Especially consider choosing active immunization for persons planning to reside for a long period or for persons who take frequent short-term trips to risk areas. The importance of protection against hepatitis A increases as length of stay increases. Need for vaccination is more important if potential exposure is in rural areas and if adequate postexposure care is not readily available. Vaccination should be considered for persons staying longer than 3 weeks, adventurous eaters, and those who will venture off the usual tourist routes into small cities, villages and rural areas. Importance of vaccination increases as access to reasonable medical care becomes limited.
Contraindications depend on vaccine type.
Yellow fever - Risk is present in rural areas. The tourist destinations of Cuzco and Machu Picchu are considered free of risk, although travel to and from those destinations may involve risk depending on the route. Peru's Amazon basin has the highest level of hepatitis A endemicity in Latin America. Diseases such as measles and diphtheria are commonly reported. Influenza risk extends throughout the year.