Dominican Republic Travel Health Guide for US Travelers
A physician-reviewed health and safety guide for Americans traveling to the Dominican Republic
As of June 2025, the US advises travelers to exercise increased caution in the Dominican Republic due to crime. Violent crime — including robbery, homicide, and sexual assault — is a concern throughout the country and can occur in tourist areas. Santo Domingo has been assessed as a CRITICAL-threat location for crime by the US State Department's OSAC. Always check the latest advisory at travel.state.gov before departing.
Before You Travel to the Dominican Republic
Plan a travel medicine visit at least 4–8 weeks before departure — sooner if you need yellow fever documentation or multiple vaccine doses. Bring vaccine records, your full flight itinerary, and a list of medications. Requirements and risks depend heavily on which regions you visit and activities planned (resort, urban, rural, adventure, VFR travel to communities outside tourist zones).
Visit a Travel Clinic
Discuss vaccines and malaria prophylaxis based on your specific itinerary and activities. The DR has both resort areas (lower malaria risk) and rural/border zones (higher risk) — your route matters greatly.
Get Travel Insurance
US health plans do not cover care abroad. Private hospitals in the DR require upfront payment and some have held patients' passports over unpaid bills. Coverage including medical evacuation is strongly recommended.
Documents & eTicket
Complete the mandatory eTicket digital entry form before travel. Passport must be valid for at least 6 months. Enroll in STEP at step.state.gov. Carry proof of yellow fever vaccination if arriving from endemic countries.
Pack a Medical Kit
Prescriptions in original packaging, ORS sachets, antidiarrheal medication, DEET repellent (≥30%), sunscreen, antifungal cream, and a thermometer. Some medications may be unavailable or counterfeit outside major cities.
Water & Food Safety
Tap water is generally not safe to drink outside resorts. Use sealed bottled water at all times. Avoid street food, raw shellfish, unpasteurized products, and ice of uncertain origin. Traveler's diarrhea is common throughout the DR.
Cash & Payments
Hospitals require upfront cash payment. ATM skimming is reported at independent ATMs — use only bank-branch ATMs. Carry Dominican pesos plus a backup card. Most US insurance plans do not accept direct billing from DR providers.
Yellow Fever in the Dominican Republic
What is Yellow Fever?
Yellow fever is a viral hemorrhagic disease transmitted by Aedes and Haemagogus mosquitoes, endemic to tropical Africa and South America. It is not a clinical concern for direct US–Dominican Republic travel. However, if your itinerary includes stopovers or prior stays in endemic countries such as Brazil, Colombia, Peru, or sub-Saharan Africa, carry your International Certificate of Vaccination (Yellow Card) as proof of vaccination, as the DR may require it on arrival.
If you continue to yellow fever endemic regions after the Dominican Republic, follow vaccination rules for those destinations separately.
Malaria in the Dominican Republic
The Dominican Republic is one of the few Caribbean islands with confirmed ongoing malaria transmission, making it more complex than typical beach destinations. Discuss your specific itinerary — including planned excursions from your resort — with your travel medicine physician.
Atovaquone-proguanil (Malarone)
Daily tablet starting 1–2 days before travel, during, and for 7 days after. Well tolerated; preferred for shorter trips to the DR.
Chloroquine
Weekly tablet — uniquely, P. falciparum in the DR remains chloroquine-sensitive. Suitable for travelers who prefer a weekly dosing schedule.
Doxycycline
Daily antibiotic; also provides partial protection against traveler's diarrhea. Take with food; avoid prolonged sun exposure as it increases photosensitivity.
Plasmodium falciparum is the only malaria species present in the Dominican Republic and notably remains sensitive to chloroquine — unlike most other malaria-endemic regions. This makes the DR unique among Caribbean destinations. In 2025, over 737 confirmed malaria cases were reported nationally, with 70% of cases as of May 2025 originating from San Juan Province. If you develop fever during or within a year of return from the DR, seek immediate medical care and inform the provider of your travel history.
Use DEET or picaridin repellents (≥30%), wear long sleeves and trousers especially at dusk and dawn, and sleep under a treated mosquito net where air conditioning is not available. Mosquito avoidance is important everywhere in the DR — even where chemoprophylaxis is not indicated — due to Dengue risk.
Recommended Vaccines for the Dominican Republic
The following vaccines are recommended or required by the CDC and WHO for US travelers to the Dominican Republic. Discuss your full list with your travel medicine physician, as recommendations vary based on your itinerary, activities, and health history.
Not required for US travelers from the mainland. Required for entry if arriving from Brazil or other yellow fever endemic countries. Confirm requirements if your itinerary includes prior stops in South America or sub-Saharan Africa.
Strongly recommended for most travelers. Risk is higher for those visiting smaller towns, rural areas, or staying with local friends and relatives outside resort zones. Injectable vaccine lasts 2 years; oral vaccine lasts 5 years.
Transmitted through contaminated food and water. Strongly recommended for all travelers to the Dominican Republic regardless of itinerary. Two-dose series provides long-term protection of 20+ years.
Spread through blood and body fluids. Recommended especially for those receiving medical care, getting tattoos or body piercings, or with any risk of exposure. Three-dose series; combination Hep A+B (Twinrix) available.
Animal rabies is not uncommon in the Dominican Republic; the last human case was reported in 2019. Pre-exposure prophylaxis (3-dose series) is recommended for travelers spending extended time outdoors, those handling animals, and adventure travelers. Post-exposure treatment is available at specialized hospitals in Santo Domingo.
Due to rising global polio cases worldwide, a one-time adult booster is recommended for all international travelers. Verify your polio vaccination status before travel to the Dominican Republic.
MMR Vaccine (Measles, Mumps, Rubella)
Measles cases are rising globally. Ensure you have received 2 doses of MMR. Adults born before 1957 are generally considered immune. Confirm current status before all international travel.
Ensure your Tdap (tetanus, diphtheria, pertussis) booster is current — within the last 10 years — before travel. Wound exposure risk is higher for adventure travelers and those visiting rural areas or taking part in outdoor activities.
Influenza Vaccine & COVID-19
Annual flu shot recommended before all international travel — influenza circulates year-round in the Caribbean. Ensure COVID-19 vaccinations and boosters are current per CDC recommendations. No COVID-19 entry requirements as of 2025.
Healthcare System in the Dominican Republic
Santo Domingo (Capital)
Santo Domingo has the country's best private medical facilities. CEDIMAT (Centro de Diagnóstico y Medicina Avanzada) is the most recommended private hospital. Modern diagnostic equipment and specialist care are available at leading private centers. Public hospitals are significantly under-resourced. US Embassy Santo Domingo maintains a vetted provider list for American citizens.
Punta Cana / Bávaro
Hospiten Bávaro (809-686-1414) provides 24/7 emergency services and is the primary hospital for tourists in the Punta Cana resort corridor. Many all-inclusive resorts also have on-site medical staff for minor concerns. For serious trauma or complex illness, evacuation to Santo Domingo or the United States may be required.
Payment Policy
All hospitals and clinics in the Dominican Republic — public and private — require cash or credit card payment upfront before admission or treatment. Private clinics may place holds on credit cards. Some have held patients' passports for unpaid bills. US Medicare and Medicaid are not accepted anywhere. Most US private insurance plans pay abroad on a reimbursement basis only — you pay first.
The US Embassy in Santo Domingo strongly recommends that all US travelers purchase supplemental insurance with medical evacuation coverage. Air evacuation to the United States can exceed $150,000 USD without coverage. Services such as MedJet Assist, International SOS, or Global Rescue are widely used by travelers to the Dominican Republic. Note: ambulance response times via 911 are variable — private ambulances are faster than public services; if you can safely reach a hospital by private vehicle or taxi, this is often recommended over waiting for an ambulance in non-life-threatening situations.
Emergency Numbers in the Dominican Republic
The 911 emergency system covers Santo Domingo, Santiago, Punta Cana, and Puerto Plata but response times and equipment quality are variable. Private ambulances respond faster than public 911 services — your resort's front desk or a private clinic should be your first call for non-life-threatening medical emergencies. If you can safely reach hospital by private vehicle or taxi, this is often faster than waiting for a public ambulance outside major urban areas.
US Embassy Santo Domingo
Av. República de Colombia #57, Santo Domingo
Emergency: 809-567-7775
Hours: Mon–Fri 7:00 AM – 4:00 PM (closed US & DR holidays)
do.usembassy.gov
US Consular Agencies
Punta Cana: Palma Real Shopping Center, Business Center 2nd Floor, Bávaro, La Altagracia
Puerto Plata: Plaza el Doral, Carretera Luperón KM 3 1/2
Both open Mon–Fri 8:00 AM – 5:00 PM.
US State Dept 24/7 Hotline
For US citizens in distress abroad:
From US/Canada: +1-888-407-4747
From abroad: +1-202-501-4444
Available 24 hours a day, 7 days a week.
STEP Enrollment
Register your trip at step.state.gov before departure. STEP allows the US Embassy to contact you during emergencies, hurricanes, or civil unrest and helps locate you if something goes wrong.
Nature & Weather Risks
Tropical Heat & Humidity
Average temperatures range from 23°C (73°F) in January to 27°C (80°F) in August, with high humidity year-round. Heat exhaustion is a genuine risk for travelers unaccustomed to tropical conditions. Stay hydrated, avoid outdoor exertion between 11am–3pm, and take breaks in shade or air conditioning.
Rivers, Waterfalls & Fresh Water
Leptospirosis risk is significant in the Dominican Republic — 186 confirmed cases and 19 deaths were reported in 2025, a 275% increase over the prior year. Avoid contact with river water, waterfalls, and flooded areas, particularly after rainfall. Do not swim in fresh water of uncertain quality.
Animal & Wildlife Risks
Animal rabies is not uncommon in the DR. Do not touch, feed, or approach stray dogs, bats, or other animals. If bitten or scratched by any animal, seek medical care immediately — even after rabies pre-exposure vaccination. Post-exposure prophylaxis is available at specialized hospitals in Santo Domingo.
Hurricanes & Flash Floods
Hurricane season runs June–November, with peak risk in August and September. Flash floods are common in mountainous interior regions after heavy rainfall. Monitor the Emergency Operations Center (COE) alerts, follow hotel emergency guidance, and ensure travel insurance covers weather cancellation and disruption.
Road Safety
Motor vehicle crashes are a leading cause of injury to US travelers in the Dominican Republic. Road conditions vary from well-maintained highways to dangerous rural roads. Avoid driving at night. Hire a professional driver for inter-city travel. The Santo Domingo Metro is a safer option within the capital. Do not use unlicensed taxis.
Sun & UV Exposure
UV radiation is intense in the Caribbean. Apply SPF 30+ sunscreen frequently, wear a hat and UPF-rated clothing, and avoid peak sun hours. Sun sensitivity is significantly increased for travelers taking doxycycline for malaria prevention — this is a very common issue for DR travelers.
Crime, Violence & Safety Risks
Robbery & Violent Crime
Robbery, mugging, and assault are common throughout the Dominican Republic, including in tourist areas. Avoid displaying expensive jewelry, phones, cameras, or cash in public. If robbed, hand over belongings without resisting. Travel with a partner or group when possible, especially at night.
Sexual Assault
Rape and sexual assault have been reported in the Dominican Republic, including at major resorts and hotels. Use of date rape drugs has been documented. Do not leave food or drinks unattended. Do not accept drinks from strangers. POLITUR (809-222-2026) and the VIDA Line (*212) provide support for gender-based violence.
Petty Crime & Scams
Pickpocketing, bag snatching, and ATM skimming are widespread. Use only ATMs located inside bank branches. Keep valuables in hotel safes. Be alert in markets, airports, beaches, and crowded areas. Avoid using your phone visibly on the street.
Transport Safety
Use only hotel-verified or app-based transport. Avoid unregistered street taxis, especially after dark. Carjackings and transport-related robberies have been reported. For longer distances, use reputable tour operators or hire a driver through your hotel rather than renting a vehicle independently.
Civil Unrest & Demonstrations
Demonstrations and protests have occurred in Santo Domingo in 2025 on multiple occasions. They can disrupt transportation and services and may turn violent. Monitor STEP alerts, avoid all protests and large public gatherings, and have an emergency plan that does not rely on US government evacuation assistance.
High-Risk Areas
Santo Domingo: Most violent crime concentrated in urban and suburban neighborhoods. Haiti border regions: Avoid all travel near the Haitian border — security conditions are severe. Los Tres Brazos / La Ciénaga (Santo Domingo): High-risk neighborhoods with elevated malaria transmission and crime. Consult the US Embassy security report before visiting unfamiliar areas.
Dominican prisons do not meet US standards and can be dangerous. If arrested or detained, immediately request that officials notify the US Embassy in Santo Domingo. Do not sign any documents without legal representation. Contact the US Embassy Emergency Line at 809-567-7775 or the 24/7 State Department hotline at +1-888-407-4747.
Other Health Risks in the Dominican Republic
One of the most common health problems for visitors to the Dominican Republic. Community sanitation and food safety measures are generally inadequate outside resort areas. Prevention: bottled or treated water only, hot cooked food, avoid street food and raw shellfish. Ask your doctor about a standby antibiotic for treatment.
Dengue is widespread throughout the Dominican Republic and year-round. Over 10,700 cases and 39 deaths were reported in 2022 alone; outbreaks continue. Aedes aegypti mosquitoes bite primarily during the day. Prevention is through insect bite precautions. Symptoms include sudden high fever, severe headache, and intense muscle and joint pain.
A significant and growing health risk in the Dominican Republic. In 2025, 186 confirmed cases and 19 deaths were reported — a 275% increase over the prior year. Transmitted through contact with water, soil, or food contaminated by animal urine. Avoid rivers, waterfalls, and flooding. Seek care immediately for fever after fresh water exposure.
Zika has not been detected in the Dominican Republic for several years as of 2025. However, the Aedes aegypti vector is present throughout the country. Pregnant travelers or those planning to become pregnant should consult a physician before travel and use comprehensive mosquito bite precautions throughout their stay.
Chikungunya cases have been reported in the Dominican Republic. The DR shares a land border with Haiti, which reported active cases in 2025. Spread by daytime Aedes mosquitoes. Causes fever, rash, and potentially debilitating joint pain that can persist for months after the acute infection resolves.
The Dominican Republic has a significant HIV prevalence in certain populations. Practice safe sex and avoid unprotected contact. If you require medical procedures while in the DR, confirm sterile equipment is used. Blood safety standards at public hospitals may be limited — for major trauma, evacuation to the United States is preferable if possible.
Pre-Departure Checklist for the Dominican Republic
- See a travel medicine physician — bring your immunization records and full itinerary including planned excursions
- Discuss and obtain a prescription for antimalarial medication if visiting La Altagracia (Punta Cana), Santo Domingo, Azua, San Juan, or Elías Piña
- Update all routine vaccines: MMR, Tdap, polio booster, flu, COVID-19
- Discuss Hepatitis A, Hepatitis B, Typhoid, and Rabies vaccines with your doctor
- Carry proof of yellow fever vaccination (Yellow Card) if your itinerary includes prior stops in Brazil or other endemic countries
- Complete the mandatory eTicket digital entry form before departing for the Dominican Republic
- Confirm passport validity is at least 6 months beyond your arrival date
- Purchase comprehensive travel insurance with medical evacuation coverage — medical evacuation can exceed $150,000 USD
- Enroll in STEP at step.state.gov
- Save emergency numbers: All emergencies 911 | POLITUR (English-speaking tourist police) 809-222-2026 | US Embassy Santo Domingo 809-567-7775 | US State Dept 24/7 +1-888-407-4747
- Pack DEET insect repellent (≥30%), long-sleeved clothing, and mosquito net for accommodations without air conditioning
- Carry extra supply of all prescription medications — some brands unavailable or counterfeit outside major cities
- Carry sufficient cash (Dominican pesos) — all hospitals and clinics require upfront payment; ATM skimming is documented
- Avoid walking alone at night; do not resist robbery attempts; do not leave drinks unattended at social venues
- Drink only sealed bottled water; avoid fresh water contact (rivers, waterfalls) due to Leptospirosis risk
- Monitor COE weather alerts and STEP updates during June–November hurricane season
