Do not travel to India due to COVID-19. Exercise increased caution due to crime and terrorism.

On April 28, 2021, the Department approved the voluntary departure of family members of U.S. government employees.

U.S. citizens who wish to depart India should take advantage of available commercial transportation options.     

Read the Department of State’s COVID-19 page before you plan any international travel.

The Centers for Disease Control and Prevention (CDC) has issued a Level 4 Travel Health Notice for India due to COVID-19, indicating a very high level of COVID-19 in the country. Visit the Embassy’s COVID-19 page for more information on COVID-19 in India.

Do not travel to:

• The state of Jammu and Kashmir (except the eastern Ladakh region and its capital, Leh) due to terrorism and civil unrest.
• Within 10 km of the India-Pakistan border due to the potential for armed conflict.

Indian authorities report rape is one of the fastest growing crimes in India. Violent crime, such as sexual assault, has occurred at tourist sites and in other locations.

Terrorists may attack with little or no warning, targeting tourist locations, transportation hubs, markets/shopping malls, and government facilities.

The U.S. government has limited ability to provide emergency services to U.S. citizens in rural areas from eastern Maharashtra and northern Telangana through western West Bengal as U.S. government employees must obtain special authorization to travel to these areas. Read the country information page.

Read the country information page.

If you decide to travel to India:

• See the U.S. Embassy’s web page regarding COVID-19. 
• Visit the CDC’s webpage on Travel and COVID-19.   
• Do not travel alone, particularly if you are a woman. Visit our website for Women Travelers.
• Review your personal security plans, and remain alert to your surroundings.
• Enroll in the Smart Traveler Enrollment Program (STEP) to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on Facebook and Twitter.
• Review the Crime and Safety Reports for India.
• U.S. citizens who travel abroad should always have a contingency plan for emergency situations, including emergency medical situations related to COVID-19. Review the Traveler’s Checklist.

State of Jammu and Kashmir

Terrorist attacks and violent civil unrest are possible in the state of Jammu and Kashmir. Avoid all travel to this state (with the exception of visits to the eastern Ladakh region and its capital, Leh). Sporadic violence occurs particularly along the Line of Control (LOC) separating India and Pakistan, and in tourist destinations in the Kashmir Valley: Srinagar, Gulmarg, and Pahalgam. The Indian government prohibits foreign tourists from visiting certain areas along the LOC. Visit our website for Travel to High-Risk Areas.

India-Pakistan Border

India and Pakistan maintain a strong military presence on both sides of the border. The only official India-Pakistan border crossing point for persons who are not citizens of India or Pakistan is in the state of Punjab between Atari, India, and Wagah, Pakistan. The border crossing is usually open, but confirm the current status of the border crossing prior to commencing travel. A Pakistani visa is required to enter Pakistan. Only U.S. citizens residing in India may apply for a Pakistani visa in India. Otherwise apply for a Pakistani visa in your country of residence before traveling to India. Visit our website for Travel to High-Risk Areas.

Northeastern States

Incidents of violence by ethnic insurgent groups, including bombings of buses, trains, rail lines, and markets, occur occasionally in the northeast.

U.S. government employees are prohibited from traveling to the states of Assam, Arunachal Pradesh, Mizoram, Nagaland, Meghalaya, Tripura, and Manipur without special authorization from the U.S. Consulate General in Kolkata. Visit our website for Travel to High-Risk Areas.

Central and East India

Maoist extremist groups, or “Naxalites,” are active in a large swath of India from eastern Maharashtra and northern Telangana through western West Bengal, particularly in rural parts of Chhattisgarh and Jharkhand and on the borders of Telangana, Andhra Pradesh, Maharashtra, Madhya Pradesh, Uttar Pradesh, Bihar, West Bengal, and Odisha. The Naxalites have conducted frequent terrorist attacks on local police, paramilitary forces, and government officials.

Due to the fluid nature of the threat, all U.S. government travelers to states with Naxalite activity must receive special authorization from the U.S. consulate responsible for the area to be visited. U.S. officials traveling only to the capital cities in these states do not need prior authorization. Visit our website for Travel to High-Risk Areas.

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Researchers around the world have wasted no time in the race to find a vaccine to combat COVID-19. Months into the pandemic, several vaccine candidates are in late-stage clinical trials to test how well they protect people from a coronavirus (SARS-CoV-2) infection. And experts predict that by the end of 2020 or early in 2021, a safe and effective option will emerge.

“This is the scientific world working at warp speed,” Barry Bloom, a professor of immunology and infectious diseases and former dean at the Harvard T.H. Chan School of Public Health, said in a Sept. 15 webinar.

Beyond the development of the medicine itself, efforts to speed up vaccine manufacturing and distribution are also in place. Here’s a look at the coronavirus vaccine prospects and the progress being made on them.

What, exactly, is a vaccine?

A vaccine is something that helps a person build up immunity to an infectious disease. It works by intentionally introducing the body to an inactive form of a disease-causing germ, or something similar to it. This then stimulates the immune system’s production of antibodies, the proteins that help to protect the person from a future infection if they ever come across the real germ.

Think of it like a workout for your immune system: You’re “sending it to the gym and preparing it to be able to do something when it encounters the real thing in the future,” says Tony Moody, M.D., associate professor of pediatrics and immunology at Duke University School of Medicine and a principal investigator at the Duke Human Vaccine Institute. “Essentially, what a vaccine is doing is teaching the immune system how to handle something before you actually encounter the real thing — so that, hopefully, when you do encounter the real thing, you’re able to deal with it quickly and get rid of it.”

In the case of the new coronavirus, a vaccine would make a person resistant to an infection from the virus and the illness it causes — COVID-19 — or, at the very least, make it so that a person who becomes infected has “a shorter course [of disease] or not as many complications,” Moody adds.

Which coronavirus vaccines are leading the pack?

Two are considered the frontrunners in the U.S.: a vaccine from Moderna and the National Institute of Allergy and Infectious Diseases (NIAID) and one from Pfizer and BioNTech.

What makes these vaccines special? The companies behind both vaccines report they are highly effective at preventing COVID-19 in clinical trial participants. Pfizer/BioNTech announced on Nov. 18 that its trial has met all of the required safety and efficacy endpoints and that its two-dose vaccine is 95 percent effective against COVID-19 beginning 28 days after the first dose. (In adults 65 and older, the vaccine was found to be 94 percent effective at preventing COVID-19.) An interim analysis of Moderna’s phase 3 clinical trial found its vaccine to be 94.5 percent effective at preventing COVID-19. It’s important to note, however, that the data from both trials has not been peer-reviewed. 

Pfizer has submitted its coronavirus vaccine to the U.S. Food and Drug Administration (FDA) for emergency use authorization (EUA). The agency is expected to meet with an advisory committee to discuss the vaccine candidate on Dec. 10. Moderna expects to file for EUA in the coming weeks, once it meets all of its safety and efficacy endpoints.

What is emergency use authorization?

An EUA is a green light, of sorts, from the FDA. It is not the same as official approval.

During a public health emergency, such as the coronavirus pandemic, the FDA can authorize previously unapproved medical products to diagnose, treat or prevent the illness of concern in a timely manner when there are no other approved or available alternatives. The EUA process is faster than standard FDA approval, which can take six to 10 months. However, data proving safety and effectiveness are still required for authorization, and the FDA and an advisory committee of experts use this data to weigh the risks and benefits of the product in question.  

What other vaccines hold promise?

The Moderna and Pfizer vaccines are two of four vaccines in the third phase of testing in U.S. trials. The others include one from AstraZeneca and the University of Oxford, and another from Johnson & Johnson.

A phase 3 trial is when researchers study the safety and effectiveness of the vaccine candidates against a placebo in a large population (more than 30,000 volunteers in the case of these vaccine trials). A phase 3 trial also allows researchers to see how well these vaccines work in populations that are most likely to get severely ill from a SARS-CoV-2 infection, including older adults, people with underlying health conditions, and racial and ethnic minorities, who have higher rates of hospitalization and death from COVID-19.

“Because if the vaccine can’t work well in the people who need it the most, then obviously we need a better vaccine or a different strategy,” says Jesse Goodman, M.D., director of Georgetown University’s Center on Medical Product Access, Safety and Stewardship (COMPASS) and former chief scientist at the FDA.

The vaccines from Moderna and Pfizer utilize a new technology, known as mRNA, which introduces a genetic code the body can use to make its own viral protein to induce an immune response. AstraZeneca’s vaccine uses a nonreplicating chimpanzee adenovirus to deliver a SARS-CoV-2 spike protein to stimulate an immune response, and Johnson & Johnson’s one-dose vaccine is made from a genetically modified adenovirus.

Just because these four are leading the pack, however, doesn’t mean the other vaccine candidates out there — all 234, according to the Milken Institute’s vaccine tracker — are out of the race. Eight additional vaccines are also in phase 3 trials around the world, a database maintained by the New York Times shows, and more than 50 others are in phase 1 and 2 studies, some of which employ “more traditional technologies that are used in currently approved vaccines,” Goodman explains.

Can more than one vaccine candidate work and be authorized or approved?

Absolutely. “In fact, it’s highly desirable,” says William Schaffner, M.D., an infectious disease specialist and professor of preventive medicine at the Vanderbilt University School of Medicine, because that would mean “there would be more vaccine manufacturers working to actually produce the vaccine, and so we could more expeditiously try to vaccinate the population in the United States and beyond.”

Kathleen Neuzil, M.D., professor in vaccinology and director of the Center for Vaccine Development and Global Health at the University of Maryland School of Medicine, echoes Schaffner’s sentiment and points to the flu vaccine for comparison: There are multiple formulations on the market, including the injectable high-dose vaccine and the nasal spray vaccine, for example, which are recommended for different populations.

“We really need every person on earth, theoretically, to be able to receive this vaccine. So, to me, [having more than one option] is a positive, because we need so much,” she adds.

When will the other coronavirus vaccines apply for EUA?

It’s hard to pinpoint when a vaccine candidate will be ready to apply for FDA authorization — that all depends on when scientists are able to collect enough data from the phase 3 clinical trials to know whether the vaccine is safe and effective at preventing a coronavirus infection or decreasing its severity in at least 50 percent of vaccine recipients. (The 50 percent efficacy standard was set by the FDA in June. For comparison, the influenza vaccine is between 40 percent and 60 percent effective.)

One thing that could delay the process: the rate at which clinical trial participants get infected. In order for the trials to show that a vaccine candidate works, some participants need to contract the coronavirus out in the community. (They are not being introduced to SARS-CoV-2 in the lab.) “The end point is the number of people who get sick; it’s not a calendar date,” Harvard’s Bloom says.

As Schaffner points out, the population that typically volunteers for clinical trials is the same population that is more likely to adhere to public health guidance put in place to prevent the spread of COVID-19. “They’re usually the type of people who, in the COVID era, are being very careful. They’re social distancing; they’re wearing masks. They don’t go out to restaurants; they haven’t traveled,” he says. “And some of us think that these trials may have to run a little longer than people anticipated for just that reason. Because the volunteers tend to be very careful people.”

An adverse reaction to a vaccine candidate could also slow the process. Both AstraZeneca and Johnson & Johnson paused their phase 3 trials to investigate a participant who may have experienced a complication from the vaccine. (The two companies have since resumed research.) Bloom says while this delays things a little bit, “it proves that the system is working.” Pointing to the trial’s safety measures in place, he adds, “It is exactly what should be done when anybody is sick.”

When will a vaccine be available to the public?

As soon as possible. In a Sept. 16 hearing before a Senate committee, Centers for Disease Control and Prevention (CDC) Director Robert Redfield, M.D., said once the FDA green-lights a vaccine, the government “wants to be in a position to distribute it within 24 hours.”

When the FDA issues an EUA for the vaccine, the CDC’s Advisory Committee on Immunization Practices (ACIP) will quickly hold a public meeting to review the vaccine’s data and then vote on whether to recommend the vaccine. The ACIP will also specify who should receive it, based on the data collected in the trials.

If initial supplies are limited, the ACIP is considering four groups to recommend for early COVID-19 vaccination until there’s enough vaccine for everyone:

• Health care personnel
• Workers in essential and critical industries
• People at high risk for hospitalization or death from COVID-19 due to underlying medical conditions
• People 65 and older

Experts have made predictions on when the vaccine will be more widely available to the general public. The CDC’s Redfield estimates it will likely take “six to nine months to get the American public vaccinated.”

How will the vaccine be distributed?

The federal government is overseeing the distribution and tracking of coronavirus vaccines in the U.S., and the CDC is working with state, tribal, territorial and local jurisdictions for vaccine plans in their respective areas. The government is also partnering with private companies to ensure high-risk individuals can easily access a vaccine when one is available.

All vaccines will be ordered through the CDC; much of the vaccine manufacturing and stockpiling is happening at the same time as late-stage clinical trials so that if/when a vaccine receives FDA authorization or approval, the medicine will be ready to roll out to the public. 

Ensuring there is proper transportation and storage for the vaccines is part of this planning process. Both the Pfizer and the Moderna vaccines require cold storage at specific temperatures — Pfizer’s more so than Moderna’s — meaning pharmacies and clinics throughout the U.S. will need to be equipped with specialized freezers and refrigerators to keep the medicines stable.

Ordering the supplies needed to vaccinate millions of Americans is another key part of the distribution planning process, as is scaling up safety surveillance and monitoring for long-term effectiveness.

“I think in the beginning, it’s going to be very, very challenging,” Harvard’s Bloom said about the vaccine distribution process. “But by the end of the spring, if not well before then, this should be running smoothly,” pending any technical glitches.

How much will the vaccine cost?

The goal: Nothing. The federal government has prepurchased hundreds of millions of vaccine doses with taxpayer money, and these will be given to Americans at no cost, according to the CDC.

Vaccine providers will be able to charge an administration fee for giving the shot, but this fee should be covered by public or private insurance, or by a government relief fund for the uninsured.

If a vaccine is not 100 percent effective, can I still get COVID-19?

That may be the case, although more details on the vaccine’s effectiveness — especially in subpopulations — should emerge in the third phase of clinical trials and in posttrial surveillance. And “that’s something that the recipients will have to understand when they get the vaccine,” Schaffner says. “The vaccine provides protection, but it won’t be like a suit of armor.”

His main message: Just because you roll up your sleeve and get the shot doesn’t mean you can throw away your mask and disregard other prevention efforts such as social distancing and handwashing. Those will be crucial “for quite some time” in order to get control over the virus, Schaffner says.

Another consideration: An approved vaccine will likely require two doses, several weeks apart, which will stretch out the time before it is effective in recipients. (Johnson & Johnson’s one-dose vaccine candidate is the exception.) The duration of immunity from the vaccine is also unclear at this point. “It’s possible people will need boosters before we’re done with all this,” Goodman adds.

Why does the vaccine development process take so long?

Though timelines may seem long and “frustratingly inefficient,” the speed at which the coronavirus vaccine process is moving is unprecedented, says Duke’s Moody.

Vaccine development typically takes 10 to 15 years, and the fastest vaccine created thus far was for mumps — that process took four years. What’s more, after a vaccine is approved, it can take months to years to scale up manufacturing and production for widespread distribution. The U.S., however, already has a head start on this.

“I think it’s really important for people to understand that the response to this pathogen has been faster than any other pathogen in history,” Moody says. “The fact that you had a virus that was first reported in China in December, and by March we were already talking about setting up a phase 1 trial … I think the speed of the response, both by the medical community and by everyone else, is actually pretty astonishing.”

What if scientists don’t come up with a coronavirus vaccine that works?

That’s unlikely at this point, but it is a possibility. And that’s why it’s important to pursue treatments for COVID-19, as well, Moody says.

“If we had sort of the Tamiflu equivalent for coronavirus where you could be exposed and take Tamiflu and be protected, or you could get early disease and it could attenuate the disease or shorten the course, that would be great,” Moody says of the antiviral treatment for influenza. “There’s a lot of work being done there. And I think all of that work needs to proceed as well.”

The FDA has so far approved the antiviral drug remdesivir for treatment of some patients hospitalized with COVID-19. The agency has also issued an EUA for convalescent plasma to treat people who are hospitalized with the illness and for bamlanivimab, a monoclonal antibody therapy to treat mild to moderate cases of COVID-19 in nonhospitalized patients.

The World Health Organization has also published guidelines that recommend the use of inexpensive and common corticosteroids such as hydrocortisone and dexamethasone for the treatment of patients with severe cases of COVID-19. The guidelines come after an analysis of several clinical trials found that corticosteroids cut the risk of death in patients hospitalized with COVID-19. The new guidelines, however, emphasize that steroids should not be used to treat patients with mild symptoms of the disease.

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As communities lift stay-at-home restrictions, it’s important to keep taking steps to protect yourself from COVID. Find out how to safely travel, visit restaurants, go to the gym and more during the reopening.

If coronavirus disease 2019 (COVID-19) stay-at-home restrictions are easing in your community, you might wonder how to visit public places and protect your health. Here’s what you need to know.

Before you head out

Follow guidance where you live. In the U.S., activity restrictions vary among cities and states. Before you head out, check your city or state health department’s website for information about local restrictions aimed at preventing the spread of the COVID virus.

The best way to protect yourself from the coronavirus is to avoid exposure. If you go out, wear a cloth face covering. Keep a distance of about 6 feet (2 meters) from others if COVID is spreading in your community, especially if you have a higher risk of serious illness. Avoid close contact with anyone who is sick or has symptoms. Also, avoid large events and mass gatherings.

In addition, practice good hygiene. Wash your hands often with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer that contains at least 60% alcohol. Cover your mouth and nose with your elbow or a tissue when you cough or sneeze and then wash your hands or use hand sanitizer. Also, avoid touching your eyes, nose and mouth.

If you feel sick, stay home. Don’t visit public areas unless you’re going to get medical care. Avoid taking public transportation if you’re sick.

And if you’re at higher risk of serious illness, don’t head out into the community just yet. It’s safer to stay home. If other members of your household return to work or visit places where social distancing isn’t possible, it’s recommended that they isolate themselves from you.

Safety tips for public places

Beyond taking general precautions to prevent COVID, consider specific safety tips for visiting different public places.

Traveling

Before traveling check the websites of the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) for health advisories and self-quarantine requirements. Consider checking the U.S. Transportation Security Administration’s website and your airline’s website for additional guidance.

Consider the risks associated with different types of travel. There might be a risk of getting the COVID virus on a crowded flight if other travelers on board are infected. On a bus or train, sitting or standing within 6 feet (2 meters) of others for a prolonged period can put you at risk of getting or spreading COVID. Traveling by car or recreational vehicle often involves stops that could put you in close contact with infected people.

If you’re planning on booking a hotel room, check the hotel’s website to learn about precautions being taken and if amenities, such as the gym or restaurant, will be open. Bring cleaning supplies with you. When you get to your room, disinfect all high-touch surfaces, such as light switches, sink faucet handles, door knobs and the remote control. Wash plates, cups or silverware (other than pre-wrapped plastic) before using. Also, confirm the hotel’s cancellation policy before making a booking.

Restaurants

Before you eat at a restaurant, check the restaurant’s COVID safety practices. Are the employees wearing cloth face coverings, regularly disinfecting high-touch surfaces and practicing social distancing? Is there good ventilation? Are tables set far enough apart from each other to allow for social distancing? Is the menu digital or disposable?

Ideally, the restaurant won’t offer salad bars, buffets and drink-filling stations that require people to use common utensils or dispensers. These things are conducive to the spread of COVID. If you need to wait in line for service, maintain a distance of at least 6 feet (2 meters) from others. If possible, use touchless payment.

When ordering takeout, try to pay online or over the phone to limit contact with others. If you’re having food delivered, ask for it to be left outside your home in a safe spot, such as the porch or your building’s lobby. Otherwise, stay at least 6 feet (2 meters) away from the delivery person. If you’re picking up your food at the restaurant, maintain social distancing while waiting in the pickup zone. After bringing home your food, wash your hands or use hand sanitizer.

Places of worship

Before going to a place of worship, check to see if the size of gatherings is being limited and how that might affect your visit. Seek out services held in large, well-ventilated areas. Continue social distancing during services.

Also, avoid contact with frequently touched items, such as books. Place any donations in a stationary collection box. If food is offered at an event, look for pre-packaged options.

Gyms

Gyms are ideal environments for the spread of germs and diseases like COVID. Before going to the gym, call to see if it’s limiting how many members are allowed in at the same time. You might have to reserve a block of time in advance, with staff cleaning the facility between blocks. Ask about the facility’s cleaning and disinfecting policies and whether you’ll be able to use the locker room or bathroom. If you are interested in group exercise classes, ask if they are being offered.

Your gym will likely enforce social distancing by blocking access to every other cardio machine or by putting up barriers around equipment. Follow the gym’s guidelines and stay at least 6 feet (2 meters) away from other members. Clean equipment before and after using it. Some equipment that’s difficult to clean, such as foam rollers and yoga blocks, might not be available.

If you’re at higher risk of serious illness, you might consider waiting to return to the gym. Ask if your gym offers virtual classes or training.

Salons

When making a hair or nail appointment, ask about safety measures. You might be required to attend your appointment alone, wash your hair at home to reduce traffic near the shampoo area, and wait in your car or outside until your appointment begins. In addition, you might ask whether the salon is offering blow drying. Eliminating blow drying could reduce the risk of spreading the COVID virus.

Ideally, the salon will stagger appointments to limit how many people are in the facility at the same time. You might ask about the salon’s disinfecting practices. Is the staff regularly wiping down high-touch surfaces? Are chairs and headrests disinfected after they are used? Is the staff wearing cloth face coverings and regularly washing their hands? Are they wearing single-use gloves for nail and facial work? Also, look for touchless payment options.

Grocery stores

Before going to get your groceries, consider visiting the chain’s website to check on the precautions being taken to prevent the spread of COVID. For smaller businesses, call the store.

To make social distancing easy, visit the grocery store early in the morning or late at night, when the store might be less crowded. If you’re at higher risk of serious illness, find out if the store has special hours for people in your situation and shop during these times. To further protect yourself from COVID you may also consider ordering your groceries online for home delivery or curbside pickup.

At the store, disinfect the handle of the shopping cart or basket. Stay at least 6 feet (2 meters) away from others while shopping and in lines. If possible, pay without touching money or a keypad or use hand sanitizer after paying. Also, apply hand sanitizer after you leave the store. When you get home, wash your hands.

Banks

During visits to the bank, use the ATM, if possible. Clean the ATM keyboard with a disinfecting wipe before using it. When you are done, apply hand sanitizer. Wash your hands when you get home.

Gas stations

Before pumping gas wipe down any handles or buttons you’ll need to touch. After you finish fueling, apply hand sanitizer. Wash your hands when you get home or the next time you are near a sink.

Pharmacy

Plan to order and pick up all of your prescriptions at the same time. If possible, call in prescription orders ahead of time and use a drive-thru window, curbside pickup, mail order or other delivery service. Ask your doctor or pharmacist if you can get a larger supply of medication so that you don’t have to visit the pharmacy as often.

Massage therapy

Before having a massage, ask about what precautions your massage therapist is taking to prevent the spread of the COVID virus. Ideally, the number of people in the space will be limited to allow for social distancing and you’ll be able to check in and out using virtual tools.

Massage rooms, communal areas and any objects you might touch should be thoroughly cleaned, disinfected and sanitized. Ask about the laundry policy for linens, towels and other washable items. Massage therapists should follow hand-washing and hygiene protocols and use equipment to protect themselves, such as gloves and masks.

Parks and outdoor spaces

Before heading out, check with state and local authorities to see if parks, recreational facilities, natural bodies of water, beaches and swim areas are open. In the U.S., the National Park Service will decide on a park-by-park basis if a national park will open. If an area is going to be open, check if bathrooms and food concession stands also are open.

Choose a park that is close to home. Travel often involves stops, which can expose you to COVID. Keep space between yourself and others when using swimming pools.

While at the park, look for open areas, trails and paths that allow you to keep a distance of 6 feet (2 meters) from others. Avoid crowded areas.

As businesses continue to open, guidelines might change. Stay informed. Also, don’t be afraid to ask questions. If you don’t feel confident about a business’s safety practices, postpone your visit. Protecting your health is worth it.

For the most up-to-date news and information about the coronavirus pandemic, visit the CDC website.

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