Before traveling to Paraguay, it helps to separate two questions: is yellow fever vaccination recommended for the places you will visit, and do you need an official vaccination certificate to enter? Your route and itinerary can change the answer.
The short answer: CDC recommends yellow fever vaccine for most travelers aged 9 months and older, but generally does not recommend it for travel limited to Asunción. Entry rules can change after travel through certain South American countries.
Last reviewed by Runway Health: September 22, 2026. Guidance checked against the current CDC traveler guidance for Paraguay and the WHO country list. Entry requirements and travel notices can change, so confirm the current rule with the relevant embassy, consulate, or airline before departure.
Yellow fever vaccine recommendation and entry rules
Health recommendation: CDC recommends it for most travelers aged 9 months and older, with a city-only Asunción exception.
Entry requirement: Direct travel from the United States does not require proof. CDC lists a requirement for eligible travelers arriving from Bolivia, Brazil, Peru, or Venezuela, including airport transits or layovers longer than 24 hours.
Health recommendations protect the traveler; entry requirements are border rules. A destination may have one without the other. Review all prior countries and airport transits, not just the final destination.
Allow time for the yellow card
If you need a first yellow fever vaccination, the International Certificate of Vaccination or Prophylaxis (ICVP, often called the yellow card) becomes valid 10 days after vaccination. When a certificate is required, a standard vaccine record or prescription is not a substitute.
- Map your itinerary. Include all countries visited before Paraguay, transit airports, and layover duration.
- Check your specific regions. Cities, highlands, parks, and rural areas can have different recommendations.
- Use an authorized yellow fever center. Confirm it can issue and validate the ICVP if documentation matters.
- Review individual suitability. Pregnancy, immune-system conditions, allergies, age, and prior vaccine history can affect the decision.
When vaccination is medically contraindicated, an authorized provider may be able to issue a waiver. Acceptance is at the destination’s discretion, so do not rely on one without confirming current policy.
Do you need malaria medication?
A clinician should review rural, cross-border, and outdoor itineraries individually. Mosquito-bite prevention remains important regardless of whether medication is prescribed.
Malaria and yellow fever are separate decisions. A clinician should consider your route, medical history, other medicines, and the start and finish timing for a prescription option. Review malaria-prevention options.
Other preparations worth discussing
- Traveler’s diarrhea: Food and water precautions matter, and a prescription treatment plan may fit some itineraries.
- Typhoid: Consider a discussion for rural travel, longer stays, or visiting friends and relatives.
- Routine vaccines: Check that routine immunizations, including MMR, are current.
Related reading: Paraguay typhoid guide and Paraguay traveler’s diarrhea guide.
Can Runway Health help?
A Runway physician can review your itinerary and health history, discuss whether yellow fever vaccination is appropriate, and, if appropriate, prescribe yellow fever vaccine for local administration. Travelers who need an ICVP should confirm that their vaccination site is an authorized yellow fever center able to issue and validate it.
Runway can also help eligible travelers evaluate prescription options for malaria prevention, traveler’s diarrhea, nausea, motion sickness, and other travel needs. A consultation does not replace confirming current entry rules for your exact route.
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Frequently asked questions
Can an airport transit change the yellow fever requirement?
Yes. Some countries apply certificate rules after travel from, or a qualifying transit through, a yellow-fever-risk country. Confirm the rule for every connection on your itinerary.
Can Runway prescribe yellow fever vaccine?
A Runway physician may prescribe yellow fever vaccine for local administration when appropriate. If you need official proof for entry, confirm the administering location is an authorized yellow fever center able to validate an ICVP.
What should I do about fever after travel?
Seek urgent medical care for fever during or after travel to a malaria-risk area, and tell the clinician where you traveled. Do not wait to see whether it resolves on its own.
The bottom line
For Paraguay, an Asunción-only itinerary can differ from travel elsewhere in the country, and a long connection in certain South American countries can change the entry-document answer. For the wider framework on certificate timing and transit rules, see Runway’s yellow fever vaccine travel guide.
Sources
- CDC Travelers’ Health: Paraguay
- CDC Yellow Book: yellow fever and malaria by country
- CDC: International Certificate of Vaccination or Prophylaxis