Precautions and Vaccines for Madagascar Starting in February

hi there on the anti-malaria front, be careful because many people can’t tolerate Malarone or its equivalents but it’s the rainy and cyclone season until April 20th, so there’ll be mosquitoes—repellent and sleeping under a mosquito net are absolutely mandatory for getting around (by car or plane), keep a close eye on weather and cyclone conditions so you don’t get stuck in the provinces (it can last several days, even a week) no mandatory vaccines for Madagascar, and there’s no yellow fever there, but rabies, mpox, and leprosy exist in some areas—no need for paranoia though!! Tetanus shot and hepatitis prevention: wash your hands and only drink bottled water (Eau Vive or Cristalline are available almost everywhere in Madagascar) have a great trip, hope it’s not too humid for you—watch out, most roads are extremely difficult or impassable during this season!!

Hi there, Thanks for your reply—we kinda figured as much. Having lived in the French West Indies and a bit in French Guiana, we’re used to mosquito repellent and sleeping under a mosquito net. Cyclone season, unfortunately, we know that too. We lived on a sailboat and had to keep a very close eye on the weather. But the roads—we’re gonna discover those for the first time! New experience! !

for the roads quickly RN7 towards the south (Tulear) is very bad even before the start of the dry season. Tana/Antsirabe was already bad (previously max 3h, now it’s 5 to 6h), and the rest is poor all the way to Fianarantsoa. RN2 (towards Tamatave) is passable when leaving Tana, but from Moamanga it’s really bad with lots of roadworks that won’t be finished before the end of 2026. RN4/RN5 towards Majunga and Diego: minimum 12/13 hours for Majunga (560 km). The first part is fairly good, but the second part isn’t great. For Diego, RN6 from the RN4 junction to Ambanja is frankly bad, then good until Diego, but there are bridge issues on the Ifatsy and Mahavavy rivers at the entrance to Ambilobe. Watch out for the first (collapsed road) and a temporary bridge for the second. Sainte Marie is very, very rainy and humid during this period. For Morondava, it’s useless—impossible to visit the Tsingy before May at the earliest, or rather the end of May. I’m only talking about the national roads, supposedly paved. For the dirt tracks, it’s better to forget about them during this period, otherwise your vacation could quickly turn into a nightmare. This really isn’t the right time for Madagascar—it’s not the Caribbean. The island is bigger than France!

Hi there, And since I’m currently here, December 2025 was exceptionally rainy, and it’s continuing into January. I had to cancel quite a few things I’d planned. So maybe by February things will be different and shift in the other direction—I hope so for you, at least. But for now, it’s not great humidity-wise. Ideally, take a malaria preventive, otherwise you can rely on avoiding bites and buy a curative treatment if symptoms appear (easy to find in Mada). You can also get artemisia capsules easily in Homeopharma shops in Mada. Take them daily. I don’t think there are scientific studies, but artemisinin is definitely very effective. So it can’t hurt if you’re not planning to take prevention otherwise. Honestly, the roads on the whole trip are brutal. Do what you want, but even before the rains, the roads were in a terrible state—after all this rain, I can’t even tell you. Just getting to Antsirabe is a chore now, when it used to be a quick trip just a few years ago. Anyway, you’ll see for yourself, but it might be wise not to plan too much road travel and adjust your movements accordingly. During your period and with such a rainy year, the coast is likely to be very difficult to navigate. But since things can change, you never know—you’ll have time to adjust. Happy preparations

Hello

We hear all sorts of things about the vaccines you need and the medications to take (is anti-malarial mandatory?). What’s the real deal for travelers?

When it comes to health issues—aside from tropical disease specialists—I don’t see who else could give a reliable opinion here. 90% of travelers who stay no more than 3 weeks in the country won’t get sick, but the others could have lifelong bouts of malaria... more or less severe. Once you’ve gotten proper advice from a doctor who specializes in tropical medicine, you can then make an informed choice about whether or not to get vaccinated and/or take anti-malarial medication. Personally, I’ve always taken anti-malarials when traveling to eastern Madagascar, as well as to West African Sahel and equatorial regions. Just because some people have never been infected without vaccines or anti-malarials doesn’t mean you won’t be... the same goes for following advice based on essential oils or other unreliable remedies... which some swear by, though. 🙁

Thanks again for your replies and information. As for the travel routes, we’ll obviously be using domestic flights. My husband is handling the planning, which will be decided based on weather conditions and other factors. We’re used to traveling and adjusting our itinerary depending on the circumstances, even if it means skipping some things. Tulear and Majunga should be doable—we have family there and want to see them. We have a meet-up with a doctor before our departure and will follow their recommendations. Have a great rest of the day