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

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

Compared with tropical destinations or countries with developing healthcare infrastructure, France presents a low overall health risk. Strong sanitation standards and universal healthcare place Europe firmly in the low-risk category for most health concerns. That said, a number of specific hazards warrant attention, and these differ markedly depending on where in France you choose to settle.

Tick-borne diseases
Tick-borne encephalitis (TBE) poses a genuine threat in certain parts of France. It is a viral illness that targets the central nervous system, transmitted through the bite of an infected tick or, less commonly, through the consumption of unpasteurised dairy products. Lyme disease, similarly spread by ticks, is well documented across numerous rural and wooded regions of the country. Both conditions are most prevalent during the warmer months of the year.

Pertussis (whooping cough)
France is currently experiencing its most severe pertussis outbreak in a quarter of a century, with case numbers also climbing sharply across several neighbouring European nations. The disease poses the greatest danger to infants and adults who lack current vaccination protection. Expats who plan to have children in France, or who spend time with young children, should treat this risk seriously and verify that their immunisations are fully up to date.

Measles
In 2024, WHO and UNICEF recorded 127,350 measles cases across Europe — a figure not seen since 1997. More than 40% of those cases involved children under five years old, and over half of all patients required hospitalisation. Although France maintains a robust childhood vaccination programme, measles continues to circulate in communities with incomplete immunisation coverage, and adults without documented immunity remain vulnerable.

Heatwaves and climate-related risks
Summer heatwaves in France have grown progressively more severe in recent years. The Mediterranean south, the Paris basin, and various inland regions bear the brunt of these extreme temperature events. The elderly, very young children, and individuals with pre-existing health conditions face the greatest danger. Expats relocating from cooler climates may not fully anticipate the ferocity of French summers and should establish clear strategies for managing extreme heat, such as maintaining adequate hydration and access to cool, shaded environments.

Air quality
Ambient particulate matter represents a measurable environmental health risk in France. Urban centres — Paris and Lyon in particular — periodically experience episodes of poor air quality, most notably during winter months and heatwave periods. Expats with respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD) should monitor local air quality alerts closely. France’s national public health agency issues regular pollution warnings, and air quality monitoring applications are in widespread use.

Food and water safety
Hepatitis A carries a moderate risk in France, though drinking water is safe throughout the country and food hygiene standards are tightly enforced. The principal risk stems from contaminated produce or undercooked shellfish rather than the water supply itself. While France has far fewer infectious diseases than many other regions, traveller’s diarrhoea can still occur, so it is sensible to take appropriate precautions before departing for France.

Rabies
Rabies exists in France but is largely confined to the bat population. Those who anticipate spending time in areas where bats are present may wish to consider vaccination. Human rabies cases linked to bat exposure are exceedingly rare, but expats working with wildlife or residing in rural locations with significant bat activity should take sensible precautions.

Are any vaccinations or inoculations required before entering France?

No vaccinations are required to enter mainland France, irrespective of your country of origin. Multiple international travel health bodies, including the US State Department, confirm this position. No yellow fever vaccination certificate is needed for entry into France.

It is essential to distinguish between required vaccinations — those that are legally enforced as a condition of entry — and recommended vaccinations, which health authorities advise for personal protection but which are not checked at the border. France imposes no mandatory vaccination requirements for entry, meaning you will not be refused admission for lacking an immunisation record. This does not, however, render vaccinations irrelevant to your wellbeing once in France.

One point worth noting concerns yellow fever: while France does not require a yellow fever certificate for entry, this does not necessarily mean there is zero transmission risk in every circumstance. If you are arriving in France after spending time in a country where yellow fever is endemic, you may need to present a yellow fever certificate when travelling onward from France to other destinations. If you are uncertain, consult your airline and the relevant authorities at your next destination.

Non-EU nationals relocating on a long-stay visa must complete a post-arrival medical examination administered by OFII (detailed in the health certificate section below). This requirement is entirely separate from entry conditions and is carried out after you have already arrived in France. All health-related entry formalities — including any COVID-era health pass requirements — were abolished in 2022 and have not been reintroduced. Travellers are no longer required to present any health documentation before entering France, regardless of where they are travelling from.

For children travelling to France with their families on long-stay visas, vaccination documentation may be requested during the OFII process. Proof of standard immunisations — including diphtheria, tetanus, polio, and, since 2024, a meningococcus update for individuals aged 16 to 24 — may be required at the OFII medical appointment. Always confirm the most current requirements directly with the French consulate or OFII before travelling, as these can change without notice.

Which vaccinations are recommended for expats moving to France?

Although France imposes no vaccination requirements for entry, health authorities worldwide advise that anyone planning to relocate there should be fully current with both routine and destination-specific vaccines. The CDC and WHO recommend the following vaccinations for those travelling to France: 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).

MMR (measles, mumps and rubella)
Measles cases are climbing in numerous countries globally. The CDC recommends that all international travellers be fully vaccinated against measles with the MMR vaccine. Expats from countries where one or two MMR doses are standard practice should confirm their immunity status before departing. France’s 2025 vaccination schedule places MMR as a priority given the intensifying measles situation across Europe.

Tdap (tetanus, diphtheria and pertussis)
The Tdap vaccine — for adults and adolescents — and DTaP for children under seven offer protection against tetanus, diphtheria, and pertussis. Given the severe and ongoing pertussis surge in France, a booster dose is strongly advisable, particularly if your most recent Tdap was administered more than five years ago. In certain countries, only the diphtheria-tetanus combination is routinely given to adults, meaning the pertussis component may not have been updated since childhood; this makes the booster especially important for many expats making the move.

Hepatitis A
The risk of hepatitis A in France is low, but vaccination is recommended for those who enjoy adventurous eating or who have certain pre-existing medical conditions such as liver or kidney disease. The virus is transmitted by consuming food or drink that has been contaminated, or by touching a contaminated surface and then the mouth. The hepatitis A vaccine is highly effective, and in some countries it is not part of the routine childhood schedule, meaning it may be a new vaccination for certain expats.

Hepatitis B
Hepatitis B is a liver infection transmitted through contact with infected bodily fluids. Vaccination triggers the immune system to produce lasting protective antibodies against the virus. It is especially relevant for expats who may undergo medical procedures, have new sexual partners, or who work in a healthcare environment.

Tick-borne encephalitis (TBE)
TBE vaccination is recommended selectively — specifically for those at greatest exposure risk. The disease is present in the Alsace region, with isolated cases occasionally recorded elsewhere in the country. Expats who plan to hike, camp, or live in heavily forested or rural areas should discuss the TBE vaccine with a travel health specialist. As this vaccine is not widely available in all countries, it may be worth arranging the course either before leaving home or after arriving in France.

Influenza
The CDC recommends influenza vaccination for all individuals over six months of age travelling internationally. France conducts annual flu vaccination campaigns, and the vaccine is readily available at pharmacies and GP surgeries. COVID-19 vaccination each autumn is recommended for those at elevated risk, as well as people living with psychiatric conditions, dementia, or trisomy 21.

France’s own vaccination calendar (2025)
The French Ministry of Health has published the 2025 vaccination schedule. The strategy focuses on better protecting children and young people from a resurgence of invasive meningococcal infections, while also targeting pneumococcal disease in older adults. Protections against pertussis, RSV, and MMR have been reinforced. Expats with children should review the French schedule carefully, as it may differ significantly from their home country’s programme — for instance, vaccination against ACWY and B meningococci is now mandatory for infants in France.

It is strongly advisable to consult a travel health clinic or specialist at least six to eight weeks before your planned relocation. Booking an appointment at least six weeks ahead of travel allows adequate time for tailored health advice and, where necessary, a course of vaccinations. Even if your departure date is rapidly approaching, it is still well worth seeking an appointment.

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

If you are a non-EU national relocating to France on a long-stay visa, a mandatory medical examination is part of the immigration procedure — but it takes place after your arrival, not as a precondition for the visa itself.

Who must complete the OFII medical check?

Each year, more than 250,000 third-country nationals receive a long-stay visa or residence permit for France. Before their stay is formally validated, the majority of these individuals must pass a compulsory medical examination organised by the Office Français de l’Immigration et de l’Intégration (OFII) or, in less common circumstances, by the regional health authority (ARS). Citizens of EU, EEA, or Swiss member states are not subject to this requirement.

What does the examination involve?

The examination serves two primary purposes: safeguarding public health by screening for communicable diseases such as tuberculosis, and evaluating individual fitness for residence and, where applicable, for employment. In practice, the process is generally straightforward. Reports from expats who attended their OFII appointments in 2024 describe an experience that frequently involved a medical history questionnaire, height and weight measurements, and an optional HIV and hepatitis test — with no chest X-rays required in some cases; doctors asked a few questions about medical history, recorded height and weight, then offered a free optional HIV and hepatitis screening, after which stamped documents were issued. The degree of scrutiny can vary by region and by the applicant’s age, so attending well prepared with a complete medical history is advisable.

Step-by-step: the OFII medical process

1. Arrive in France on your long-stay visa and validate it online via the France-Visas or ANEF portal within the required timeframe.
2. Receive a convocation (appointment letter) from OFII by post or email, specifying the date, time, and location of your medical examination. Your convocation will specify the exact location, usually the OFII medical centre linked to your département.
3. Attend the appointment at the designated OFII centre, bringing identity documents, your visa, vaccination records, and any relevant medical documents. Be prepared to provide proof of vaccinations including diphtheria, tetanus, polio, and — since 2024 — a meningococcus update for those aged 16 to 24.
4. Undergo the health assessment, which may include a questionnaire, basic measurements, a tuberculosis screening review, and optional blood tests.
5. The doctor uploads your certificate directly to OFII’s system. Within 24 hours, the France-Visas or ANEF portal shows “medical exam completed.”
6. OFII issues a certificate on completion of the checks. This certificate does not contain confidential medical information but simply states whether the foreign national complies with French health regulations or not.
7. The certificate is not mandatory for a residency permit application, however it is required to collect a residency card at the prefecture.

What if a health issue is found?

The presence of a chronic condition such as diabetes or HIV does not place your residency rights at risk; strict confidentiality rules apply, and the examining doctor will only note that referral to appropriate care is recommended. If the appointment reveals the need for a particular treatment or vaccination, the certificate will include relevant details and you will be directed toward suitable healthcare services.

Failing to attend or postponing the examination can block visa validation, disrupt residence permit renewals, and potentially trigger an Obligation de Quitter le Territoire Français (OQTF — a removal order). Always treat your OFII convocation as a high-priority appointment. Visit the official OFII website for the most current requirements, as the procedure is subject to periodic revision.

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

France’s healthcare system is consistently placed among the world’s finest. Both the public and private sectors deliver comprehensive care, with little meaningful difference in quality between them. For expats who are accustomed to purely private insurance models or single-payer systems with lengthy waiting times, France’s approach is likely to be a welcome change.

The public system: Assurance Maladie and PUMa
France operates a predominantly public healthcare model known as Assurance Maladie, bolstered by a supplementary layer of private cover called a mutuelle (complementary health insurance). Unlike purely single-payer systems where care is entirely free at the point of use, France operates on a reimbursement basis, with clearly defined rules governing what is covered and at what percentage.

How reimbursements work
GP visits, specialist consultations, hospital admissions, prescription medications, and maternity care all fall within the state system. Most GP appointments cost approximately €25, with the government reimbursing around 70% of that amount. Hospital stays are reimbursed at 80%, and long-term conditions classified as Affections de Longue Durée (ALD) are covered at 100%. The most significant gaps in public coverage relate to dental treatment, optical care (including glasses and contact lenses), and certain specialists. While a mutuelle is not legally required, it is strongly advisable to close these financial gaps.

Registering for coverage
To access state healthcare benefits, you must enrol with Assurance Maladie — a step that is obligatory for expats residing in France for more than three months. Central to the system is the Carte Vitale, a small green health insurance card linked to your French social security number. When presented at medical appointments or pharmacies, it triggers automatic reimbursement processing. Obtaining this card is one of the most important early steps in settling into French life.

Finding a GP (médecin traitant)
Your first priority should be registering with and formally declaring a GP (médecin traitant). For the majority of specialist consultations, a GP referral keeps you within the coordinated care pathway and ensures maximum reimbursement rates. Without a registered GP, you may receive reduced reimbursement for specialist visits. French pharmacies also play a substantial role in everyday healthcare, frequently serving as the first point of contact for minor ailments and questions.

Quality and accessibility
In France, life expectancy stands at 83 years — 1.9 years above the OECD average — and the entire population is covered for a core set of healthcare services. That said, access to specialists can vary significantly: some areas experience longer waiting times for certain types of care, and home support services may differ by region. Rural areas in particular can suffer from a shortage of doctors — a phenomenon the French refer to as “déserts médicaux” (medical deserts). This reality underscores the growing value of remote and coordinated healthcare, which is particularly helpful for expats based in rural France.

Private healthcare and language
In France, “private healthcare” does not describe a completely separate system. Many physicians operate within the broader public reimbursement framework but may charge higher fees, offer reduced waiting times, or provide enhanced comfort options. The public system remains the foundation, and private arrangements typically concern convenience and supplementary services rather than access to care itself. While France is not as internationally oriented as some other European nations, major cities — particularly Paris, Lyon, Bordeaux, and Strasbourg — have doctors who consult in several languages. Expats in smaller towns should generally be prepared to communicate in French during medical interactions or arrange for a translation service.

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

France encompasses remarkable geographic diversity — from the forests of Alsace and the Mediterranean coastline to the heights of the Alps and the wetlands of the Atlantic coast — and health risks do differ from one region to another. Expats settling outside major urban centres, or who travel widely across the country, should be alert to these variations.

Tick-borne encephalitis and Lyme disease
TBE is transmitted to humans through the bite of infected ticks or, occasionally, via the consumption of unpasteurised milk products. Those living or spending time in areas where TBE is present face heightened risk between April and November, with the danger peaking for people who hike or camp in forested terrain. The Alsace region is most closely associated with TBE, though isolated cases have been reported elsewhere in the country. The Massif Central, Pyrenees, Jura, and other densely wooded zones also carry Lyme disease risk. After any outdoor activity in woodland or tall grass, a thorough check of the whole body for ticks is essential.

Altitude sickness
France includes areas of high altitude (2,400m or above) and zones of very high altitude (3,658m or above). Anyone venturing into elevated terrain should be mindful of ill effects, including Acute Mountain Sickness — a potentially life-threatening condition arising from oxygen deprivation at altitude. This is of particular relevance to expats skiing or trekking in the Alps or Pyrenees, where rapid ascent to considerable heights is common. Symptoms include headaches, dizziness, and nausea. Gradual ascent, adequate hydration, and medication such as acetazolamide are established preventive strategies. If symptoms appear, immediate descent to lower elevations is critical.

Urban air quality
Major French cities — above all Paris, Lyon, and Marseille — experience intermittent episodes of poor air quality driven primarily by vehicle emissions, industrial activity, and, with increasing frequency, dust transported northward from the Sahara during southerly weather patterns. Expats with asthma, allergies, or cardiovascular conditions should monitor the national air quality index (Atmo France) regularly and have a clear management plan in place.

Mosquito-borne disease in the south
A limited number of chikungunya cases have been identified in coastal regions. The tiger mosquito (Aedes albopictus), capable of transmitting both dengue and chikungunya, has become firmly established across much of southern and central France and continues to extend its range northward. Dengue is a severe flu-like illness spread through mosquito bites; the mosquitoes that carry it are active during daylight hours, from dawn through dusk. Malaria is not normally present in metropolitan France unless contracted overseas.

Heatwaves in the south and urban centres
The Mediterranean south — encompassing Provence, Languedoc, and the Côte d’Azur — experiences the most intense summer heat, but heatwaves now affect the entire country, including Paris. France has substantially improved its public health response since the catastrophic heatwave of 2003, implementing early-warning systems, cooling centres, and routine public health advisories during hot spells. Expats should acquaint themselves with the national heatwave alert system (Plan Canicule), operated by Santé Publique France.

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

It is essential to verify all health requirements and recommendations against authoritative, current sources. Requirements evolve — vaccination schedules are revised, new outbreaks emerge, and immigration health regulations change over time. The resources listed below represent the most reliable starting points for up-to-date information.

• French Ministry of Health / Santé Publique France (Public Health France)
  The national public health agency provides disease surveillance data, vaccination schedules, heatwave alerts, and health advisories. The official vaccination calendar is updated and published each year.
  santepubliquefrance.fr
• Ameli.fr — French National Health Insurance (Assurance Maladie)
  The official portal for managing your French health coverage. You can create an account, track reimbursements, check your Carte Vitale status, and access the simplified vaccination calendar.
  ameli.fr
• Service-Public.fr (French government information portal)
  Covers vaccinations, healthcare access rights, and residency requirements in both French and English.
  service-public.fr
• World Health Organization (WHO) — France
  The WHO European Region office supplies country-level health data, outbreak alerts, and vaccination guidance.
  who.int/europe
• CDC Travellers’ Health — France
  The US Centers for Disease Control and Prevention maintains a dedicated France travel health page covering vaccine recommendations, health notices, and essential packing guidance.
  wwwnc.cdc.gov/travel/destinations/traveler/none/france
• Travel Health Pro (UK — NaTHNaC) — France
  The National Travel Health Network and Centre (NaTHNaC), which operates the NHS Fit for Travel service, provides in-depth health advice for travellers and residents in France, including vaccine recommendations and disease risk summaries.
  travelhealthpro.org.uk/country/74/france
  fitfortravel.nhs.uk — France
• OFII (Office Français de l’Immigration et de l’Intégration)
  The French immigration and integration office oversees the compulsory medical examination for non-EU long-stay residents. Consult this site for details on appointment procedures and current requirements.
  ofii.fr
• France-Visas
  The official French government portal for long-stay visa applications, including any health-related documentation requirements.
  france-visas.gouv.fr

Please note that fees, processing times, vaccination requirements, and immigration health rules are all subject to change. Always consult official sources directly before making decisions or bookings, and seek advice from a qualified travel health professional for personalised medical guidance.

Frequently Asked Questions

Do I need to get vaccinated before moving to France?

No vaccinations are legally required to enter France. However, health authorities around the world strongly advise ensuring your routine immunisations — including MMR, Tdap, hepatitis A, influenza, and polio — are fully current before relocating. In light of current disease activity, the pertussis booster is of particular importance. Arrange a consultation with a travel health clinic at least six to eight weeks before your planned move for personalised guidance.

Will my existing vaccination records from home be accepted in France?

France does not operate a formal system for officially “accepting” foreign vaccination records in the way some countries do. However, your immunisation history will be reviewed at your OFII medical appointment if you are a non-EU national on a long-stay visa. Bring your complete vaccination record — ideally with certified translations if it is not in French. The examining doctor will assess whether your immunisation history is adequate; any gaps may result in recommendations for catch-up doses.

Is health insurance required to get a long-stay visa for France?

Yes. Non-EU nationals applying for a French long-stay visa (including the Visa de Long Séjour valant Titre de Séjour / VLS-TS) are generally required to demonstrate comprehensive health insurance coverage for the duration of their stay, especially in the initial months before they can enrol in the state system. Private international health insurance is the most widely used solution for new arrivals. Once you have been legally resident for three months, you are entitled to register with Assurance Maladie (CPAM) under the PUMa scheme.

What happens if I develop a serious illness in France?

Medical staff in France are highly qualified, and facilities generally do not suffer from the lengthy waiting times that expats may have encountered elsewhere. In a genuine emergency, dial 15 (SAMU, the medical emergency service), 18 (the fire brigade, which also responds to medical emergencies), or 112 (the pan-European emergency number). French hospitals are well equipped, and emergency care will be provided regardless of your insurance status. With a Carte Vitale and a mutuelle, the majority of costs will be covered or reimbursed after treatment.

How do I find a doctor in France who speaks my language?

In larger cities — particularly Paris, Lyon, Bordeaux, and Strasbourg — it is relatively easy to locate GPs and specialists who consult in languages other than French. Platforms such as Doctolib, France’s leading online appointment booking service, allow you to filter searches by language. Expat community groups and forums are also an invaluable source of personal recommendations. In smaller towns and rural areas, multilingual doctors are far less common, and you may need to use a telephone interpretation service or bring a trusted bilingual companion to appointments.

Is there malaria risk in France?

Malaria is not normally present in France unless the illness was contracted abroad. No antimalarial medication is recommended for travel within metropolitan France. If you are heading to one of France’s overseas territories — such as French Guiana or Mayotte — the situation is entirely different, and you should consult the specific guidance applicable to those destinations.

What is the OFII medical and when does it happen?

Most non-EU nationals residing in France will encounter the Office Français de l’Immigration et de l’Intégration (OFII) and are required to complete a mandatory medical examination. After validating your visa in France, you will receive a convocation letter from OFII — typically within the first few months of arrival — specifying the date and location of your appointment. The examination takes place at an OFII medical centre in your département and is usually completed quickly. The certificate issued upon completion is required when collecting your residency card at the prefecture.

Can I use a European Health Insurance Card (EHIC) in France?

EU, EEA, and Swiss nationals may use their European Health Insurance Card (EHIC) during temporary visits to France. For those establishing long-term residence, registering with the French healthcare system is strongly advisable. The EHIC grants access to state-provided healthcare during temporary stays on the same terms as a French resident, but it is not a substitute for full enrolment with Assurance Maladie once you are living in France permanently. UK nationals holding a Global Health Insurance Card (GHIC) benefit from similar temporary provisions, but long-term residents should likewise register with the French system.