cash in excess of IDR100,000,000 or equivalent when you arrive and leave. This covers all forms of currency, not only cash.

IDR100,000,000 is worth about $A10,000.

Local travel

Travel permits.

You may need a travel permit or Surat Keterangan Jalan to travel to some areas of the Papua provinces.

Check if you need a permit with the nearest  Embassy or Consulate of Indonesia  or with your travel provider.

Mobile Phone Reception and Wi-Fi

Mobile phone reception and Wi-Fi are not always available, including in remote areas and some resort islands. 

If you plan to stay in Indonesia for more than 90 days and would like to use your mobile phone purchased overseas, you'll need to register your mobile phone IMEI number with  Indonesian Customs  within the first 60 days of your stay. 

If you plan to stay in Indonesia for less than 90 days, you can visit the local cellular operator/provider booth at the airport to get an access period to use the Indonesian cellular network, which is only valid for 90 days and includes data roaming.

A customs payment may be required, or a tourist SIM card can be purchased for short-term stays. You can use Wi-Fi networks without registration.

To stay in communication and avoid mobile service interruptions: 

• check mobile coverage with your service provider
• register your mobile device with  Indonesian Customs  on arrival if you plan to connect to the mobile network 

Driving permit

To drive in Indonesia, you need either:

• an Indonesian licence
• an International Driving Permit (IDP)

Check that your licence or permit is appropriate for the type of vehicle you're driving.

Your Australian licence isn't enough.

Your travel insurer will deny any claims you make if:

• you're unlicensed
• you don't hold the correct class of licence

Road travel

Traffic can be extremely congested.

Road users are often unpredictable or undisciplined.

You're more likely to be killed in a motor vehicle accident in Indonesia than in Australia. Drive defensively. Some traffic incidents can escalate into violent disputes quickly. Obey traffic laws, including obtaining appropriate driving or motorbike licenses before travelling to Indonesia.

Consider hiring a taxi or a driver who is familiar with local roads and traffic conditions. If you hire a car, taxi or driver, make sure you do so from legal companies. Only use licensed official metered taxis. See ‘Safety’. 

• Driving or riding

Motorcycles

Motorcycle accidents have killed and injured foreigners, including Australians. This includes in tourist areas, particularly Bali, Lombok and the Gili Islands.

If you're riding a motorbike and there's an accident, you'll often be assumed to be at fault. You may be expected to compensate all parties.

If you hire a motorbike:

• make sure your insurance policy covers you
• check if any policy restrictions apply, for example if you're not licensed to ride a motorcycle in Australia

Always wear a helmet.

Public transport

Buses, trains and the metro rail can be crowded, particularly:

• around public holidays
• during peak commute times

Safety standards may not be observed.

• Transport and getting around safely

Only use licensed official metered taxis. 

• only travel in licensed taxis with signage, a "taxi" roof sign and meters
• book via phone or an official taxi company mobile app

You can book licensed official metered taxis

• on the taxi company's official mobile app
• from inside airports
• at stands at major hotels

Unofficial operators can have taxis that look similar to those run by reputable companies. Make sure the taxi meter is working before you get into the taxi. 

See  Safety .

Rail travel

Inter-city rail networks operate on the islands of Java, Sumatra and Sulawesi.

Commuter trains operate in Java, including Jakarta.

Trains can be crowded, particularly:

• during peak commuter times

Travel between islands

Travel by ferry or boat can be dangerous.

Passenger and luggage limits aren't always observed.

Equipment may not be properly maintained, and they may not have GPS or emergency communications equipment.

There may not be enough life jackets. It's unlikely that the crew will have life jackets for children.

In March 2024, a ferry sank in the Thousand Islands off the coast of Jakarta, resulting in one death, and a liveaboard boat caught fire and sank in Raja Ampat, Papua Barat Daya, requiring several passengers to be rescued.

In August 2023, two crew died after a boat carrying passengers sank in the Banyak Islands, Aceh, and three people went missing after a ship sank in the Thousand Islands off the coast of Jakarta.

In July 2023, 15 people died after a ferry sank off Sulawesi Island.

In January 2023, 23 passengers and 6 crew were rescued after an inter-island ferry sank while returning from Nusa Penida to Sanur Beach, Bali.

In May 2022, 19 people died after a ferry sank in the Makassar Strait.

In June 2018, a ferry sank on Lake Toba in Sumatra and 100s of people died.

If you plan to travel by sea between islands:

• make sure any ferry or boat you board has appropriate safety equipment, GPS and communication equipment, and life jackets
• wear a life jacket at all times
• take enough life jackets for all children travelling with you
• ask your tour operator or crew about safety standards before you travel
• check sea, weather conditions and forecasts before embarking on boat or ferry travel, and delay travel if conditions are not safe

If appropriate safety equipment isn't available, use another provider.

Avoid travelling by water after dark unless the vessel is properly equipped. Avoid travel during wet weather or storms.

DFAT doesn't provide information on the safety of individual commercial airlines or flight paths.

Check Indonesia's air safety profile with the Aviation Safety Network.

The European Union (EU) has published a list of airlines that have operating bans or restrictions within the EU. See the  EU list of banned airlines .

Australian travellers should make their own decisions on which airlines to travel with.

Emergencies

Depending on what you need, contact your:

• family and friends
• travel agent
• insurance provider

Search and rescue services

Medical emergencies and ambulance.

SMS 1717 for Jakarta Police

Police Stations in Bali

Refer to the Bali Tourism Board’s list of  police stations in Bali

Always get a police report when you report a crime.

Your insurer should have a 24-hour emergency number.

Consular contacts

Read the Consular Services Charter for what the Australian Government can and can't do to help you overseas.

Australian Embassy, Jakarta 

Jalan Patra Kuningan Raya Kav. 1-4 Jakarta Selatan 12950

Phone: (+62 21) 2550 5555 Email: [email protected] Website: indonesia.embassy.gov.au Facebook: Australian Embassy Jakarta, Indonesia X: @DubesAustralia Instagram: @KeDubesAustralia

Make an appointment online or call (+62 21) 2550 5500 or (+62 21) 2550 5555.

Australian Consulate-General, Bali

Jalan Tantular 32 Renon Denpasar Bali 80234

Phone: (+62 361) 2000 100 Email: [email protected] Website: bali.indonesia.embassy.gov.au X: @KonJenBali Instagram:  @konjenbali

Australian Consulate-General, Makassar

Wisma Kalla Lt. 7 Jalan Dr Sam Ratulangi No. 8 Makassar South Sulawesi 90125

Phone: (+62 411) 366 4100 Email: [email protected] Website: makassar.consulate.gov.au Facebook: Australian Consulate-General, Makassar, Sulawesi X: @KonJenMakassar Instagram:  @konjenmakassar

Australian Consulate-General, Surabaya

Level 3 ESA Sampoerna Center Jl. Dokter.Ir. H. Soekarno No. 198 Klampis Ngasem, Sukolilo, Surabaya

Phone: (+62 31) 9920 3200 Email: [email protected] Website: surabaya.consulate.gov.au Instagram: @KonJenSurabaya

Check the websites for details about opening hours and any temporary closures.

24-hour Consular Emergency Centre

In a consular emergency, if you can't contact an embassy, call the 24-hour Consular Emergency Centre on:

• +61 2 6261 3305 from overseas
• 1300 555 135 in Australia

Travelling to Indonesia?

Sign up to get the latest travel advice updates..

Be the first to know official government advice when travelling.

• Skip to main content
• Skip to "About this site"

Language selection

Search travel.gc.ca.

Help us to improve our website. Take our survey !

COVID-19: travel health notice for all travellers

Indonesia travel advice

Latest updates: Health – editorial update

Last updated: September 9, 2024 16:09 ET

On this page

Safety and security, entry and exit requirements, laws and culture, natural disasters and climate, indonesia - exercise a high degree of caution.

Exercise a high degree of caution in Indonesia due to political and social tensions and the threat of terrorism throughout the country.

Indonesian Papua - Avoid non-essential travel

Avoid non-essential travel to all the provinces of Indonesia Papua due to the regular occurrence of violent incidents, threats made against foreigners by militant groups and risk of kidnapping.

Back to top

Political demonstrations across Indonesia

Since August 22, 2024, there are ongoing demonstrations and violent clashes between protesters and security forces in Jakarta and other cities across Indonesia.

More information on demonstrations

• Indonesian Papua

Political tension and regular violent incidents continue to occur in Indonesian Papua.

In February 2023, militant groups threatened to attack and take hostages, specifically referencing foreigners. You may also face increased threats of violence or kidnapping if you travel to Indonesian Papua.

Labour disputes at the Freeport-McMoRan mine near Timika have led to demonstrations, public transportation disruptions and violence.

Fatal attacks have occurred on roads near the mine. Foreigners have been targeted by local militants.

There is a heightened police and military presence in this area.

There is a threat of terrorism in Indonesia.

While effective counterterrorism measures by Indonesian authorities are in place, terrorist cells are active and have the capacity to carry out attacks throughout the country.

Attacks have targeted:

• military and government facilities
• tourist attractions and popular public places
• nightclubs and entertainment venues
• public transportation

Further attacks are likely, and terrorists may also target:

• crowded places
• places with high pedestrian traffic and where foreigners may gather
• commercial establishments
• local government offices
• public transit stations
• busy streets
• long lineups at tourist attractions
• places of worship

Stay at hotels that have robust security measures, including metal detectors, guards and security cameras. Keep in mind, however, that even the most secure locations cannot be considered completely free of risk.

Be particularly vigilant during religious holidays and other public celebrations, as terrorists have used such occasions to mount attacks.

• Always be aware of your surroundings when in public places and identify ways to leave the area in case of emergency
• Monitor local media
• Follow the instructions of the local authorities

Violent crime

Violent crime, such as armed robberies, occurs regularly. Be particularly cautious on the road from Banda Aceh to Medan, where armed robberies have occurred.

Foreigners travelling alone and those travelling at night are at particular risk.

Standards of police services differ considerably from those in Canada.

• Avoid showing signs of affluence
• Ensure that your personal belongings, including your passport and other travel documents, are secure at all times
• If you’re travelling by car, keep valuable belongings out of sight, windows closed and doors locked

Petty crime

Petty crime, such as pickpocketing and purse snatching, occurs throughout Indonesia, specifically in tourist areas, such as Bali and Lombok. Criminals sometimes force people to withdraw cash from ATMs.

Merchants don’t always honour pricing agreements. Use good judgment in engaging services of tourist guides, especially in places that tourists rarely visit.

There is a threat of kidnapping, particularly in the provinces of Indonesian Papua and Aceh province. Foreign travellers have been kidnapped and killed. Terrorist groups have also kidnapped tourists in East and West Kalimantan.

• Be extra vigilant if travelling in these areas
• Avoid travelling alone and after dusk
• Use varied routes and schedules when moving from one place to another

Women's safety

Women travelling alone may face some forms of harassment and verbal abuse.

Advice for women travellers

Demonstrations

Demonstrations take place from time to time. Even peaceful demonstrations can turn violent at any time. They can also lead to disruptions to traffic and public transportation. Security forces may use tear gas and water cannons to disperse crowds and prevent vandalism.

• Avoid areas where demonstrations and large gatherings are taking place
• Follow the instructions of local authorities
• Monitor local media for information on ongoing demonstrations

Mass gatherings (large-scale events)

Political and social tension

There are long-standing sectarian and social tensions throughout Indonesia, particularly in the provinces of:

• Central Sulawesi, in Palu, Poso and Tentena
• Maluku, especially in Ambon

Sectarian violence targeting civilians has occurred. The potential for violence remains, despite ongoing security operations efforts from local authorities. Be aware of your surroundings.

There is a very high rate of credit and debit card fraud in Indonesia, including online fraud.

 When using debit or credit cards:

• pay careful attention if other people are handling your cards
• use ATMs located in public areas or inside a bank or business
• avoid using card readers with an irregular or unusual feature
• cover the keypad with one hand when entering your PIN
• check for any unauthorized transactions on your account statements

Romance scams

If you’re travelling to Indonesia to meet someone you’ve only met online, keep it mind that you may be the victim of a scam. Be wary of unsolicited emails or requests for a wire transfer.

Don’t send money to someone you have never met in person.

Overseas fraud

Spiked food and drinks

Even if the wrapping or container appears intact, snacks, beverages, gum and cigarettes may contain drugs that could put you at risk of sexual assault and robbery.

• Be wary of accepting these items from new acquaintances
• Never leave food or drinks unattended or in the care of strangers

People have died after drinking methanol-adulterated alcohol. Counterfeits of well-known alcohol brands often contain dangerous amounts of methanol. Poisoning incidents have happened at hotels, bars, and shops in tourist areas like Bali, Lombok, the Gili Islands and Sumatra.

• Be cautious if you choose to drink alcohol
• Be wary of lesser-known or illegal brands
• Avoid buying alcohol from individuals
• Seek medical assistance if you begin to feel sick

Alcohol, drugs and travel

Road safety

Road conditions and road safety vary greatly throughout the country. Driving conditions may be hazardous during the rainy season.

Road travel in Indonesia can be very challenging due to:

• reckless driving
• perilous road conditions
• inadequate lighting
• poor signage
• high traffic congestion

If you plan to rent a car, consider hiring a driver.

Avoid driving after dark outside of major cities or major roads as some drivers do not use lights.

You may face mob anger if you are involved in an accident that causes serious injury. In such cases, remain in your vehicle and wait for a police officer to arrive.

Motorcycles and scooters

Motorcycle and scooter accidents are the main cause of death and serious injury among foreigners visiting many parts of Indonesia, including Bali.

Rental motorcycles are also often targeted and stolen. In such cases, you may have to pay the replacement cost for a new motorcycle.

Public transport

Public transport can be crowded and safety standards are poor. Many remote parts of Indonesia have poor transportation networks.

Crashes involving overcrowded buses are common. Large buses are generally available only on Java. Minibuses are available elsewhere.

If you choose to travel by bus,

• keep in mind that minibus drivers may try to overcharge foreigners
• keep your belongings secure due to pickpocketing

The condition of taxis varies. Foreign travellers using taxis have been victims of armed robbery, either by the driver or other passengers.

• Pre-arrange transportation with a safe and reliable taxi company
• Only use a taxi company whose vehicles are equipped with a meter
• Never enter a cab if it already has one or more passengers
• Don’t hail taxis off the street and avoid using unmarked taxi services

Reliable taxis are available from Bluebird, Thunderbird and Express. Be careful of “lookalike” taxis from competitors.

Ferry accidents are common and are often caused by poor safety practices or extreme weather conditions.

If you choose to travel by ferry:

• make sure the vessel you are boarding is carrying appropriate safety equipment and that life jackets are provided for all passengers and accessible at all times
• don’t board vessels that appear overloaded or unseaworthy
• verify the safety standards of ferries with your tour operator

We do not make assessments on the compliance of foreign domestic airlines with international safety standards.

Information about foreign domestic airlines

Every country or territory decides who can enter or exit through its borders. The Government of Canada cannot intervene on your behalf if you do not meet your destination’s entry or exit requirements.

We have obtained the information on this page from the Indonesian authorities. It can, however, change at any time.

Verify this information with the  Foreign Representatives in Canada .

Entry requirements vary depending on the type of passport you use for travel.

Before you travel, check with your transportation company about passport requirements. Its rules on passport validity may be more stringent than the country’s entry rules.

Regular Canadian passport

Your passport must be valid for at least 6 months beyond the date of entry into Indonesia and must contain at least one blank page for the placement of the Indonesian visa or entry stamp.

Passport for official travel

Different entry rules may apply.

Official travel

Passport with “X” gender identifier

While the Government of Canada issues passports with an “X” gender identifier, it cannot guarantee your entry or transit through other countries. You might face entry restrictions in countries that do not recognize the “X” gender identifier. Before you leave, check with the closest foreign representative for your destination.

Other travel documents

Different entry rules may apply when travelling with a temporary passport or an emergency travel document. Before you leave, check with the closest foreign representative for your destination.

Useful links

• Foreign Representatives in Canada
• Canadian passports

Tourist visa: required Business visa: required Social-cultural visit visa: required

Indonesia strictly enforces its immigration and visa requirements. Foreign travellers have been detained in immigration detention centres for visa violations or overstays. Those in violation may be subject to substantial fines and deportation.

A round-trip or onward airline ticket is required to obtain all types of visas.

Tourist visa

If you are travelling for tourism with a regular Canadian passport, you may obtain a visa in advance or on arrival at select points of entry.

Business and social-cultural visas

If you are travelling to Indonesia for business or social-cultural purposes (e.g. volunteer work), you must obtain a visa prior to your arrival. You must provide a letter from both the sponsoring organization in Indonesia and the sending organization in Canada to obtain your visa.

A business or social-cultural single-entry visa is extendable from within Indonesia.

Aid workers

Aid workers must have a sponsor in Indonesia to obtain a visa. Those going to Aceh also require prior authorization from the Directorate General of Immigration in Aceh or Jakarta.

Journalists

Journalists visiting Indonesia for reporting and filming purposes must obtain authorization from the Directorate General of Immigration in Jakarta before applying for a visa.

Directorate General of Immigration  – Ministry of Law and Human Rights of Indonesia

Restricted areas

You must obtain a permit to travel to Indonesian Papua.

Entry regulations and permission to remain in Indonesian Papua may change at any time.

Other entry requirements

Love bali tourist levy.

Tourists entering Bali are subject to the Love Bali Tourist Levy. This fee will is in addition to the visa fees paid to enter Indonesia.

If your are travelling to Bali, you must pay directly through the levy website.

Levy for Foreign Tourists – Provincial Government of Bali

SATUSEHAT Health Pass Form

To enter Indonesia, you must fill out the SATUSEHAT Health Pass (SSHP) form. This is an electronic health declaration that you must complete before you check in for your flight to Indonesia. Once you have submitted the SSHP form, you’ll receive a barcode. Save or print out a copy of the barcode for Indonesian authorities to scan upon arrival.

SATUSEHAT Health Pass – Ministry of Health of the Republic of Indonesia

Customs officials may ask you to show them a return or onward ticket and proof of sufficient funds to cover your stay.

• Children and travel

Learn more about travelling with children .

Yellow fever

Learn about potential entry requirements related to yellow fever (vaccines section).

Relevant Travel Health Notices

• Global Measles Notice - 13 March, 2024
• Zika virus: Advice for travellers - 31 August, 2023
• COVID-19 and International Travel - 13 March, 2024
• Polio: Advice for travellers - 20 August, 2024
• Dengue: Advice for travellers - 9 September, 2024

This section contains information on possible health risks and restrictions regularly found or ongoing in the destination. Follow this advice to lower your risk of becoming ill while travelling. Not all risks are listed below.

Consult a health care professional or visit a travel health clinic preferably 6 weeks before you travel to get personalized health advice and recommendations.

Routine vaccines

Be sure that your  routine vaccinations , as per your province or territory , are up-to-date before travelling, regardless of your destination.

Some of these vaccinations include measles-mumps-rubella (MMR), diphtheria, tetanus, pertussis, polio, varicella (chickenpox), influenza and others.

Pre-travel vaccines and medications

You may be at risk for preventable diseases while travelling in this destination. Talk to a travel health professional about which medications or vaccines may be right for you, based on your destination and itinerary. 

Yellow fever   is a disease caused by a flavivirus from the bite of an infected mosquito.

Travellers get vaccinated either because it is required to enter a country or because it is recommended for their protection.

• There is no risk of yellow fever in this country.

Country Entry Requirement*

• Proof of vaccination is required if you are coming from a country   where yellow fever occurs.

Recommendation

• Vaccination is not recommended.
• Discuss travel plans, activities, and destinations with a health care professional.
• Contact a designated  Yellow Fever Vaccination Centre  well in advance of your trip to arrange for vaccination.

About Yellow Fever

Yellow Fever Vaccination Centre

* It is important to note that  country entry requirements  may not reflect your risk of yellow fever at your destination. It is recommended that you contact the nearest  diplomatic or consular office  of the destination(s) you will be visiting to verify any additional entry requirements.

There is a risk of hepatitis A in this destination. It is a disease of the liver. People can get hepatitis A if they ingest contaminated food or water, eat foods prepared by an infectious person, or if they have close physical contact (such as oral-anal sex) with an infectious person, although casual contact among people does not spread the virus.

Practise  safe food and water precautions and wash your hands often. Vaccination is recommended for all travellers to areas where hepatitis A is present.

 The best way to protect yourself from seasonal influenza (flu) is to get vaccinated every year. Get the flu shot at least 2 weeks before travelling.  

 The flu occurs worldwide. 

•  In the Northern Hemisphere, the flu season usually runs from November to   April.
•  In the Southern Hemisphere, the flu season usually runs between April and   October.
•  In the tropics, there is flu activity year round. 

The flu vaccine available in one hemisphere may only offer partial protection against the flu in the other hemisphere.

The flu virus spreads from person to person when they cough or sneeze or by touching objects and surfaces that have been contaminated with the virus. Clean your hands often and wear a mask if you have a fever or respiratory symptoms.

Malaria  is a serious and sometimes fatal disease that is caused by parasites spread through the bites of mosquitoes.   There is a risk of malaria in certain areas and/or during a certain time of year in this destination. 

Antimalarial medication may be recommended depending on your itinerary and the time of year you are travelling. Consult a health care professional or visit a travel health clinic before travelling to discuss your options. It is recommended to do this 6 weeks before travel, however, it is still a good idea any time before leaving.    Protect yourself from mosquito bites at all times:  • Cover your skin and use an approved insect repellent on uncovered skin.  • Exclude mosquitoes from your living area with screening and/or closed, well-sealed doors and windows. • Use insecticide-treated bed nets if mosquitoes cannot be excluded from your living area.  • Wear permethrin-treated clothing.    If you develop symptoms similar to malaria when you are travelling or up to a year after you return home, see a health care professional immediately. Tell them where you have been travelling or living. 

In this destination, rabies is commonly carried by dogs and some wildlife, including bats. Rabies is a deadly disease that spreads to humans primarily through bites or scratches from an infected animal. While travelling, take precautions , including keeping your distance from animals (including free-roaming dogs), and closely supervising children.

If you are bitten or scratched by a dog or other animal while travelling, immediately wash the wound with soap and clean water and see a health care professional. In this destination, rabies treatment may be limited or may not be available, therefore you may need to return to Canada for treatment.  

Before travel, discuss rabies vaccination with a health care professional. It may be recommended for travellers who are at high risk of exposure (e.g., occupational risk such as veterinarians and wildlife workers, children, adventure travellers and spelunkers, and others in close contact with animals). 

Polio (poliomyelitis) is an infectious disease that can be prevented by vaccination. It is caused by poliovirus type 1, 2 or 3. Circulating vaccine-derived poliovirus 2 (cVDPV2) is present in this country.

Polio is spread from person to person and through contaminated food and water. Infection with the polio virus can cause paralysis and death in individuals of any age who are not immune.

Recommendations:

• Be sure that your polio vaccinations are up to date before travelling. Polio is part of the routine vaccine schedule for children in Canada.
• One booster dose of the polio vaccine is recommended as an adult .

Measles is a highly contagious viral disease. It can spread quickly from person to person by direct contact and through droplets in the air.

Anyone who is not protected against measles is at risk of being infected with it when travelling internationally.

Regardless of where you are going, talk to a health care professional before travelling to make sure you are fully protected against measles.

Japanese encephalitis is a viral infection that can cause swelling of the brain.  It is spread to humans through the bite of an infected mosquito. Risk is very low for most travellers. Travellers at relatively higher risk may want to consider vaccination for JE prior to travelling.

Travellers are at higher risk if they will be:

• travelling long term (e.g. more than 30 days)
• making multiple trips to endemic areas
• staying for extended periods in rural areas
• visiting an area suffering a JE outbreak
• engaging in activities involving high contact with mosquitos (e.g., entomologists)

  Hepatitis B is a risk in every destination. It is a viral liver disease that is easily transmitted from one person to another through exposure to blood and body fluids containing the hepatitis B virus.  Travellers who may be exposed to blood or other bodily fluids (e.g., through sexual contact, medical treatment, sharing needles, tattooing, acupuncture or occupational exposure) are at higher risk of getting hepatitis B.

Hepatitis B vaccination is recommended for all travellers. Prevent hepatitis B infection by practicing safe sex, only using new and sterile drug equipment, and only getting tattoos and piercings in settings that follow public health regulations and standards.

Coronavirus disease (COVID-19) is an infectious viral disease. It can spread from person to person by direct contact and through droplets in the air.

It is recommended that all eligible travellers complete a COVID-19 vaccine series along with any additional recommended doses in Canada before travelling. Evidence shows that vaccines are very effective at preventing severe illness, hospitalization and death from COVID-19. While vaccination provides better protection against serious illness, you may still be at risk of infection from the virus that causes COVID-19. Anyone who has not completed a vaccine series is at increased risk of being infected with the virus that causes COVID-19 and is at greater risk for severe disease when travelling internationally.

Before travelling, verify your destination’s COVID-19 vaccination entry/exit requirements. Regardless of where you are going, talk to a health care professional before travelling to make sure you are adequately protected against COVID-19.

Safe food and water precautions

Many illnesses can be caused by eating food or drinking beverages contaminated by bacteria, parasites, toxins, or viruses, or by swimming or bathing in contaminated water.

• Learn more about food and water precautions to take to avoid getting sick by visiting our eat and drink safely abroad page. Remember: Boil it, cook it, peel it, or leave it!
• Avoid getting water into your eyes, mouth or nose when swimming or participating in activities in freshwater (streams, canals, lakes), particularly after flooding or heavy rain. Water may look clean but could still be polluted or contaminated.
• Avoid inhaling or swallowing water while bathing, showering, or swimming in pools or hot tubs. 

Travellers' diarrhea is the most common illness affecting travellers. It is spread from eating or drinking contaminated food or water.

Risk of developing travellers' diarrhea increases when travelling in regions with poor standards of hygiene and sanitation. Practise safe food and water precautions.

The most important treatment for travellers' diarrhea is rehydration (drinking lots of fluids). Carry oral rehydration salts when travelling.

Typhoid   is a bacterial infection spread by contaminated food or water. Risk is higher among children, travellers going to rural areas, travellers visiting friends and relatives or those travelling for a long period of time.

Travellers visiting regions with a risk of typhoid, especially those exposed to places with poor sanitation, should speak to a health care professional about vaccination.  

There is a risk of schistosomiasis in this destination. Schistosomiasis is a parasitic disease caused by tiny worms (blood flukes) which can be found in freshwater (lakes, rivers, ponds, and wetlands). The worms can break the skin, and their eggs can cause stomach pain, diarrhea, flu-like symptoms, or urinary problems. Schistosomiasis mostly affects underdeveloped and r ural communities, particularly agricultural and fishing communities.

Most travellers are at low risk. Travellers should avoid contact with untreated freshwater such as lakes, rivers, and ponds (e.g., swimming, bathing, wading, ingesting). There is no vaccine or medication available to prevent infection.

Insect bite prevention

Many diseases are spread by the bites of infected insects such as mosquitoes, ticks, fleas or flies. When travelling to areas where infected insects may be present:

• Use insect repellent (bug spray) on exposed skin
• Cover up with light-coloured, loose clothes made of tightly woven materials such as nylon or polyester
• Minimize exposure to insects
• Use mosquito netting when sleeping outdoors or in buildings that are not fully enclosed

To learn more about how you can reduce your risk of infection and disease caused by bites, both at home and abroad, visit our insect bite prevention page.

Find out what types of insects are present where you’re travelling, when they’re most active, and the symptoms of the diseases they spread.

There is a risk of chikungunya in this country. The level of risk may vary by:

The virus that causes chikungunya is spread through the bite of an infected mosquito. It can cause fever and pain in the joints. In some cases, the joint pain can be severe and last for months or years.

Protect yourself from mosquito bites at all times.

Learn more:

Insect bite and pest prevention Chikungunya

Zika virus is a risk in this country. 

Zika virus is primarily spread through the bite of an infected mosquito. It can also be sexually transmitted. Zika virus can cause serious birth defects.

During your trip:

• Prevent mosquito bites at all times.
• Use condoms correctly or avoid sexual contact, particularly if you are pregnant.

If you are pregnant or planning a pregnancy, you should discuss the potential risks of travelling to this destination with your health care provider. You may choose to avoid or postpone travel. 

For more information, see Zika virus: Pregnant or planning a pregnancy.

Lymphatic filariasis , also known as elephantiasis, is caused by filariae (tiny worms) spread to humans through the bite of an infected mosquito. It can cause a range of illnesses. Risk is generally low for most travellers. Protect yourself from mosquito bites. There is no vaccine available for lymphatic filariasis although drug treatments exist.

• In this country,   dengue  is a risk to travellers. It is a viral disease spread to humans by mosquito bites.
• Dengue can cause flu-like symptoms. In some cases, it can lead to severe dengue, which can be fatal.
• The level of risk of dengue changes seasonally, and varies from year to year. The level of risk also varies between regions in a country and can depend on the elevation in the region.
• Mosquitoes carrying dengue typically bite during the daytime, particularly around sunrise and sunset.
• Protect yourself from mosquito bites . There is no vaccine or medication that protects against dengue.

Animal precautions

Some infections, such as rabies and influenza, can be shared between humans and animals. Certain types of activities may increase your chance of contact with animals, such as travelling in rural or forested areas, camping, hiking, and visiting wet markets (places where live animals are slaughtered and sold) or caves.

Travellers are cautioned to avoid contact with animals, including dogs, livestock (pigs, cows), monkeys, snakes, rodents, birds, and bats, and to avoid eating undercooked wild game.

Closely supervise children, as they are more likely to come in contact with animals.

Human cases of avian influenza have been reported in this destination. Avian influenza   is a viral infection that can spread quickly and easily among birds and in rare cases it can infect mammals, including people. The risk is low for most travellers.

Avoid contact with birds, including wild, farm, and backyard birds (alive or dead) and surfaces that may have bird droppings on them. Ensure all poultry dishes, including eggs and wild game, are properly cooked.

Travellers with a higher risk of exposure include those: 

• visiting live bird/animal markets or poultry farms
• working with poultry (such as chickens, turkeys, domestic ducks)
• hunting, de-feathering, field dressing and butchering wild birds and wild mammals
• working with wild birds for activities such as research, conservation, or rehabilitation
• working with wild mammals, especially those that eat wild birds (e.g., foxes)

All eligible people are encouraged to get the seasonal influenza shot, which will protect them against human influenza viruses. While the seasonal influenza shot does not prevent infection with avian influenza, it can reduce the chance of getting sick with human and avian influenza viruses at the same time.

Person-to-person infections

Stay home if you’re sick and practise proper cough and sneeze etiquette , which includes coughing or sneezing into a tissue or the bend of your arm, not your hand. Reduce your risk of colds, the flu and other illnesses by:

•   washing your hands often
• avoiding or limiting the amount of time spent in closed spaces, crowded places, or at large-scale events (concerts, sporting events, rallies)
• avoiding close physical contact with people who may be showing symptoms of illness 

Sexually transmitted infections (STIs) , HIV , and mpox are spread through blood and bodily fluids; use condoms, practise safe sex, and limit your number of sexual partners. Check with your local public health authority pre-travel to determine your eligibility for mpox vaccine.  

Tuberculosis is an infection caused by bacteria and usually affects the lungs.

For most travellers the risk of tuberculosis is low.

Travellers who may be at high risk while travelling in regions with risk of tuberculosis should discuss pre- and post-travel options with a health care professional.

High-risk travellers include those visiting or working in prisons, refugee camps, homeless shelters, or hospitals, or travellers visiting friends and relatives.

Medical services and facilities

Heath care is inadequate.

Most medical staff don’t speak English or French. You may have to pay in advance, in cash, to obtain medical services.

Medical evacuation can be very expensive and you may need it in case of serious illness or injury.

Make sure you get travel insurance that includes coverage for medical evacuation and hospital stays.

Health and safety outside Canada

You must abide by local laws.

Learn about what you should do and how we can help if you are arrested or detained abroad .

Overview of the criminal law system in Indonesia  

Penalties for possession, use or trafficking of illegal drugs are severe. Convicted offenders can expect long jail sentences. They can also be detained for long periods, without the possibility of release on bail, while police conduct investigations prior to prosecution.

Police have arrested tourists after random drug testing throughout the country.

Drugs, alcohol and travel

Some prescription and over-the-counter medications that are legal in Canada, such as those containing morphine and codeine, are classified as controlled substances in Indonesia. It’s illegal to bring them into the country, even in small quantities, without prior permission from the Indonesian Ministry of Health and the required documentation.

If you attempt to bring banned pharmaceuticals into Indonesia without prior authorization and proper documentation, Indonesian authorities may confiscate them. You may also be subject to fines and imprisonment.

In some areas, Islamic practices and beliefs closely adhere to local customs, laws and regulations.

Religious police enforce sharia law in Aceh. Specific applications of sharia may differ by region and apply to non-Muslims as well.

Be aware of the relevant provisions specifically related to the region, regardless of your religion.

Dress and behaviour

To avoid offending local sensitivities:

• dress conservatively
• behave discreetly
• respect religious and social traditions

In 2025, the lunar month of Ramadan is expected to begin on or around February 28.

In public, between sunrise and sunset, be discreet when:

2SLGBTQI+ persons

Indonesian national law doesn't criminalize sexual acts or relationships between persons of the same sex. However, they are prohibited and punishable under local laws in some provinces.

In Aceh, Sharia law is enforced and sexual acts between Muslim individuals of the same sex is punished by caning. They could also face arrest under charges related to immoral behaviour, prostitution or social ills.

2SLGBTQI+ persons could be discriminated against based on their sexual orientation, gender identity, gender expression or sex characteristics.

2SLGBTQI+ persons should carefully consider the risks of travelling to Indonesia.

Travel and your sexual orientation, gender identity, gender expression and sex characteristics

Dual citizenship 

Dual citizenship is not legally recognized in Indonesia.

If local authorities consider you a citizen of Indonesia, they may refuse to grant you access to Canadian consular services. This will prevent us from providing you with those services.

Indonesia allows minors to carry dual citizenship until the age of 18. After this time, they must choose between their Indonesian citizenship and foreign citizenship.

General information for travellers with dual citizenship

International Child Abduction

The Hague Convention on the Civil Aspects of International Child Abduction is an international treaty. It can help parents with the return of children who have been removed to or retained in certain countries in violation of custody rights. It does not apply between Canada and Indonesia.

If your child was wrongfully taken to, or is being held in Indonesia by an abducting parent:

• act as quickly as you can
• consult a lawyer in Canada and in Indonesia to explore all the legal options for the return of your child
• report the situation to the nearest Canadian government office abroad or to the Vulnerable Children's Consular Unit at Global Affairs Canada by calling the Emergency Watch and Response Centre

If your child was removed from a country other than Canada, consult a lawyer to determine if The Hague Convention applies.

Be aware that Canadian consular officials cannot interfere in private legal matters or in another country's judicial affairs.

• International Child Abductions: A guide for affected parents
• Canadian embassies and consulates by destination
• Request emergency assistance

Imports and exports

Local customs authorities may enforce strict regulations concerning temporary import or export of items such as audiovisual material.

Gambling is illegal in Indonesia.

Identification

You must carry adequate identification, such as your passport and your stay permit, at all times.

You may be detained and fined if you don’t have the original on you.

Traffic drives on the left.

You must carry an International Driving Permit along with your Canadian driver’s licence.

If you got your International Driving Permit outside of Indonesia, local authorities may ask to approve it.

If you’re involved in an accident, you must stop and exchange information with and provide assistance to other drivers.

• International Driving Permit registration  – Traffic Police, Government of Indonesia (in Indonesian)
• More about the International Driving Permit

The currency is the rupiah (IDR).

Credit cards are not widely accepted outside of large urban centres and tourist areas.

Carry cash when visiting remote areas.

Climate change is affecting Indonesia. Extreme and unusual weather events are becoming more frequent. Indonesia is located in a very active seismic zone and is prone to natural disasters such as:

• earthquakes
• volcanic eruptions

Monitor local news to stay informed on the current situation.

Earthquakes and tsunamis

Each year, Indonesia experiences thousands of earthquakes. Some trigger tsunamis and cause significant damage. Deaths and injuries occasionally occur.

A tsunami can occur within minutes of a nearby earthquake. However, the risk of tsunami can remain for several hours following the first tremor. If you're staying on the coast, familiarize yourself with the region's evacuation plans in the event of a tsunami warning.

• Earthquakes  - What to Do?
• Tsunami alerts - U.S. Tsunami Warning System

Indonesia has 129 active volcanoes and periodically experiences major volcanic events that can be dangerous, even life-threatening. Ash clouds can disrupt air travel, including on the island of Bali, and cause or worsen respiratory problems.

Active volcanoes are monitored to provide residents with an early warning should unusual activity occur. Local authorities can raise alert levels and order evacuations on short notice.

If you are near active volcanoes:

• take official warnings seriously and respect exclusion zones
• monitor local media to stay up-to-date on latest developments
• follow the advice of local authorities, including evacuation orders
• be prepared to modify your travel arrangements or even evacuate the area on short notice
• National Disaster Management Authority
• Map of active volcanoes in Indonesia – MAGMA Indonesia

Rainy season

The rainy season extends from November to March, but heavy rains are common throughout the year. Flooding and landslides can occur with little warning, especially in remote areas where extensive deforestation is common, but also in major cities, including Jakarta. Such incidents have led to fatalities and destruction of property.

Seasonal flooding can hamper overland travel and reduce the provision of essential services. Roads may become impassable and bridges damaged.

• Be aware of health risks associated with flood waters
• Keep informed of regional weather forecasts as well as road closures or detours
• Avoid disaster areas
• Follow the advice of local authorities

Tornadoes, cyclones, hurricanes, typhoons and monsoons

Air pollution

Unrestricted burning in Sumatra and Kalimantan sometimes causes air pollution to rise to unhealthy levels, especially from June to October.

Monitor air pollution levels closely, as they change quickly.

During periods of high pollution:

• limit your activities outdoors
• monitor local media
• follow the instructions of local authorities

Local services

In case of emergency, dial 110 for police.

Research and carry contact information for local medical facilities.

Consular assistance

Timor-Leste

There is no Canadian government office in Bali. You can obtain consular assistance from the Australian Consulate General of Australia, in Bali, under the Canada-Australia Consular Services Sharing Agreement.

Sign up to receive email updates from the Australian government on situations and events that could affect your safety while in Bali.

Smartraveller  - Australian travel advice

For emergency consular assistance, call the Embassy of Canada to Indonesia, in Jakarta, and follow the instructions. At any time, you may also contact the Emergency Watch and Response Centre in Ottawa.

The decision to travel is your choice and you are responsible for your personal safety abroad. We take the safety and security of Canadians abroad very seriously and provide credible and timely information in our Travel Advice to enable you to make well-informed decisions regarding your travel abroad.

The content on this page is provided for information only. While we make every effort to give you correct information, it is provided on an "as is" basis without warranty of any kind, expressed or implied. The Government of Canada does not assume responsibility and will not be liable for any damages in connection to the information provided.

If you need consular assistance while abroad, we will make every effort to help you. However, there may be constraints that will limit the ability of the Government of Canada to provide services.

Learn more about consular services .

Risk Levels

  take normal security precautions.

Take similar precautions to those you would take in Canada.

  Exercise a high degree of caution

There are certain safety and security concerns or the situation could change quickly. Be very cautious at all times, monitor local media and follow the instructions of local authorities.

IMPORTANT: The two levels below are official Government of Canada Travel Advisories and are issued when the safety and security of Canadians travelling or living in the country or region may be at risk.

  Avoid non-essential travel

Your safety and security could be at risk. You should think about your need to travel to this country, territory or region based on family or business requirements, knowledge of or familiarity with the region, and other factors. If you are already there, think about whether you really need to be there. If you do not need to be there, you should think about leaving.

  Avoid all travel

You should not travel to this country, territory or region. Your personal safety and security are at great risk. If you are already there, you should think about leaving if it is safe to do so.

Articles Travel Requirements - Indonesia

Explore other articles and discussions on this topic.

04/09/2024 • FAQs

Information.

• https://sshp.kemkes.go.id/
• https://lovebali.baliprov.go.id/

A .gov website belongs to an official government organization in the United States.

A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

• General Committee-Related Information
• ACIP Work Groups
• ACIP Meeting Information
• ACIP Recommendations
• Apply for ACIP Membership
• ACIP Committee Members
• Evidence-Based Recommendations—GRADE
• GRADE Evidence Tables – Recommendations in MMWR
• Evidence to Recommendations Frameworks

Related Topics:

• View All Home
• ACIP GRADE Handbook
• Vaccine-Specific Recommendations
• Vaccines & Immunizations

Japanese Encephalitis Vaccine Evidence to Recommendations

CDC vaccine recommendations are developed using an explicit evidence-based method based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Policy Question: Should inactivated Vero cell culture-derived Japanese encephalitis (JE) vaccine (JE-VC) be recommended for use in persons aged ≥2 months at risk of travel-related exposure to JE virus?

• Population : Persons aged ≥2 months traveling to JE risk areas
• Intervention : JE-VC administered as a 2-dose primary series
• Comparison : No JE vaccination
• Outcomes : The benefits considered critical outcomes for which there were data available included short and long-term seroprotection using the established immunologic correlate of protection (JE virus neutralizing antibodies at a PRNT50 titer ≥10) (Table 1). The harms considered critical outcomes were serious adverse events and adverse events of special interest (i.e., fever, rash, hypersensitivity/urticaria, neurologic adverse events, and medically attended adverse events).

JE is a mosquito-borne disease that occurs throughout most of Asia and parts of the western Pacific. JE virus is transmitted in an enzootic cycle between mosquitoes and amplifying vertebrate hosts, primarily pigs and wading birds. JE virus is transmitted to humans by infected mosquitoes. Humans usually do not develop a level or duration of viremia sufficient to infect mosquitoes, and therefore are considered dead-end hosts. JE virus transmission occurs primarily in rural agricultural areas.

JE-VC (manufactured as IXIARO) is the only JE vaccine licensed and available in the United States. JE-VC is manufactured by Valneva Austria GmbH. In March 2009, the US Food and Drug Administration (FDA) licensed JE-VC for use in adults aged ≥17 years. In June 2009, the Advisory Committee on Immunization Practices (ACIP) approved recommendations for use of JE-VC in adults [Fischer 2010]. In September 2010, FDA approved a JE-VC booster dose for adults and, in February 2011, adult booster dose recommendations were approved [CDC 2011]. In May 2013, FDA approval for use of JE-VC was extended to include children aged 2 months through 16 years. A Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) for use of JE-VC in children was presented to ACIP and recommendations for pediatric use of JE-VC were approved in June 2013. In April 2018, FDA approval for a booster dose was extended to include the pediatric age group.

There are no efficacy data for JE-VC. However, a JE virus 50% plaque reduction neutralization test (PRNT 50 ) titer of ≥10 is an established immunologic correlate of protection [Markoff 2000; Hombach 2005]. JE-VC was licensed based on its ability to induce neutralizing antibodies and a non-inferiority comparison to a licensed inactivated mouse brain-derived JE vaccine (JE-MB [manufactured as JE-VAX]). JE-MB is no longer available in the United States. At the time of licensure, JE-VC had been studied in <5,000 adults. Since JE-VC's licensure, more than 1 million doses have been distributed in the United States. Since the 2013 GRADE, additional immunogenicity and safety data from clinical trials and surveillance activities have become available. The ACIP JE Vaccine Work Group used GRADE methods to review and evaluate these newly available data [Ahmed 2013]. Additional factors also were assessed in considering JE vaccine recommendations, as outlined in the Evidence to Recommendations (EtR) framework [Lee 2018]. The results of the work group's deliberations and the proposed JE vaccine recommendations are presented below.

Domain 1. The Problem

Criterion: public health priority.

Criterion question: Is the problem of public health importance?

JE virus is the leading vaccine-preventable cause of encephalitis in Asia, with an estimated 67,900 cases annually [Campbell 2011]. In the highest risk areas in Asia prior to vaccination programs, incidence rates as high as 20 cases per 100,000 children per year were reported. Risk areas for JE virus transmission include most of Asia and parts of the Western Pacific. JE clearly is of public health importance for residents in these regions.

While JE incidence is high in some JE-endemic regions, JE cases are infrequently reported in the United States. A JE vaccine was first licensed in the United States at the end of 1992. In the 25-year period from 1993–2017, 12 JE cases were reported among U.S. tourists or expatriates. All cases occurred in 2003 or later and none were immunized. There was a median of 0 cases reported per year (range: 0–2 cases). Based on the 12 reported cases from 1993-2017 and approximately 4-5 million U.S. citizen trips annually to Asia during that time period, the overall estimated JE risk for a U.S. traveler is <1 case per million trips to Asia. Therefore, JE cannot be considered a substantial public health problem for U.S. travelers overall.

JE virus is not found in the United States. When humans are infected with JE virus, they have a low level viremia and so are considered "dead end" hosts. Therefore, the risk is extremely low for subsequent local transmission of JE virus in the United States from an infected traveler, and importation of JE virus by an infected traveler is not a public health concern.

While the risk for JE in most travelers is low, it varies based on travel duration, season, location, activities, and accommodations. Vaccination will be of benefit to some travelers. For some persons, such as those taking up long term residence in rural areas of Asia, risk might approach a similar level to populations of endemic areas. There are examples of substantial JE disease risk among certain groups. For example, more than 300 cases of JE were reported among soldiers deployed to Asia from the United States, the United Kingdom, Australia, and Russia in the period before JE vaccine was widely available and utilized among military personnel.

Most JE virus infections in humans are asymptomatic; <1% of infected people develop encephalitis. However, when disease occurs, outcome is often severe, with a 20–30% mortality rate, and 30–50% of survivors having significant neurologic, cognitive, or behavioral sequelae. There is no antiviral therapy and treatment consists of supportive care. Given its substantial morbidity and mortality, JE can be considered a serious problem for individual travelers. Substantial resources might be needed to care for a person with a serious long-term disability.

Finally, JE vaccine is paid for out-of-pocket by most U.S. civilian travelers. It is typically not covered by private insurers and is not covered under the Vaccines for Children program. Therefore, the costs and benefits of immunization are primarily at the individual rather than societal level.

The work group agreed JE is a public health problem in JE endemic countries. For the U.S. population, it is an individual traveler rather than societal concern, so the question of public health importance is not directly applicable. In addition, JE vaccine is typically paid for out-of-pocket, unlike vaccines in the national immunization program. However, since certain travelers might have a sufficiently high risk to warrant vaccination, the consensus was that the public health importance "varies" related to the individual person's itinerary and activities.

Domain 2. Benefits and Harms

Methodology for grade.

GRADE was used to assess the benefits and harms of JE-VC. To identify published literature that contained relevant evidence, we conducted a search of Medline, Embase, CINAHL, and Cochrane Library databases for papers in any language published from May 2013 through February 28 2018. The date limits were selected to provide an update to the literature search conducted for the previous GRADE for use of JE-VC in children, which covered the period January 2006 through April 2013. We used the following search strategy and keywords: "Japanese encephalitis" and "vaccine" and "IXIARO or JESPECT or IC51 or JEEV or Vero or purified inactivated". The title and abstract of the studies were reviewed to identify relevant articles; if no abstract was provided, the paper itself was reviewed.

Articles that presented data on JE-VC were included if they met the following criteria: 1) Involved human subjects; 2) Reported primary data; 3) Included data relevant to the outcome measures being assessed (i.e., vaccine efficacy, seroprotection at 1 and 6 months after vaccination, serious adverse events, or adverse events of special interest); and 4) Included data for an FDA-approved dose (i.e., 0.25mL for children aged 2 months through 2 years and 0.5mL for children and adults aged ≥3 years). Publications that met the above criteria but represented a single case report were excluded.

We identified 479 records using the search strategy. Among these studies, 466 were excluded as they did not include any JE-VC data or did not present primary data. Four studies that included JE-VC human data also were excluded: 1) Two studies that presented safety or immunogenicity data at ≥7 months post-vaccination (i.e., outside the timeframe of interest); 2) One study that only presented data on cross-protective capacity of JE-VC against various JE virus genotypes among a cohort of travelers described in a separate publication; and 3) One study that included study groups that received JE-VC and rabies vaccine with or without meningococcal vaccine but did not include a study group that received JE-VC alone. Following the 470 exclusions, nine studies remained; these were combined with the 12 studies identified in the evidence retrieval process for the previous GRADE assessment [ACIP 2013]. In total, data from 21 published studies were included in this GRADE evaluation.

Unpublished data also were considered for JE-VC and another similar inactivated Vero cell culture-derived JE vaccine (JEEV) manufactured by Biological E (Hyderabad, India). JEEV is manufactured with technology licensed from Valneva. JEEV and IXIARO use the same virus strain, adjuvant, and virus purification; however, no process comparability studies have been completed and it cannot be assumed that the two final vaccine products are the same. JEEV is approved in India for use in children aged 1 through 2 years (two 0.25mL doses administered 28 days apart) and adults aged 18 through 49 (two 0.5mL doses administered 28 days apart) [Central Drugs Standard Control Organization 2013]

Evidence type was assessed through a review of study design, risk of bias, inconsistency, indirectness, imprecision, and other considerations (i.e., publication bias, strength of association, dose response, or opposing plausible residual confounding).

Criterion 1: Magnitude of desirable anticipated effects

Criterion question: How substantial are the desirable anticipated effects?

Seroprotection at 1 month

The evidence used to evaluate seroprotection at 1 month after vaccination with JE-VC was from 12 studies, including four randomized controlled trials (RCTs) (Table 2). Of the 1,673 JE-VC recipients in the 12 studies combined, 1,582 (95%) achieved seroprotection levels at 1 month after the 2-dose primary series. The only study with a seroprotection rate <95% was conducted among a cohort of older adults aged ≥64 years in which 128 (65%) of 197 participants achieved seroprotection levels at 42 days after the 2-dose series. These data on immunogenicity in older adults were considered by the work group and presented to ACIP in October 2015 and were submitted to FDA. While there are lower seroprotection rates in older adults compared to younger adults, there are no data on safety, immunogenicity, or optimal timing of a possible third primary series dose or early booster dose for older adults.

In the four RCTs, seroprotection rates for JE-VC recipients were similar to or higher than seroprotection rates for recipients of the comparator vaccines. When data from the four RCTs were combined and weighted using a random effects model, there was no significant difference in seroprotection rates between recipients of JE-VC and the other JE vaccines (Figure 1).

In addition to the studies of JE-VC, we reviewed evidence for seroprotection in one RCT performed using a similar JE vaccine (JEEV) among children aged 1 and 2 years in India [Biological E 2013] (Table 3). The findings were similar to those seen with JE-VC.

Seroprotection at 5 to 6 months

The evidence used to evaluate seroprotection at 5 to 6 months after vaccination with JE-VC was from six studies of JE-VC, including two RCTs (Table 4). Of the 941 JE-VC recipients in the six studies combined, 864 (92%) achieved seroprotection levels at 5 to 6 months after the 2-dose primary series. Seroprotection rates in the individual studies ranged from 83% to 100%. The findings from the two RCTs in adults showed that a significantly higher proportion of JE-VC recipients achieved seroprotection levels at this time point compared with subjects who received mouse brain-derived JE vaccine (Figure 2).

Additional information

The work group noted that the majority of data are in adults; however, data from the three pediatric studies supported by adult data were considered sufficient for pediatric licensure. While herd immunity is important for some vaccines, it is not a consideration for immunization against JE, as JE virus circulates in an enzootic cycle in the environment and is not transmitted from person-to person.

On the basis of these seroprotection data at 1 and 5–6 months after the primary series of JE-VC, the work group concluded the desirable anticipated effects were "large".

Criterion 2: Magnitude of undesirable anticipated effects

Criterion question: How substantial are the undesirable anticipated effects?

Serious adverse events

The evidence used to evaluate serious adverse events following JE-VC was from 16 studies, including 12 clinical trials and four post-marketing assessments that included data from three countries. Among the 12 clinical trials, eight were RCTs and four were observational studies (Table 5). Any serious adverse events within 1 month after either JE-VC dose were reported in 29 (1%) of the 4,855 subjects in these 12 clinical trials. Serious adverse events within 6 to 7 months after the first dose were reported in 72 (1%) of 5,269 subjects included in four clinical trials (Table 6). Although the relatively small numbers of subjects in these clinical trials limit the ability to detect rare serious adverse events, post-marketing surveillance data following distribution of >1 million doses provide indirect but reassuring support for the vaccine's safety. Three large post-marketing surveillance evaluations reported 1.1 to 1.8 serious adverse events per 100,000 doses distributed (Table 7). These reported rates are similar to or lower than rates of serious adverse events per 100,000 doses distributed from post-marketing adverse event surveillance for other vaccines, including quadrivalent human papillomavirus vaccine (1.9 per 100,000 doses), 23-valent pneumococcal polysaccharide vaccine (2.0), yellow fever vaccine (3.8), and live attenuated herpes zoster vaccine (4.4)[Arana 2018, Miller 2016, Lindsey 2016, Miller 2018]. In one small postlicensure study among children, a retrospective chart review for medical visits following administration of JE-VC to 145 children in a travel clinic detected no serious adverse events.

When data from the eight RCTs were combined and weighted using a random effects model, there was no significant difference in proportions of subjects with serious adverse events within 1 month of JE-VC or the comparison vaccines (Figure 3). The risk ratio for serious adverse events within 6 to 7 months after the first dose of JE-VC or control vaccine from two studies was 0.7, but the result was non-significant (Figure 4). No patterns in the timing or types of serious adverse events were identified in the clinical trials or surveillance data.

Adverse events of special interest

The evidence used to evaluate adverse events of special interest (i.e., fever, rash, hypersensitivity/urticaria, neurologic, and medically attended adverse events) following JE-VC was from 12 studies, including eight clinical trials and four post-marketing assessments. Fever within 7 days after either JE-VC dose was reported in 296 (8%) of 3,892 subjects in seven studies; proportions of subjects with fever in individual studies ranged from 0% to 21% (Table 8). The differences in proportions were likely related to several factors, including the different age groups studied, variable locations of study sites (i.e., Europe, United States, Australia, India, and the Philippines), differences in study methodology, and the different study population sizes with less precision in some smaller studies. In the two studies with the highest fever rates for JE-VC recipients, there were no significant differences in fever rates for recipients of the control vaccines. Rash within 7 days after either JE-VC dose was reported in 81 (2%) of 3,892 subjects, with proportions in individual studies all ≤4% (Table 9). Hypersensitivity or urticaria within 1 month of either dose was reported in 15 (<1%) of 3,868 JE-VC recipients in six studies, with proportions ≤5% in all studies (Table 10). Neurologic adverse events (excluding headache) within 1 month of either JE-VC dose were reported in 26 (1%) of 3,668 recipients, and proportions were ≤1% in each of the studies (Table 11). Medically attended adverse events within 1 month after either dose were reported in 571 (14%) of 3,947 subjects. The proportion of subjects with medically attended adverse events in individual studies ranged from 0 through 19%; the two studies with the highest percentage of subjects with medically attended adverse events were conducted among children in the Philippines and elderly adults in Europe (Table 12).

In passive post-marketing surveillance, the reported incidence of hypersensitivity was 3.0 to 4.4 per 100,000 doses distributed (Table 13) and neurologic adverse events (excluding headache) was 0.2 to 1.1 per 100,000 doses distributed (Table 14). In a post-marketing adverse event surveillance study conducted among military personnel and involving retrospective review of medical records, the rate of hypersensitivity reactions was 24.8 per 100,000 doses administered and the rate of neurologic events was 22.0 per 100,000 doses administered. These much higher rates reflected the different methodology used in the study. An active surveillance approach was used and events were identified using ICD-9 codes but complete descriptions of events often were lacking, preventing clarification of the nature of some events. In addition, the assessment was conducted among military personnel who were often given multiple other vaccines concomitantly, including some reactogenic vaccines (e.g., anthrax and smallpox vaccines).

When data from the RCTs were combined and weighted using a random effects model, there were no significant differences in the proportions with any of these adverse events of special interest between recipients of JE-VC and comparison vaccines (Figures 5-9).

Outcomes for a similar JE vaccine in children

In addition to the studies of JE-VC, we reviewed evidence for serious adverse events and adverse events of special interest (fever, rash) in one RCT performed using a similar JE vaccine (JEEV) among children aged 1 and 2 years in India [Biological E 2013] (Table 3). The findings were for this vaccine were similar to those seen with JE-VC.

The results described here include all reported adverse events, whether assessed as related or unrelated. Causality often cannot be determined, especially in surveillance data when reported events occur among persons who often have received multiple vaccines concurrently.

On the basis of these adverse event and safety data from clinical trials and surveillance, the work group concluded the undesirable anticipated effects were small.

Criterion 3: Balance of desirable versus undesirable effects

Criterion question: Do the desirable effects outweigh the undesirable effects?

JE-VC is the only JE vaccine licensed and available in the United States. With no alternative vaccine, this assessment was focused on comparing the balance of risks and benefits of JE-VC. Seroprotection rates were high at both 1 month and 5 to 6 months after the 2-dose primary series of JE-VC. JE-VC seroprotection rates were non-inferior to rates for other JE vaccines previously available in the United States or used internationally.

Serious adverse events following JE-VC were uncommon within 1 month and 6 to 7 months of vaccination. In RCTs, there were no significant differences in the proportions of subjects with serious adverse events occurring within 1 month or 6 to 7 months in the JE-VC or comparison groups. Comparator groups in the largest studies received the commonly used 7-valent pneumococcal conjugate vaccine (Prevnar) or hepatitis A vaccine (Havrix 720), or phosphate buffered saline with 0.1% aluminum hydroxide. For adverse events of special interest including fever, rash, hypersensitivity/urticaria, neurologic, and medically attended adverse events, there also were no significant differences in the proportions with any of these events among JE-VC and comparator vaccine recipients. Post-marketing surveillance data from >1.3 million doses distributed provided additional reassuring data, with reported rates of serious adverse events similar to rates reported in post-marketing surveillance assessments for other vaccines used in the United States. No patterns in the timing or types of serious adverse events were identified in the clinical trials or surveillance data. Overall, no important safety concerns were identified.

In general, with high seroprotection rates following vaccination and with no important safety concerns identified, the work group considered the desirable effects of a vaccine to prevent a rare but potentially serious, untreatable disease outweighed the undesirable effects of vaccination. However, as with any vaccine, rare serious adverse events can occur, and so for some travelers with lower risk itineraries, even a low probability of vaccine-related serious adverse events might be higher than the risk for disease. Therefore, for each traveler, a healthcare provider should consider and discuss the balance of desirable and undesirable vaccine effects and the traveler's probable risk based on itinerary and activities, and JE vaccine should be targeted to travelers who are at higher risk for disease.

Criterion 4: Certainty of evidence for outcomes

Criterion question: What is the overall certainty of this evidence for the critical outcomes?

The GRADE approach was followed for assessing the type of evidence [Ahmed 2013]. For the benefits considered critical outcomes (i.e., seroprotection at 1 month and 5 to 6 months following JE-VC), evidence type is 1 for the RCTs and 3 for observational studies (Table 15). For harms considered critical outcomes (i.e., serious adverse events and adverse events of special interest) evidence type is 2 for RCTs (downgraded because of inadequate blinding) and 3 for observational studies.

For serious adverse events at 1 month, there was some concern about inconsistency and imprecision in the RCTs. However, complementary information from surveillance assessments and observational studies provided additional data supportive of the vaccine's safety.

The overall quality of evidence is type 1 (i.e., high) for vaccine effectiveness using seroprotection as the endpoint and type 2 (i.e., moderate) for safety (Table 16).

Domain 3. Values

Criterion 1: target population perception of value.

Criterion question: Does the target population feel that the desirable effects are large relative to undesirable effects?

A population survey was conducted using the Porter Novelli Public Services Styles survey mechanism to gather data on perspectives and perceptions of JE disease and the vaccine. Porter Novelli maintains a panel of approximately 55,000 persons representative of the non-institutionalized U.S. population. Members are randomly recruited by mail using probability-based sampling by address. Respondents receive cash-equivalent reward points for their participation. Porter Novelli regularly conducts surveys covering a variety of topics. For the SpringStyles survey conducted from March 21 through April 11, 2018, 10,904 adults were invited to participate.

Two JE questions were included in the survey:

• P ossible responses: Very likely/Somewhat likely/Not sure/Somewhat unlikely/Very unlikely
• P ossible responses: Chance of getting the disease/Chance of dying or being disabled/The vaccine is safe/Chance of serious side effects/Cost of the vaccine/I do not get any vaccinations/Other reasons not listed

In total, 6,427 (59%) of invited participants completed the survey. Median age was 51 years (range: 18–94 years) and 2,907 (45%) were male. Races included White, Non-Hispanic (n=4,796; 74%), Hispanic (n=675; 11%), Black, Non-Hispanic (n=547; 9%) and other (n=436; 7%). There were 328 (5%) with no formal education, 1,456 (23%) with up to high school education, and 4,643 (72%) with at least some college or higher education. Household income was <$20,000 for 5,967 (9%), $25,000 to <$60,000 for 1,890 (29%), and ≥$60,000 for 3,940 (61%). Data were weighted using eight factors including gender, age, household income, race/ethnicity, household size, education, census region, and metro status to match U.S. Current Population Survey proportions.

Responses to the JE questions were provided by 6,384 (99%) of 6,427 participants. Among respondents, the likelihood of getting JE vaccine was "very likely" for 1,032 (16%), "somewhat likely" for 1,033 (16%), "not sure" for 1,575 (25%), "somewhat unlikely" for 1,088 (17%) and "very unlikely" for 1,656 (26%). Overall, there were more unlikely to get vaccinated (43%) compared with those likely to get vaccinated (32%).

The results suggest there is variability in the population perception of whether the potential benefits of vaccination outweigh harms.

Criterion 2: Uncertainty around target population perception of value

Criterion question: Is there important uncertainty about or variability in how much people value the main outcomes?

Among the 2,065 respondents "very likely" or "somewhat likely" to get the vaccine, the three most important factors for their decision were chance of getting the disease (n=1,439; 70%), the chance of dying or being disabled (n=1,209; 59%) and that the vaccine is safe (n=847; 41%). Compared with those "very likely" to get the vaccine, those "somewhat likely" to get the vaccine more frequently noted vaccine cost (35% versus 10%) and the chance of serious side effects (26% versus 16%). Among the 2,744 "very unlikely" or "somewhat unlikely" to get the vaccine, the three most important factors were cost of the vaccine (n=1,771; 65%), chance of getting the disease (1,281; 47%), and chance of serious side effects (n=756; 28%). Of note, among those "very likely" to get the vaccine, 76% selected the chance of getting the disease as an important factor in their decision, and among those "very unlikely" to get the vaccine, 41% also selected the chance of getting the disease as a factor.

The survey results suggest there are differences in the population regarding perceptions of disease risk and the value of vaccination. While some in the population clearly value the availability of a vaccine to prevent a rare disease with potentially serious outcomes and no specific treatment, others were less likely to place value on it when the vaccine is expensive and, while generally safe, has the possibility of rare serious side effects. Disease risk was considered a reason to both receive and not receive the vaccine. There is clearly substantial variability in individual perception and tolerance of risk impacting decision-making on vaccination choices.

Domain 4. Acceptability

Criterion: acceptability to key stakeholders.

Criterion question: Is the option acceptable to key stakeholders?

Travel medicine practitioners were considered an important stakeholder group in regards to the use of JE vaccine. The work group investigated mechanisms to survey U.S. travel medicine practitioners regarding JE vaccine recommendations but none could be identified within the timeframe available. Four members of the JE ACIP work group who are travel medicine practitioners and members of the International Society of Travel Medicine played an active role in discussions about the recommendations.

Several publications authored by U.S. healthcare providers have included opinions on the existing ACIP JE vaccine recommendations [Caldwell 2018, Connor 2017, Burchard 2009, Teitelbaum 2009, Shlim 2002]. The opinions on JE vaccination expressed in these publications and in meetings range from suggesting limited use based on an individual assessment for each traveler to broader consideration for any traveler to a rural or peri-urban area irrespective of duration of travel or itinerary.

The manufacturer of Ixiaro (Valneva) sponsored an "Expert Advisory Group on JE Prevention" that has had several meetings and written three letters to ACIP in January 2015, April 2017, and October 2017. The group has suggested revisions to the JE vaccine recommendations and urged broadening of the recommendations to include traveler groups the work group considered ill-defined for being at higher risk. The work group reviewed the letters and two of the travel medicine practitioners with dissenting opinions on the recommendations made presentations to the work group. However, it is unknown how representative their opinions are among other travel medicine practitioners. The manufacturer has similarly suggested broadening of the recommendations, but due to a conflict of interest, acceptability to the manufacturer was given low priority.

For the public, the proposed recommendations for JE vaccination are likely to be acceptable as they describe and target vaccination of travelers with the highest risk for infection and so limit the number of travelers for whom an expensive vaccine for a very low risk disease might be recommended. Factors that increase risk for JE among travelers are described in the JE vaccine recommendations. Most travelers are likely to value a discussion of the risks and benefits of vaccination including consideration of the traveler's tolerance of risk, while others might prefer more concrete recommendations that clearly define who should receive vaccine based on a specific factor such as duration of travel. Some travelers who have an insurer that covers travel vaccines might prefer a recommendation for vaccination for all travelers.

While there is some variability among stakeholders opinions on the recommendations, there is stakeholder agreement that: 1) There is overall low risk for most travelers; 2) There is a need to inform travelers about risks and prevention measures for JE; and 3) Vaccine should be targeted to travelers at higher risk. All members of the work group agreed the vaccine recommendations were acceptable, and considered that they will probably be acceptable to most stakeholders as they are based on individual clinical decision-making with consideration of 1) risks related to the specific travel itinerary, 2) likelihood of future travel to JE-endemic countries, 3) high morbidity and mortality of JE when it occurs, 4) availability of an effective vaccine, 5) possibility, but low probability, of serious adverse events following vaccination, and 6) traveler's personal perception and tolerance of risk.

Domain 5. Resource Use

Criterion: resource allocation.

Criterion question: Is the option a reasonable and efficient allocation of resources?

JE vaccination is cost-effective or cost-saving for local populations in JE endemic countries [Yin 2012, Touch 2010, Siraprapasiri 1997]. However, JE vaccination is not expected to be cost effective among travelers as there is 1) a substantially lower risk of disease of <1 reported case per million U.S. travelers compared with 1–10 cases of JE per 100,000 population per year in endemic countries, and 2) use of much lower cost vaccines in most vaccination programs in Asia (e.g., a live attenuated JE vaccine manufactured in China and used widely throughout Asia costs <1 USD per dose compared with a 2-dose primary series of JE-VC for US travelers which costs approximately 600 USD).

There were several general resource considerations the work group noted when discussing JE vaccination for travelers. From a societal perspective, JE vaccination is probably not an efficient use of resources. The vaccine is expensive and the disease is rare. However, the question of resource use is less relevant for travel vaccines which are usually paid for by the travelers themselves and are not covered under the Vaccines for Children program or by most insurance plans. Travelers make individual decisions on vaccination. Mortality and disability rates following disease are high, and about one third of participants in the survey described in Domain 3 indicated vaccination was probably a reasonable investment. Nonetheless, there are opportunity costs in travelers purchasing this vaccine compared with an alternative preventive measure. The cost of the vaccine also raises a health equity issue, and could lead to health disparities since some higher risk travelers might not be able to afford the vaccine; however, the vaccine recommendations cannot address this issue.

The work group did not consider a cost-effectiveness analysis of JE-VC essential. However, the work group decided to perform a comparative analysis of different vaccination strategies to: 1) Provide perspective on the numbers of travelers needed to be vaccinated and associated costs to avert a case; 2) Compare the relative costs of vaccination for travelers with different itineraries and disease risk; and 3) Better understand the cost implications of possibly expanding the current JE vaccine recommendations to a broader group of travelers. A comparative analysis of strategies for JE vaccination for U.S. travelers to Asia was performed by CDC's Health Economics and Modeling Unit according to ACIP guidelines [Meltzer 2018]. An analytic horizon of 6 years was used, but productivity losses were evaluated over average life expectancy. The analysis compared JE vaccination in three groups. Risk group l included travelers who plan to spend ≥1 month in JE endemic areas and approximates the group for whom JE vaccine is recommended under ACIP guidelines. Risk group 2 included travelers who will spend <1 month in JE endemic areas with at least 20% of their time doing outdoor activities in rural areas. This group approximates travelers for whom JE vaccination should be considered after evaluating their itinerary and weighing the benefits, risks, and costs. Risk group 3 included the remainder of shorter-term and lower-risk U.S. travelers to Asia for whom JE vaccination is not recommended.

To prevent one JE case, the number of travelers who would need to be vaccinated was 0.7 million in Risk group 1, 1.6 million in Risk group 2, and 9.8 million in Risk group 3. The cost to prevent one JE case from a societal perspective was approximately $0.6 billion for Risk group 1, $1.3 billion for Risk group 2, and $7.9 billion for Risk group 3. The variable with the greatest influence on the cost-effectiveness of vaccination was disease incidence among travelers. As baseline incidence relies upon reported JE cases, to address any uncertainty about the sensitivity of surveillance, a sensitivity analysis was conducted increasing the baseline incidence 100 times, although it is very unlikely 100 JE cases are occurring among U.S. travelers annually when fewer than 1 case is reported. With the incidence 100 times higher, the numbers needed to vaccinate to prevent a case were 7,000, 16,000 and 98,000, and the cost per case averted was $5 million, $12 million, and $78 million in each Risk group, respectively. If JE vaccination recommendations were expanded from Risk group 1 to Risk group 1 and 2, it would cost society an additional $1.6 billion to prevent one additional case of JE. Similarly, expanding JE vaccination recommendations from Risk groups 1 and 2 to all travelers would cost society an additional $14.6 billion to prevent an additional JE case.

Between 1993 and 2017, among 12 JE cases reported in US travelers, 8 (67%) occurred among the 20% travelers in the category in which vaccination would have been recommended. Among the remainder of travelers for whom itinerary information was known (n=3), all had at least some rural exposure which would have warranted discussion of risks, prevention measures, and consideration of vaccination [Hills 2017].

The work group decided the question of whether the intervention was a reasonable and efficient allocation of collective resources was not directly applicable to JE vaccination as travel vaccines are usually paid for by the travelers themselves who make individual decisions on vaccine purchase. In general, JE vaccination for travelers cannot be considered an efficient use of societal resources as it is an expensive vaccine for a low risk disease in this population. Nonetheless, the comparative analysis supports the proposed tiered JE vaccine recommendations as it indicated a large increased cost to society to prevent a case of JE when including Risk groups 1 and 2 compared with Risk group 1 alone, supporting a more cautious approach or "consideration" of vaccination for those in Risk group 2. In addition, there was a very large increased cost to society if Risk group 3 was included, which does not support a broad recommendation of JE vaccination for all travelers. Overall, vaccine recommendations targeted to higher risk groups are probably a reasonable allocation of resources as the financial implications of vaccine purchase will be borne by travelers most at risk of a severe disease who will therefore receive the most benefit.

Criterion: Implementation feasibility

Criterion question: Is the option feasible to implement?

JE vaccination is provided by generalist and specialist healthcare providers. Administration is feasible as part of a pre-travel consultation. Barriers to implementation of risk-based vaccine recommendations include lack of understanding of factors that might increase the risk for JE and, therefore, which travelers might benefit most from vaccination. However, specific information is provided in a table accompanying the recommendations that guides practitioners on factors that increase JE risk (Box). Other resources such as the CDC Yellow Book: Health Information for International Travel also are readily available [CDC 2017].

The work group considered risk-based recommendations were probably feasible to implement.

Conclusions and additional considerations

Conclusions.

Overall, the work group determined the desirable consequences probably outweigh undesirable consequences in most settings when risk-based recommendations are appropriately implemented. We recommend the intervention for individuals based on clinical decision-making. The proposed recommendations are presented below.

Additional considerations

Among the shorter-term travelers for whom vaccination would be "considered" rather than "recommended" there was no consistent risk factor, destination, or feature to enable further targeting of recommendations. This suggests the only way to prevent every case would be to recommend vaccination for all travelers; however, weighing the risks and benefits, the work group members considered vaccine recommendations should be targeted to the subset of travelers with greater risk of infection.

Recommendations for the Prevention of JE Among Travelers

JE is a very low risk disease for most U.S. travelers to JE-endemic countries. However, some travelers will be at increased risk of infection based on their planned itinerary. Factors that increase the risk of JE virus exposure include: 1) longer duration of travel, 2) travel during the JE virus transmission season, 3) spending time in rural areas, 4) participating in extensive outdoor activities, and 5) staying in accommodations without air conditioning, screens, or bed nets (Box).

Healthcare providers should assess each traveler's risk for mosquito exposure and JE virus infection based on their planned itinerary, and discuss ways to reduce their risk. All travelers to JE-endemic countries should be advised to take precautions to avoid mosquito bites to reduce the risk for JE and other vector-borne diseases. These precautions include using insect repellent, permethrin-impregnated clothing, and bed nets, and staying in accommodations with screened or air-conditioned rooms.

For some people who might be at increased risk for JE based on travel duration, season, location, activities, and accommodations, JE vaccine can further reduce the risk for infection. The decision whether to vaccinate should be individualized and consider the: 1) risks related to the specific travel itinerary, 2) likelihood of future travel to JE-endemic countries, 3) high morbidity and mortality of JE when it occurs, 4) availability of an effective vaccine, 5) possibility, but low probability, of serious adverse events following vaccination, and 6) traveler's personal perception and tolerance of risk.

JE vaccine is recommended for persons moving to a JE-endemic country to take up residence, longer-term (e.g., ≥1 month) travelers to JE-endemic areas, and frequent travelers to JE-endemic areas. JE vaccine also should be considered for shorter-term (e.g., <1 month) travelers with an increased risk of JE based on planned travel duration, season, location, activities, and accommodations (Box). Vaccination also should be considered for travelers to endemic areas who are uncertain of specific duration of travel, destinations, or activities.

JE vaccine is not recommended for travelers with very low risk itineraries, such as shorter-term travel limited to urban areas or travel that occurs outside of a well-defined JE virus transmission season.

Box. Factors that increase risk for Japanese encephalitis among travelers

• Highest incidence of disease has been reported among longer-term travelers.
• Although no specific duration of travel puts a traveler at risk for JE, longer-term travel increases the likelihood that a traveler might be exposed to an infected mosquito.
• Longer-term travel includes cumulative periods in endemic areas; this includes frequent travelers, and persons residing in urban areas who are likely to visit higher risk rural areas.
• JE virus transmission occurs seasonally in some areas, and year-round in other areas.
• Information on expected JE virus transmission by country is available on the CDC website (see Japanese encephalitis chapter in CDC Health Information for International Travel [the Yellow Book]). These data should be interpreted cautiously because JE virus transmission varies within countries and from year to year.
• Highest risk occurs from mosquito exposure in rural or agricultural areas.
• Mosquitoes that transmit JE virus typically breed in flooded rice fields, marshes, and other stagnant collections of water.
• Some cases have been reported among travelers to coastal areas or resorts located in or adjacent to rural or rice growing areas.
• JE can occur in large, focal outbreaks indicating extensive active JE virus transmission in those areas.
• Outdoor recreation such as camping, hiking, trekking, biking, rafting, fishing, hunting, or farming.
• Spending substantial time outdoors, especially during the evening or night.

Accommodations

Accommodations without air conditioning, screens, or bed nets increase risk of mosquito exposure.

Table 1. Summary of outcome measure ranking and inclusion for use of inactivated Vero cell culture-derived JE vaccine (JE-VC)

Table 1 Footnotes

JE=Japanese encephalitis

• Seroprotection defined as a neutralizing antibody titer ≥10 by 50% plaque reduction neutralization test against the JE virus SA14-14-2 JE virus [Markoff 2000; Hombach 2005].
• Serious adverse event defined as any of the following outcomes: 1) death, 2) life-threatening adverse event, 3) inpatient hospitalization, 4) persistent or significant incapacity or substantial disruption of the ability to conduct normal life functions, or 5) congenital anomaly/birth defect [FDA. 21 CFR 312.32].
• Systemic adverse events evaluated include fever, rash, hypersensitivity/urticaria, neurologic, and medically attended adverse events.

Table 2. Seroprotection at 1 month after a 2-dose primary series of inactivated Vero cell culture-derived JE vaccine (JE-VC) administered according to the FDA-approved dose and schedule

Table 2 Footnotes

JE=Japanese encephalitis; PRNT 50 =50% plaque reduction neutralization test; RCT=Randomized controlled trial; Obs=Observational study

• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross (Korea) [Kaltenbock 2010; Erra 2012], inactivated mouse brain-derived JE vaccine (JE-VAX) manufactured by Biken (Japan) [Tauber 2007; Lyons 2007], or inactivated Vero cell culture-derived JE vaccine adsorbed (JEEV) manufactured by Biological E (India) [Biological E 2013(a)].
• Of an additional 21 children aged 1-2 years who received two 0.5mL doses of JE-VC, 20 (95%) were seroprotected at 1 month after the second dose.
• RCT with no comparative immunogenicity data.
• Of an additional 98 children aged 3-11 years who received two 0.25mL doses of JE-VC, 94 (96%) were seroprotected at 1 month after the second dose.
• Seroprotection measured at 4–8 weeks after final vaccine dose.
• Complete data unavailable and estimated from graph.
• Seroprotection measured at 42 days after dose 2 of JE-VC.

Figure 1. Pooled risk ratio for seroprotection at 1 month after a 2-dose primary series of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

*Pooled risk ratios computed using the random effects model (Mantel-Haenszel method). Risk ratio = Proportion seroprotected in JE-VC group / Proportion seroprotected in other Japanese encephalitis (JE) vaccine group. Risk ratio >1.0 favors JE-VC versus other JE vaccine.

Table 3. Seroprotection, serious adverse events, and systemic adverse events following receipt of JEEV[1,2]

Table 3 Footnotes

• JEEV is manufactured by Biological E (Hyderabad, India) with technology licensed from Intercell (now Valneva Austria GmbH). JEEV and JE-VC (IXIARO) use the same virus strain, adjuvant, and virus purification; however, no process comparability studies have been completed and it cannot be assumed that the two final vaccine products are the same [Central Drugs Standard Control Organization 2013].
• Randomized, controlled, open-label study in India in which children aged 1–2 years received two 0.25mL doses of JEEV (N=304) or three doses of JenceVac (N=152). The seroprotection rate in JEEV recipients was non-inferior to that in JenceVac recipients [Biological E 2013].
• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross (Korea).

Table 4. Seroprotection at 5 to 6 months after a 2-dose primary series of inactivated Vero cell culture-derived JE vaccine (JE-VC) administered according to the FDA-approved dose and schedule[1]

Table 4 Footnotes

• For studies in children, follow-up was at 6 months after completing the 2-dose primary series. For studies in adults, follow-up was at 5 months after completing the 2-dose primary series or 6 months after the first dose.
• Inactivated mouse brain-derived JE vaccine (JE-VAX) manufactured by Biken (Japan).
• Of an additional 96 children aged 3-11 years who received two 0.25mL doses of JE-VC, 74 (77%) were seroprotected at 6 months after the second dose.

Figure 2. Pooled risk ratio for seroprotection at 5 to 6 months after a 2-dose primary series of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

Table 5. Serious adverse events reported within 1 month after either dose of JE-VC

Table 5 Footnotes

• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross (Korea) [Kaltenbock 2010], 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer Inc.) or hepatitis A vaccine (Havrix 720) manufactured by GSK [Dubischar 2017b], hepatitis A vaccine (Havrix 1440) manufactured by GSK [Kaltenbock 2009], inactivated mouse brain-derived JE vaccine (JE-VAX) manufactured by Biken (Japan) [Tauber 2007; Lyons 2007], phosphate buffered saline with 0.1% aluminum hydroxide [Tauber 2008], inactivated Vero cell culture-derived JE vaccine (JEEV) manufactured by Biological E (India) [Biological E 2013], or purified chick embryo cell culture rabies vaccine (Rabipur)[Jelinek 2015(a); data presented in Jelinek 2015(b)].
• Six serious adverse events following JE-VC included two febrile seizures (2 days after dose 2 and 20 days after dose 1), cellulitis (9 days after dose 2), gastroenteritis and hematoma (12 days after dose 1), pneumonia (23 days after dose 2), and dengue (24 days after dose 1). Five serious adverse events following comparison vaccines included three febrile seizures (9 days and 4 weeks after Havrix and 4 weeks after Prevnar), dyspnea (14 days after Havrix), and gastroenteritis (20 days after Havrix).
• Only serious adverse event following JE-VC was a myocardial infarction at 3 weeks after dose 2.
• Ten serious adverse events following JE-VC included one each of rectal hemorrhage, chest pain, limb abscess, appendicitis, facial injury, facial fracture, ulna fracture, adnexal pain, ovarian cyst, and dermatomyositis. Six serious adverse events after placebo included appendicitis (n=2), acute coronary syndrome, proctalgia, urinary calculus, and circulatory collapse.
• Only serious adverse event following JE-VC was a seizure in a patient with a history of epilepsy.
• Only one event, considered related to vaccination, described and was eyelid edema and generalized pruritus a few hours after first JE-VC dose.
• RCT with no comparative safety data.
• Adverse events collected until day 42 after dose 2 of JE-VC; the five serious adverse events were not described.

Table 6. Serious adverse events reported within 6 to 7 months after the first dose of JE-VC[1]

Table 6 Footnotes

• For studies in children, follow-up was at 7 months after the first dose of vaccine. For studies in adults, follow-up was at 6 months after the first dose.
• 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer Inc.), hepatitis A vaccine (Havrix 720) manufactured by GSK [Dubischar 2017b], or inactivated mouse brain-derived JE vaccine (JE-VAX) manufactured by Biken (Japan) or phosphate buffered saline with 0.1% aluminum hydroxide [Dubischar-Kastner 2010 (b)].
• Serious adverse events reported in 23 JE-VC recipients included pneumonia (n=6), febrile seizures (n=5), dengue (n=2), gastroenteritis (n=2), and one each with hematoma, cellulitis, hepatitis A, strabismus, car accident, Kawasaki disease, typhoid, upper respiratory infection, urinary tract infection, stillbirth, meningitis, and disseminated intravascular coagulation. One subject had two preferred terms reported (gastroenteritis and hematoma) and two subjects had three preferred terms reported (one with meningitis, pneumonia and disseminated intravascular coagulation, and one with dengue, pharyngitis, and upper respiratory infection). The stillbirth occurred in a subject who became pregnant >4 months after vaccination. One death occurred in a 12 year old male with meningitis, pneumonia, and disseminated intravascular coagulation with onset 4 months after he received dose 2 of JE-VC. Serious adverse events in 11 comparison vaccine recipients included febrile seizures (n=4), pneumonia (n=3), dengue (n=1), gastroenteritis (n=1), familial periodic paralysis (n=1), hyponatremia (n=1), dyspnea (n=1); one subject had two preferred terms reported.
• The 38 serious adverse events occurring within 6 months following receipt of JE-VC were not delineated. One death occurred in a 70 year old female with adenocarcinoma of the lung diagnosed 1 month after she received dose 2 of JE-VC.
• Three serious adverse events in JE-VC recipients included one subject each with diabetes mellitus (3 months after dose 2), dizziness (4 months after dose 2), and intentional self-injury; only 92 subjects completed the study but timing of discontinuation is unknown.
• The eight serious adverse events were not described.

Table 7. Serious adverse events reported through post-marketing surveillance following receipt of JE-VC[1]

Table 7 Footnotes

• Adverse events reported through VAERS and other similar passive surveillance systems may or may not be causally related to the vaccine.
• 85,583 doses distributed in the United States from May 2009–March 2010 are included in both studies, but there was no overlap in the 9 serious adverse events identified in the two studies.
• One report each of neuritis (9 hours after vaccination), oropharyngeal spasm (day of vaccination), meningismus (1 day after vaccination), and iritis (1 day after vaccination). The patient with iritis had also received typhoid vaccine.
• Includes one report each of an immediate hypersensitivity reaction (day of vaccination), a delayed hypersensitivity reaction (2 days after vaccination), appendicitis (5 days after vaccination), myopericarditis (11 days after vaccination), and encephalomyelitis (39 days after vaccination). Two serious adverse events occurred after administration of JE-VC alone and three events occurred after concomitant administration of JE-VC with other vaccines.
• Includes one death that occurred 8 days after JE-VC administration as a result of cardiovascular collapse due to ischemic heart disease. The remaining eight events included cardiomyopathy (n=1), myocardial infarct/acute myocarditis (n=1), angina pectoris (n=1), systemic febrile reaction (n=1), acute kidney injury/myopathy (n=1), anaphylaxis (n=1), immediate hypersensitivity (15 minutes after administration of JE-VC) (n=1), and seizure (n=1). Eight of the serious events occurred following administration of JE-VC concomitantly with other vaccines.
• Doses administered

Figure 3. Pooled risk ratio for serious adverse events within 1 month after either dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

*Pooled risk ratios computed using the random effects model (Mantel-Haenszel method). Risk ratio = Proportion with serious adverse event in JE-VC group / Proportion with serious adverse event in control vaccine group. Risk ratio <1.0 favors JE-VC versus control vaccine.

Figure 4. Pooled risk ratio for serious adverse events within 6 to 7 months after the first dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

Table 8. Fever reported as a solicited adverse event within 7 days after either dose of JE-VC

Table 8 Footnotes

• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross (Korea) [Kaltenbock 2010], 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer Inc.) or hepatitis A vaccine (Havrix) manufactured by GSK [Dubischar 2017(b)], phosphate buffered saline with 0.1% aluminum hydroxide [Tauber 2008], or inactivated mouse brain-derived JE vaccine (JE-VAX) manufactured by Biken (Japan) [Lyons 2007].
• Fever defined as temperature ≥38.0C.
• Exact numbers not provided so calculated from percentages; fever defined as ≥37.7C.
• May include unsolicited adverse events of fever that occurred up to 28 days after either dose of JE-VC
• Fever defined as ≥37.6C.
• Fever was collected for 4 days following vaccination and was subjective as reported by the participant.

Table 9. Rash reported as a solicited adverse event within 7 days after either dose of JE-VC

Table 9 Footnotes

• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross [Kaltenbock 2010], 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer Inc.) or hepatitis A vaccine (Havrix) manufactured by GSK [Dubischar 2017b], phosphate buffered saline with 0.1% aluminum hydroxide [Tauber 2008], or inactivated mouse brain-derived JE vaccine (JE-VAX) manufactured by Biken (Japan) [Lyons 2007].
• May include unsolicited adverse events of rash that occurred up to 28 days after either dose of JE-VC.
• Rash was collected for 4 days following vaccination

Table 10. Hypersensitivity or urticaria[1] reported as an unsolicited adverse event within 1 month after either dose of JE-VC

Table 10 Footnotes

• Unsolicited adverse events reported within 28 days after vaccination and classified by the study investigator as hypersensitivity or urticaria.
• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross [Kaltenbock 2010], 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer Inc.) or hepatitis A vaccine (Havrix) manufactured by GSK [Dubischar 2017(b)], or phosphate buffered saline with 0.1% aluminum hydroxide [Tauber 2008].
• Events within 14 days of either dose of JE-VC
• Adverse events collected until day 42 after dose 2 of JE-VC.

Table 11. Neurologic adverse events[1] reported as an unsolicited adverse event within 1 month after either dose of JE-VC

Table 11 Footnotes

• Unsolicited adverse events reported within 28 days after vaccination and classified by the study investigator as nervous system disorder other than headaches. No cases of meningitis, encephalitis, acute disseminated encephalomyelitis, or Guillain Barré syndrome were reported among JE-VC or comparison vaccine recipients.
• Inactivated mouse brain-derived JE vaccine (JenceVac) manufactured by Green Cross [Kaltenbock 2010], 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer, Inc.) or hepatitis A vaccine (Havrix) manufactured by GSK [Dubischar 2017b], or phosphate buffered saline with 0.1% aluminum hydroxide [Tauber 2008].

Table 12. Medically attended adverse events within 1 month after either dose of JE-VC

Table 12 Footnotes

• 7-valent pneumococcal conjugate vaccine (Prevnar) manufactured by Wyeth (now Pfizer Inc.) or hepatitis A vaccine (Havrix 720) manufactured by GlaxoSmithKline [Dubischar 2017(b)], phosphate buffered saline with 0.1% aluminum hydroxide [Tauber 2008], or hepatitis A vaccine (Havrix 1440) manufactured by GSK [Kaltenbock 2009].
• Majority of medically attended events in both groups were respiratory, gastrointestinal, or skin infections.
• Medically attended events affecting at least 2 subjects included nasopharyngitis, bronchitis, diarrhea, hematochezia, nausea, upper abdominal pain, vomiting, pyrexia, and cough.

Table 13. Hypersensitivity reactions reported through post-marketing surveillance following receipt of JE-VC[1]

Table 13 Footnotes

• 85,583 doses distributed in the United States from May 2009–March 2010 are included in both studies
• Includes five reports of rash, and one report each of urticaria, glossodynia, oral hypoaesthesia/swollen tongue, oropharyngeal spasm, pruritus. One (oropharyngeal spasm) was classified as a serious adverse event.
• The 12 events included occurred within 10 days after vaccination. Seven hypersensitivity reactions occurred after administration of JE-VC alone and five events occurred after concomitant administration of JE-VC with other vaccines. Two reports were classified as serious adverse events.
• The 24 events included one report of anaphylaxis, seven immediate hypersensitivity events (occurred <2 hours after administration of JE-VC), 15 delayed hypersensitivity events, and one hypersensitivity event that occurred within 1 day after administration but lacked more specific timing data to classify as immediate or delayed hypersensitivity. Two reports were classified as serious adverse events. Fifteen (63%) events, including both serious events, occurred after concomitant administration of JE-VC with other vaccines.
• Includes four reports of events with ICD-9 codes for delayed hypersensitivity/serum sickness, two reports with codes for anaphylactic shock, and three reports with codes for angioedema. For four reports there was concurrent administration of other vaccines.

Table 14. Neurologic adverse events other than headaches reported through post-marketing surveillance following receipt of JE-VC[1]

Table 14 Footnotes

• Includes one report each of neuritis and meningism.
• Includes one report of encephalomyelitis at 39 days after vaccination with JE-VC and two reports of seizures on the day of vaccination. All subjects had received other vaccines. One of the reports was classified as a serious adverse event.
• Two reports of seizures, both following concomitant administration of JE-VC with other vaccines. One classified as serious.
• Includes 6 reports with codes for convulsions and 2 with a code for meningitis. For four reports there was concurrent administration of other vaccines.

Figure 5. Pooled risk ratio for fever as a solicited adverse event within 7 days after either dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

*Pooled risk ratios computed using the random effects model (Mantel-Haenszel method). Risk ratio = Proportion with fever in JE-VC group / Proportion with fever in control vaccine group. Risk ratio <1.0 favors JE-VC versus control vaccine.

Figure 6. Pooled risk ratio for rash as a solicited adverse event within 7 days after either dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

*Pooled risk ratios computed using the random effects model (Mantel-Haenszel method). Risk ratio = Proportion with rash in JE-VC group / Proportion with rash in control vaccine group. Risk ratio <1.0 favors JE-VC versus control vaccine.

Figure 7. Pooled risk ratio for hypersensitivity or urticaria as an unsolicited adverse event within 1 month after either dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

*Pooled risk ratios computed using the random effects model (Mantel-Haenszel method). Risk ratio = Proportion with hypersensitivity or urticaria in JE-VC group / Proportion with hypersensitivity or urticaria in control vaccine group. Risk ratio <1.0 favors JE-VC versus control vaccine.

Figure 8. Pooled risk ratio for neurologic adverse events other than headache within 1 month after either dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

Figure 9. Pooled risk ratio for medically attended adverse events within 1 month after either dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine (JE-VC) in randomized controlled trials*

*Pooled risk ratios computed using the random effects model (Mantel-Haenszel method). Risk ratio = Proportion with medically attended adverse events in JE-VC group / Proportion with medically attended adverse events in control vaccine group. Risk ratio <1.0 favors JE-VC versus control vaccine.

Table 15. Limitations and evidence type for benefits and harms for JE-VC

Table 15 Footnotes

RCT = Randomized controlled trial with JE-VC; Obs = Observational study, RCT without comparative data for the outcome measure, or post-marketing surveillance data.

• Publication bias, strength of association, dose response, or opposing plausible residual confounding.
• RCTs or overwhelming evidence from observational studies
• RCTs with important limitations, or exceptionally strong evidence from observational studies
• Observational studies, or RCTs with notable limitations
• Clinical experience and observations, observational studies with important limitations, or RCTs with several major limitations
• Risk of bias due to inadequate blinding of study participants and personnel.

Table 16. Overall quality of evidence for JE-VC

Table 16 Footnotes

RCT = Randomized controlled trial.

• Body of evidence for each outcome includes both RCTs and observational studies; the study design that provides higher quality of evidence was selected.
• ACIP. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) for Use of Inactivated Vero Cell Culture-derived Japanese Encephalitis Vaccine in Children . 2013. Accessed April 11, 2018
• Ahmed F. U.S. Advisory Committee on Immunization Practices handbook for developing evidence-based recommendations . Version 1.2. Atlanta, GA: Centers for Disease Control and Prevention (CDC); 2013.
• Arana JE, Harrington T, Cano M, et al. Post-licensure safety monitoring of quadrivalent human papillomavirus vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2009-2015. Vaccine. 2018;36:1781–8.
• Biological E. Unpublished data presented to the ACIP JE Vaccine Work Group by Katrin Dubischar-Kastner (Intercell AG , now Valneva Austria GmbH ). April 2013.
• Burchard GD, Caumes E, Connor BA, et al. Expert opinion on vaccination of travelers against Japanese encephalitis. J Travel Med. 2009;16:204–16.
• Butler S, Sutter D, Maranich A. Tolerability of Japanese encephalitis vaccine in pediatric patients. J Pediatric Infect Dis So c. 2017;6:149–152.
• Caldwell JP, Chen LH, Hamer DH. Evolving epidemiology of Japanese encephalitis: implications for vaccination. Curr Infect Dis Rep. 2018;20:30.
• Campbell GL, Hills SL, Fischer M, e al. Estimated global incidence of Japanese encephalitis: a systematic review. Bull World Health Organ. 2011;89:766–74.
• CDC. Recommendations for use of a booster dose of inactivated Vero cell culture-derived Japanese encephalitis vaccine: Advisory Committee on Immunization Practices, 2011. MMWR. 2011;60:661–3.
• CDC. CDC Yellow Book 2018: Health Information for International Travel. New York: Oxford University Press; 2017.
• Central Drugs Standard Control Organization. Product approval information for JEEV (Japanese encephalitis purified inactivated vaccine adsorbed). Biological E Limited, Hyderabad, India. 2013.
• Connor B, Bunn W. The changing epidemiology of Japanese encephalitis and new data: The implications for new recommendations for Japanese encephalitis vaccine. Trop Dis Travel Med Vaccines. 2017;3:14.
• Cramer JP, Dubischar K, Eder S, et al. Immunogenicity and safety of the inactivated Japanese encephalitis vaccine IXIARO® in elderly subjects: Open-label, uncontrolled, multi-center, phase 4 study. Vaccine. 2016(a);34:4579–85.
• Cramer JP, Jelinek T, Paulke-Korinek M, et al. One-year immunogenicity kinetics and safety of a purified chick embryo cell rabies vaccine and an inactivated Vero cell-derived Japanese encephalitis vaccine administered concomitantly according to a new, 1-week, accelerated primary series. J Travel Med. 2016(b);23(3).
• Dubischar-Kastner K, Eder S, Buerger V, et al. Long-term immunity and immune response to a booster dose following vaccination with the inactivated Japanese encephalitis vaccine IXIARO, IC51. Vaccine. 2010(a);28:5197–202.
• Dubischar-Kastner K, Kaltenboeck A, Klingler A, et al. Safety analysis of a Vero-cell culture derived Japanese encephalitis vaccine, IXIARO® (IC51), in 6 months of follow-up. Vaccine. 2010(b);28:6463–9.
• Dubischar KL, Kadlecek V, Sablan JB, et al. Immunogenicity of the inactivated Japanese encephalitis virus vaccine IXIARO in children from a Japanese encephalitis virus-endemic region. Pediatr Infect Dis J. 2017(a);36:898–904.
• Dubischar KL, Kadlecek V, Sablan B et al. Safety of the inactivated Japanese encephalitis virus vaccine IXIARO in children: An open-label, randomized, active-controlled, phase 3 study. Pediatr Infect Dis J. 2017(b);36:889–97.
• Erra EO, Hervius Askling H, Rombo L, et al. A single dose of Vero cell–derived Japanese encephalitis (JE) vaccine (IXIARO) effectively boosts immunity in travelers primed with mouse brain–derived JE vaccines. Clin Infect Dis. 2012;55:825–34.
• Food and Drug Administration. CFR – Code of Federal Regulations 21CFR312.32 . Accessed October 12, 2018.
• Fischer M, Lindsey N, Staples JE, Hills S. Japanese encephalitis vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2010;59(RR-1):1-27.
• Hills S. Epidemiology and risk of Japanese encephalitis in U.S. travelers . Presentation to the Advisory Committee on Immunization Practices (ACIP), October 26, 2017, Atlanta, GA. Accessed September 25, 2018.
• Hombach J, Solomon T, Kurane I, et al. Report on a WHO consultation on immunological endpoints for evaluation of new Japanese encephalitis vaccines, WHO, Geneva, 2–3 September, 2004. Vaccine. 2005;23:5205–11.
• Jelinek T, Burchard GD, Dieckmann S et al. Short-term immunogenicity and safety of an accelerated pre-exposure prophylaxis regimen with Japanese encephalitis vaccine in combination with a rabies vaccine: A phase III, multicenter, observer-blind study. J Travel Med. 2015(a);22:225–31.
• Jelinek T, Cramer JP, Dieckmann S, et al. Evaluation of rabies immunogenicity and tolerability following a purified chick embryo cell rabies vaccine administered concomitantly with a Japanese encephalitis vaccine. Travel Med Infect Dis. 2015(b);13:241–50.
• Jelinek T, Cromer MA, Cramer JP, et al. Safety and immunogenicity of an inactivated Vero cell-derived Japanese encephalitis vaccine (IXIARO®, JESPECT®) in a pediatric population in JE non-endemic countries: An uncontrolled, open-label phase 3 study. Travel Med Infect Dis. 2018;22:18–24.
• Kaltenböck A, Dubischar-Kastner K, Eder G, et al. Safety and immuno­genicity of concomitant vaccination with the cell-culture based Japanese encephalitis vaccine IC51 and the hepatitis vaccine HAVRIX1440 in healthy subjects—A single-blind, randomized, controlled phase 3 study. Vaccine. 2009;27:4483–9.
• Kaltenböck A, Dubischar-Kastner K, Schuller E, et al. Immunogenicity and safety of IXIARO (IC51) in a phase II study in healthy Indian children between 1 and 3 years of age. Vaccine. 2010;28:834–9.
• Lee G, Carr W. Updated framework for development of evidence-based recommendations by the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep . 2018;67:103–8.
• Lindsey NP, Rabe IB, Miller ER et al. Adverse event reports following yellow fever vaccination, 2007– Travel Med . 2016;23:1–6.
• Lyons A, Kanesa-thasan N, Kuschner RA, et al. A Phase 2 study of a purified, inactivated virus vaccine to prevent Japanese encephalitis. Vaccine . 2007;25:3445–53.
• Markoff L. Points to consider in the development of a surrogate for efficacy of novel Japanese encephalitis virus vaccines. Vaccine . 2000;18 Suppl 2:26–32.
• Meltzer M. Comparative analysis of strategies for JE vaccination for U.S. travelers to Asia . Presentation to the Advisory Committee on Immunization Practices (ACIP), June 21, 2018, Atlanta, GA. Accessed September 20, 2018.
• Miller ER, Moro PL, Cano M, et al. Post-licensure safety surveillance of 23-valent pneumococcal polysaccharide vaccine in the Vaccine Adverse Event Reporting System (VAERS), 1990-2013. Vaccine . 2016;34:2841–6.
• Miller ER, Lewis P, Shimabukuro TT, et al. Post-licensure safety surveillance of zoster vaccine live (Zostavax®) in the United States, Vaccine Adverse Event Reporting System (VAERS), 2006-2015. Hum Vaccin Immunother . 2018; 14:1963–9.
• Rabe IB, Miller ER, Fischer M, Hills SL. Adverse events following vaccination with an inactivated, Vero cell culture-derived Japanese encephalitis vaccine in the United States, 2009-2012. Vaccine . 2015;33:708–12.
• Schuller E, Jilma B, Voicu V, et al. Long-term immunogenicity of the new Vero cell-derived, inactivated Japanese encephalitis virus vaccine IC51 Six and 12 month results of a multicenter follow-up phase 3 study. Vaccine . 2008;26:4382–6.
• Schuller E, Klade CS, Wolfl G, et al. Comparison of a single, high-dose vaccination regimen to the standard regimen for the investigational Japanese encephalitis vaccine, IC51: A randomized, observer-blind, controlled Phase 3 study. Vaccine . 2009;27:2188–93.
• Schuller E, Klingler A, Dubischar-Kastner K, et al. Safety profile of the Vero cell-derived Japanese encephalitis virus (JEV) vaccine IXIARO. Vaccine . 2011;29:8669–76.
• Shlim D, Solomon T. Japanese encephalitis vaccine for travelers: Exploring the limits of risk. Clin Infect Dis . 2002;35:183–8.
• Siraprapasiri T, Sawaddiwudhipong W, Rojanasuphot S. Cost benefit analysis of Japanese encephalitis vaccination program in Thailand. Southeast Asian J Trop Med Public Health . 1997;28:143–8.
• Tauber E, Kollaritsch H, Korinek M, et al. Safety and immunogenic­ity of a Vero-cell-derived, inactivated Japanese encephalitis vaccine: A non-inferiority, phase III, randomised controlled trial. Lancet . 2007;370:1847–53.
• Tauber E, Kollaritsch H, von Sonnenburg F, et al. Randomized, double-blind, placebo-controlled phase 3 trial of the safety and tolerability of IC51, an inactivated Japanese encephalitis vaccine. J Infect Dis . 2008;198:493–9.
• Taucher 2017. VLA-401: JE-VC post-marketing adverse event surveillance among U.S. military personnel . Presentation to the Advisory Committee on Immunization Practices (ACIP), October 26, 2017, Atlanta, GA.
• Teitelbaum P. Expert opinion on vaccination of travelers against Japanese encephalitis. J Travel Med . 2009;16:441.
• Touch S, Suraratdecha C, Samnang C, et al. A cost-effectiveness analysis of Japanese encephalitis vaccine in Cambodia. Vaccine . 2010;28:4593–9.
• Walker WL, Hills SL, Miller ER, et al. Adverse events following vaccination with an inactivated, Vero cell culture-derived Japanese encephalitis vaccine in the United States, 2012–2016. Vaccine . 2018;36:4369–74.
• Woolpert T, Staples JE, Faix DJ, et al. Immunogenicity of one dose of Vero cell culture-derived Japanese encephalitis (JE) vaccine in adults previously vaccinated with mouse brain-derived JE vaccine. Vaccine . 2012;30:3090–6.
• Yin Z, Beeler Asay GR, Zhang L, et al. An economic evaluation of the use of Japanese encephalitis vaccine in the expanded program of immunization of Guizhou province, China. Vaccine . 2012;30:5569–77.

View the complete list of GRADE evidence tables‎

ACIP comprises medical and public health experts who develop recommendations on the use of vaccines in the civilian population of the United States.

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Vaccines for Travelers

Vaccines protect travelers from serious diseases. Depending on where you travel, you may come into contact with diseases that are rare in the United States, like yellow fever. Some vaccines may also be required for you to travel to certain places.

Getting vaccinated will help keep you safe and healthy while you’re traveling. It will also help make sure that you don’t bring any serious diseases home to your family, friends, and community.

On this page, you'll find answers to common questions about vaccines for travelers.

Which vaccines do I need before traveling?

The vaccines you need to get before traveling will depend on few things, including:

• Where you plan to travel . Some countries require proof of vaccination for certain diseases, like yellow fever or polio. And traveling in developing countries and rural areas may bring you into contact with more diseases, which means you might need more vaccines before you visit.
• Your health . If you’re pregnant or have an ongoing illness or weakened immune system, you may need additional vaccines.
• The vaccinations you’ve already had . It’s important to be up to date on your routine vaccinations. While diseases like measles are rare in the United States, they are more common in other countries. Learn more about routine vaccines for specific age groups .

How far in advance should I get vaccinated before traveling?

It’s important to get vaccinated at least 4 to 6 weeks before you travel. This will give the vaccines time to start working, so you’re protected while you’re traveling. It will also usually make sure there’s enough time for you to get vaccines that require more than 1 dose.

Where can I go to get travel vaccines?

Start by finding a:

• Travel clinic
• Health department
• Yellow fever vaccination clinic

Learn more about where you can get vaccines .

What resources can I use to prepare for my trip?

Here are some resources that may come in handy as you’re planning your trip:

• Visit CDC’s travel website to find out which vaccines you may need based on where you plan to travel, what you’ll be doing, and any health conditions you have.
• Download CDC's TravWell app to get recommended vaccines, a checklist to help prepare for travel, and a personalized packing list. You can also use it to store travel documents and keep a record of your medicines and vaccinations.
• Read the current travel notices to learn about any new disease outbreaks in or vaccine recommendations for the areas where you plan to travel.
• Visit the State Department’s website to learn about vaccinations, insurance, and medical emergencies while traveling.

Traveling with a child? Make sure they get the measles vaccine.

Measles is still common in some countries. Getting your child vaccinated will protect them from getting measles — and from bringing it back to the United States where it can spread to others. Learn more about the measles vaccine.

Find out which vaccines you need

CDC’s Adult Vaccine Quiz helps you create a list of vaccines you may need based on your age, health conditions, and more.

Take the quiz now !

Get Immunized

Getting immunized is easy. Vaccines and preventive antibodies are available at the doctor’s office or pharmacies — and are usually covered by insurance.

Find out how to get protected .

Disclaimer Policy: Links with this icon ( ) mean that you are leaving the HHS website.

• The Department of Health and Human Services (HHS) cannot guarantee the accuracy of a non-federal website.
• Linking to a non-federal website does not mean that HHS or its employees endorse the sponsors, information, or products presented on the website. HHS links outside of itself to provide you with further information.
• You will be bound by the destination website's privacy policy and/or terms of service when you follow the link.
• HHS is not responsible for Section 508 compliance (accessibility) on private websites.

For more information on HHS's web notification policies, see Website Disclaimers .