Romania – Health Risks, Inoculations, Vaccinations, and Health Certificates

What are the main health risks for expats living in Romania?

Romania carries a moderate degree of health risk for newly arrived residents. Infectious diseases transmitted through food, water, and other routes are present in the country, and significant outbreaks can occur. Practising sound hygiene — such as drinking bottled or boiled water in rural settings and exercising care with food from informal vendors — is a sensible baseline, particularly during the adjustment period after relocating to less urbanised parts of the country.

Tick-borne encephalitis (TBE) is a viral infection spread by tick bites, with the greatest risk found in woodland and forested terrain. Vaccination, combined with wearing full-length clothing and applying insect repellent, are the most effective ways to guard against the neurological complications TBE can cause. The vaccine is particularly relevant for long-term residents, those living or working in rural and forested environments, outdoor enthusiasts such as campers and hikers, and individuals who consume unpasteurised dairy products. Ticks are most active between April and August.

Rabies is a life-threatening viral disease that attacks the nervous system and is transmitted through the bites or scratches of infected animals. Vaccination — either before potential exposure or promptly after — prevents the virus from progressing to active disease. Pre-exposure vaccination is advisable for those with significant outdoor exposure or regular animal contact, while post-exposure treatment is critical following any suspected incident. Stray dogs remain a familiar sight in some Romanian towns and villages, making this a relevant risk for residents throughout the country.

The European Centre for Disease Prevention and Control confirmed West Nile virus cases in Romania as recently as November 2024, and a measles outbreak has been ongoing across the country for several years. Vaccination coverage declined during the 2010s, driven by rising vaccine hesitancy, delays in immunisation programmes, supply disruptions, and the emigration of medical professionals — a combination of factors that helped fuel the epidemic.

Leptospirosis is present in Romania, and residents should avoid exposure to potentially contaminated water and soil. Leishmaniasis also occurs, and protecting against sand fly bites is the primary preventive measure. Hantavirus has been recorded in Romania; contact with rodents or their nesting areas should be avoided. Tuberculosis (TB) is present, and limiting close contact with infected individuals is recommended.

Air pollution can be a real concern in larger cities, particularly in Bucharest during winter when heating systems and traffic combine to push air quality to problematic levels. Romania’s continental climate brings cold winters, hot summers, and mild transitional seasons. Mountain areas face harsher winter conditions, while plains and the Black Sea coast tend to be warmer throughout the year. Heat-related illness presents a meaningful risk during the peak summer months, especially for older residents and those with pre-existing health conditions.

Are any vaccinations or inoculations required before entering Romania?

Romania imposes no immunisation requirements or unusual health conditions on people entering the country. There is no yellow fever transmission within Romania, and no yellow fever vaccination certificate is demanded at entry — even for travellers arriving from countries where yellow fever is endemic — unless specifically required under current Romanian border health regulations. It is always wise to confirm the most recent entry rules with the Romanian embassy or consulate prior to travel, as these requirements can be revised.

COVID-19-related travel measures have been lifted in Romania, and travellers are no longer required to present vaccination certificates, proof of recovery, or negative test results. This reflects the position as of 2025, though travellers should verify current guidance through official channels before departing.

The US Department of State has indicated that it is not aware of any HIV/AIDS entry restrictions applying to visitors or foreign residents in Romania. Romania does not feature on any current list of countries that require HIV testing as part of a residency application, but those pursuing long-term visas or work authorisation should verify this directly with the Romanian immigration authority, as requirements may be updated at any time.

To be clear: no vaccination currently constitutes a legal requirement for entry into Romania. However, the absence of a mandatory rule should not be interpreted as an indication that vaccination is unnecessary. Health agencies in numerous countries consistently recommend a range of vaccines for people relocating to Romania, as outlined in the following section.

Which vaccinations are recommended for expats moving to Romania?

Both the CDC and WHO recommend the following vaccinations for those travelling to or residing in Romania: typhoid, hepatitis A, polio, tick-borne encephalitis, rabies, hepatitis B, influenza, COVID-19, pneumonia, meningitis, chickenpox, shingles, Tdap (tetanus, diphtheria and pertussis), and MMR (measles, mumps and rubella). Not every vaccine on this list carries equal urgency for all individuals — the appropriate selection depends on your current immunity, age, profession, and planned lifestyle in Romania.

All travellers and those relocating to Romania are advised to be current on routine immunisations, including diphtheria-pertussis-tetanus (DPT), MMR, polio, varicella (chickenpox), shingles, and annual influenza. Hepatitis A vaccination is recommended for anyone aged six months and older. If the vaccination schedule in your home country differed — for instance, if a combined hepatitis A and B vaccine was not part of your standard programme — reviewing your immunisation records and completing any outstanding doses before departure is worthwhile.

Measles is spreading in many countries globally, and all international travellers should be fully immunised with the MMR vaccine in line with CDC recommendations for international travel. This concern is especially relevant in Romania: first-dose MMR coverage fell from 83% in 2022 to 78% in 2024, and only 62% of Romanian children received the second dose of the MMR vaccine in 2024 — significantly below the 95% threshold that WHO considers necessary for herd protection. Confirming that you and your family are fully vaccinated prior to arrival is therefore a high priority.

Rabies vaccination is generally recommended for higher-risk individuals such as veterinarians, animal handlers, and those who plan to spend extended time outdoors, undertake rural travel, engage in adventurous activities like cycling, or travel with children. Expats planning long-term residence in Romania — particularly those living away from major cities — should speak with a travel health professional about pre-exposure rabies vaccination.

Hepatitis B has a moderate presence within the Romanian population, and vaccination is advisable for those with potential occupational exposure, those who may receive medical treatment in Romania, or anyone intending to remain in the country for the long term.

Consulting a travel health clinic or specialist at least four to six weeks before relocating is strongly recommended. This lead time is necessary to allow multi-dose vaccine courses — such as those for hepatitis B or pre-exposure rabies — to be completed before departure.

Do you need a health certificate to move to or work in Romania?

Romania does not generally require a formal pre-entry medical examination for most standard visa categories. Nonetheless, certain visa and residency pathways do include health-related documentation as part of the application process.

On entering Romania, travellers are required to hold a valid health insurance certificate alongside their travel document. This requirement concerns adequate health coverage rather than a medical fitness assessment, but it is a mandatory document for entry for those subject to its conditions under the relevant visa or travel rules.

Those applying for long-term stays or work permits should check the specific documentation requirements for their visa category through the Romanian Ministry of Foreign Affairs’ official visa portal at eviza.mae.ro. Visa applications may include evidence of health insurance, and certain work permit categories — particularly those in healthcare or other regulated sectors — may call for additional health documentation or screening.

Romania does not publish a standardised list of approved “panel physician” clinics for immigration medical examinations in the manner of some other countries, such as Canada or Australia. If a medical examination is required as part of a specific residency or employment application, you will generally be directed to an authorised Romanian medical institution or public health directorate. The cost and scope of such examinations — which may include a chest X-ray, blood tests, and a general clinical assessment — vary by institution and application type. You should always confirm current requirements directly with the relevant Romanian authority or your visa application centre, as these details are liable to change.

EU and EEA citizens registering for residency in Romania under free movement provisions are generally not subject to health examination requirements. Non-EU nationals applying for a long-stay visa or Romanian residence permit should consult the specific conditions of their visa category, as requirements may include proof of health insurance as a condition of approval.

How does healthcare in Romania compare to what expats may be used to?

Romania operates a social health insurance (SHI) system founded on the principle of solidarity, with compulsory contributions funding a comprehensive basic benefits package. This package extends to approximately 89% of the population — the second-lowest rate of population coverage for a core set of services among OECD countries. While the benefits basket is broad in scope, some services may not be fully covered, and patients can face co-payments for certain treatments.

Rather than a single-payer, tax-funded model like those in Canada or the United Kingdom, Romania’s system is contribution-based. The National Health Insurance House (CNAS) oversees public healthcare, guaranteeing coverage for Romanian citizens and legal residents alike. Public healthcare is provided free at the point of use but can be affected by lengthy waiting times and resource constraints. Expats employed in Romania are enrolled through payroll deductions, while the self-employed and retirees must register voluntarily.

Despite improvements over recent decades, Romania’s health system continues to perform below OECD averages across several dimensions, including health risk factors, service quality, healthcare capacity, access to care, and funding levels. In 2023, more than half of the Romanian population (54%) lived in rural areas, where healthcare access presents significant challenges. Over 90% of hospitals and independent specialist clinics are located in urban centres.

Although Romania’s public healthcare system is open to all legal residents including expats, many choose private coverage to benefit from higher-quality care and shorter waiting times. Private hospital networks such as Regina Maria, MedLife, and Sanador are widely recognised for their quality of service. A number of private clinics and health centres in Romania are specifically oriented towards the international community, with multilingual staff and experience serving foreign patients.

Public hospitals provide emergency treatment at no charge, while private hospitals may require payment upfront. In a medical emergency, dial 112 for assistance. Comprehensive private health insurance is strongly advisable for all expats, both to gain access to better-quality facilities and to protect against the financial impact of unexpected hospitalisation or specialist care.

The system remains strongly hospital-oriented, with Romania’s hospital bed rate (7.3 per 1,000 inhabitants) well above the OECD average of 4.2, and hospital services accounting for 44% of total health expenditure. This stands in contrast to many Western European systems that have moved towards community-based and primary care as the initial point of contact. Registering with a family doctor (medic de familie) should be a priority upon arrival in Romania, as this is the gateway to the public health system.

What are the risks of travel within Romania, and are there regional health differences?

There is no malaria in Romania. Mosquitoes are present during summer months in the Danube Delta and certain low-lying areas, but these do not carry a malaria risk. Mosquito protection — repellents and long-sleeved clothing worn at dawn and dusk — nonetheless remains sensible in these regions due to the documented presence of West Nile virus.

The Carpathian Mountains run through the heart of Romania, and those who hike or spend time in forested highland areas face a heightened risk of tick bites, making TBE vaccination especially pertinent for this group. The vaccine is particularly advised for travel to smaller towns, villages, and rural locations off the main tourist routes. Altitude sickness is not generally a significant concern in the Carpathians — the highest peaks reach around 2,500 metres, which is below the elevation at which serious altitude illness typically develops — but gradual acclimatisation is still a sensible precaution.

Residents in rural Romania report almost 1.5 times more unmet healthcare needs than those living in cities. For expats settling outside Bucharest or other major centres such as Cluj-Napoca, Timișoara, or Brașov, this is a significant practical consideration. Urban areas benefit from considerably better healthcare infrastructure, while rural regions can suffer from doctor shortages and equipment limitations.

Bucharest and other large cities experience air quality problems, particularly in winter when temperature inversions trap particulate matter from traffic and heating at ground level. Residents with asthma or respiratory conditions should track local air quality data and ensure they have adequate medication to hand. The Black Sea coastal area around Constanța carries relatively low health risks overall but draws heavy tourist numbers in summer, which can facilitate the spread of common gastrointestinal infections.

Emergency treatment is primarily delivered at regional emergency hospitals, which are equipped with specialist emergency units and are administered by regional authorities. Every county has at least one regional emergency hospital, with Bucharest served by several. Expats living in remote or rural locations should bear in mind that emergency services may take longer to reach them, and planning in advance for access to the nearest emergency hospital is a sensible precaution.

Where can expats get reliable and up-to-date health advice for Romania?

Health requirements, disease alerts, and vaccination guidance are all subject to regular revision. Consulting official and authoritative sources both before and after your move is essential. The following resources are the most valuable for expats preparing to relocate to Romania:

• Romanian Ministry of Health (Ministerul Sănătății): Romania’s principal national health authority. The official website at www.ms.ro publishes public health announcements, disease alerts, vaccination programmes, and healthcare regulations. All formal health policy for Romania is issued through this body.
• National Institute of Public Health Romania (INSP): The INSP manages disease surveillance and produces epidemiological reports. Visit insp.gov.ro for current outbreak information and public health guidance.
• World Health Organization (WHO) — Romania: The WHO country office for Romania publishes health statistics, vaccination coverage data, and public health updates. Access the WHO Europe page at who.int/europe/countries/romania.
• US Centers for Disease Control and Prevention (CDC) — Romania: The CDC traveller health page for Romania offers current vaccine recommendations and disease risk assessments. Visit wwwnc.cdc.gov/travel/destinations/traveler/none/romania.
• UK Travel Health Pro (NaTHNaC) — Romania: The National Travel Health Network and Centre provides peer-reviewed travel health information for Romania, including risk assessments and recommended precautions. Visit travelhealthpro.org.uk/country/183/romania.
• Romanian Ministry of Foreign Affairs — Visa Portal: For visa requirements, health insurance documentation needs, and residency applications, visit the official e-visa portal at eviza.mae.ro.
• Fit for Travel (NHS Scotland): Provides accessible travel health guidance for Romania at fitfortravel.nhs.uk.

Always verify specific details — including fees, health certificate formats, and processing timelines — directly with the relevant authority or your nearest Romanian consulate, as these particulars are subject to change and may differ according to your nationality and visa category.

Frequently Asked Questions

Is proof of vaccination required to enter Romania?

No. As of 2025, Romania does not require travellers to present proof of vaccination upon entry. No yellow fever certificate is required, and COVID-19 vaccination documentation is no longer requested. Depending on your nationality and visa category, you may be required to show proof of health insurance coverage. Always check the latest entry requirements with the Romanian embassy or consulate before travelling.

Will my home-country vaccinations be accepted in Romania?

Since Romania imposes no vaccination requirements for entry, there is no formal process for validating foreign immunisation records at the border. However, if you intend to register with a local family doctor or use the public health system, presenting your vaccination history — ideally translated into Romanian or available in English — will help healthcare providers assess your immunisation status and avoid administering unnecessary repeat doses.

Is health insurance required for residency in Romania?

In certain visa and entry situations, travellers to Romania must demonstrate that they hold a valid health insurance certificate. For longer-term residents, expats employed in Romania are automatically enrolled in the CNAS public insurance system through payroll contributions, while the self-employed and retirees must register voluntarily. Irrespective of eligibility for public coverage, comprehensive private international health insurance is strongly recommended for better access to quality care and protection against significant out-of-pocket expenses.

What happens if I develop a serious illness in Romania?

For emergencies, call 112 to request ambulance services. Public emergency hospitals exist in every county and offer free emergency treatment. For serious conditions requiring specialist intervention, private hospitals in Bucharest and other large cities — including Sanador, Regina Maria, and MedLife — provide high-quality care, but adequate private health insurance or personal funds to cover costs will be necessary. In cases of extreme medical complexity, evacuation to another country may be required, which highlights the importance of holding comprehensive international health insurance that includes medical evacuation cover.

How do I find an English-speaking doctor in Romania?

Private clinics in major cities — particularly Bucharest, Cluj-Napoca, Timișoara, and Brașov — frequently employ English-speaking physicians and international patient liaison staff. Healthcare networks including Regina Maria, MedLife, and Medicover are well regarded for their services to the international community. English proficiency among staff in public hospitals is less reliable, especially outside major urban areas. Expat community forums and dedicated Facebook groups can be a useful source of personal recommendations for English-speaking doctors in a particular city.

Is there a risk of rabies in Romania, and what should I do if bitten?

Yes, rabies is present in Romania at a moderate level, most commonly in wild animals and stray dogs. If you are bitten or scratched by any animal, clean the wound thoroughly with soap and water for a minimum of 15 minutes and seek medical attention without delay — do not wait to see whether symptoms develop. Post-exposure prophylaxis (PEP) is available in Romania and is highly effective when administered promptly. Expats who plan to spend considerable time outdoors, in rural areas, or in roles involving animal contact should consider pre-exposure rabies vaccination before they arrive.

Should I be concerned about the measles outbreak in Romania?

Yes, this is a legitimate and serious concern. Romania has been at the centre of one of Europe’s most significant measles outbreaks in recent years, driven by falling vaccination coverage. Before moving to Romania, ensure that you and every member of your family are fully up to date with the MMR vaccine — which requires two doses. If your vaccination history is unclear, a blood test (serology) can determine whether you have immunity, and a booster dose can be administered if required. This applies with particular force to children and young adults.

Do I need tick-borne encephalitis (TBE) vaccination for Romania?

TBE vaccination is strongly advisable for anyone who will be spending time in forested or rural areas, especially in the Carpathian mountain regions. The highest transmission risk occurs between April and August, when ticks are most active. The vaccine is administered as a three-dose course and provides reliable protection. Even after vaccination, wearing long-sleeved clothing, using tick repellent, and thoroughly checking your skin following outdoor activity remain important precautions. As TBE vaccine may not be routinely stocked in all countries, making arrangements well in advance of your move is essential.