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I Was on a Fully Vaccinated Cruise Ship in Greece — Here's What It Was Like

During a 10-day trip aboard a cruise ship in Greece this summer, there were plenty of COVID tests and lots of hand sanitizing. And that was just fine with me.

Paul Brady is the news director at Travel + Leisure and the brand's expert on cruise travel. He has been covering the travel industry for more than 15 years for outlets including Condé Nast Traveler , Skift , and The Huffington Post .

Breakfast buffet or nasal swab? On a cruise ship this summer in the Mediterranean, the answer is why not both?

Aboard the brand-new Silver Moon cruise ship in late July, all 300 or so passengers lined up for their mandatory COVID-19 tests while cruising the Levantine Sea, heading from Limassol, Cyprus to Rhodes, Greece. For all of them, it would've been at least the second COVID test in four days, after a mandatory swab simply to board the ship in Athens.

Silversea, which operates the Silver Moon, also mandates vaccinations for all passengers and crew aboard, meaning the ship was a fully inoculated, heavily tested bubble sailing in the waters of Greece . And while vaccine mandates are these days much-discussed in the U.S., they weren't controversial aboard the Silver Moon . As I lined up for my test, passengers were mostly in bright spirits and happy to comply with protocols designed to keep everyone aboard safe.

"This is what our guests wanted," said Barbara Muckermann, the chief commercial officer of Silversea, in an interview with Travel + Leisure aboard the Silver Moon last month. As further proof, she pointed to feedback from a recent survey Silversea conducted, in which 87 percent of respondents said they'd be happy to sail aboard a fully vaccinated vessel. The number for a ship with no such mandate? Just 14 percent.

"I ​think the protocols we have are non-invasive, and they're a great compromise to have an amazing experience and still feel very safe," Muckermann said. "We've managed to strike the right balance."

Return to the Seas

After spending a few days aboard the ship, I had to agree with her. Though I work at a travel magazine and have enjoyed cruises in the past, there was, while I made plans to board the Silver Moon, no forgetting the horrifying headlines of the past 17 months. Rightly or wrongly, cruise ships became a symbol of the early days of the pandemic, when uncertainty and fear were constant companions and news of even healthy passengers stuck aboard ships captured the world's attention.

Today, ships around the world are sailing again, like the Celebrity Edge, the super-sized vessel that resumed operations in June, making it the first to carry paying guests from a U.S. port since March 2020 . While vessels like the Celebrity Edge and Silver Moon are back to business, it's not a case of business as usual. Royal Caribbean Group, the parent company of both brands, has implemented a 74-point plan to reimagine life on board, improving air filtration, enhancing cleaning standards, and planning for what happens if (and, as it turns out , when) passengers test positive for COVID.

"The cruise industry has gone from being the poster child for what could go wrong with travel in the COVID era to what could go right," Royal Caribbean CEO Richard Fain told me during an interview aboard the Silver Moon . "We've now seen that — with the vaccine and some of [these] very simple protocols — cruising can be safer than a day on Main Street, U.S.A."

Life on Board

In my experience, during a 10-day trip around Greece and Cyprus, those protocols were effective without being overly annoying. At the ship's breakfast buffet, three handwashing stations were set up for guests to use before they approached the food. Even after washing up, guests weren't allowed to handle serving utensils; crew members dished out croissants, fresh fruit, and thick Greek yogurt.

Most of the venues on board also offered hand sanitizing stations, something that many cruise ships have offered for years. In many public areas, seating was arranged to encourage physical distance between parties; in places where that wasn't possible, table tents marked those seats that were off limits in the interest of keeping people at least six feet apart.

Throughout the ship, crew members were diligent about wearing masks, even outdoors. Passengers, too, largely heeded the ship-wide requirement to wear masks. I did notice far fewer masks on the open-air pool deck, and masks obviously came off whenever travelers were seated in bars and restaurants aboard the ship. But as far as I noticed, everyone on board was respectful, courteous, and conscientious about wearing masks whenever the rules required it — and this was well before the latest word from the CDC encouraging the use of face coverings even for the vaccinated.

Life on Land

Of course, the ship side of things is only half the story. In all the ports we visited, adherence to COVID protocols appeared far more slack. While I'm no epidemiologist, I certainly witnessed plenty of mask-slipping , extremely casual temperature taking, and hand sanitizer bottles languishing untouched on the edges of tables and shelves. Such is life these days, in many corners of the world. While proof of vaccination is ostensibly required to, say, dine indoors at a restaurant in Greece, only a couple of individuals bothered to ask me for such verification.

Then again, much of what visitors want to see and do in this part of the world in July is outdoors, whether it's hitting the Acropolis in Athens, the beaches around Nafplion, the cafes of Santorini, or the wineries in Crete. Being outside — where the risk of COVID transmission is substantially lower than it is inside — is part of the allure of Greece in the summertime, whether you're there on a cruise or not. Besides, more than 49 percent of Greece's residents have been fully vaccinated, a stat that may explain some of the nonchalance I noticed along the way.

Overall, being on the ship and in Greece felt very much like the past few months in my home city of New York, where, in mid-July, masks were required on public transit, yes, but seen less often in other places. (Since my trip, New York has tightened its protocols again.)

Broadly speaking, there seemed to be two unwritten rules in Greece, both on land and aboard the ship: outdoors, anything goes. Indoors, probably better to throw that mask on. For me, this thinking never felt burdensome or excessive — in fact, I appreciated that the rules, at least on the ship, were simple to follow and consistently applied. In the end, we were all, in more ways than one, in the same boat.

Greece Covid-19: Travel Updates

Last update: May 3rd, 2022 Disclaimer: The following information is subject to future short notice changes & updates. From May 1st 2022 and as long as the epidemiological data allow so , travelers of all ages are no longer requested to demonstrate any COVID19-related document .

GENERAL GREECE COVID-19 INFORMATION

Important Note: Covid-19 protocols for traveling to and in Greece are suspended ! • From May 1st, 2022 onwards, travellers visiting Greece, regardless of the country of origin, are no longer requested to demonstrate a vaccination certificate, a Covid-19 test or a proof of recovery. • From March 15th, 2022 onwards, travellers visiting Greece are no longer required to fill out the Passenger Locator Form (PLF). For more information, please consult: https://travel.gov.gr/#/ .

TRAVELLING BY FERRY

To travel by ferry in Greece and the Greek island s: • A vaccination certificate or, proof of Covid-19 recovery , or a negative covid test result is not necessary . • Face masks (FFP2 or N95) are obligatory in all interior and exterior areas of the ferry. If you do not wear a mask you will not be allowed to board the ferry. Exception: Only passengers who are not allowed to wear masks due medical reasons with according proof and children under 4 years old will be allowed to board without wearing a mask. To travel by ferry from Greece to Italy , all passengers more than 6 years old need to have one of the following certificates: • A full vaccination certificate issued by a certified authority, carried out less than 9 months ago, (EU Digital Certification or equivalent certification for the Italian authorities) OR • A PCR test of less than 72 hours OR • A Rapid Antigen test of less than 48 hours OR • An official proof of COVID-19 recovery which is valid on the trip date, not more than 6 months should have passed after the first positive test result, (EU Digital Certification or equivalent certification for the Italian authorities). Do you need to make a test in Athens or the Greek islands? Find out the laboratories & medical centers located in popular destinations.

DISCOVER MORE ABOUT GREECE

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Greece Releases Updated Rules for Port Activity

In view of the opening of tourism and the arrival of the first cruise ship to Greece today, the health ministry released updated health and Covid-19 management protocols to be enforced at all Greek ports.

The new rules apply to all forms of transport making use of ports including coastal ferries, cruise ships, and international ferry operators . 

Besides the guidelines for embarkation and disembarkation, the regulations which apply to port authorities, cruise companies and ferry operators, also require contingency planning and standard operating procedures (SOP) in case a Covid-19 incident is found on board. 

Among others, port authorities will be required to have designated areas for Covid-19 case management, including special medical and isolation facilities. 

With regard to cruise ships , the ministry sets out terms including number of expected cruise ship arrivals at each port daily and for the entire tourism season as well as the number of passengers allowed to disembark. 

Furthermore, Greek ports have been designated as home ports, contingency ports, or transit ports.

According to the new regulations:

– embarkation/disembarkation of crew and passengers is allowed as long as it does not coincide with other arrivals in terms of time and space;

– each port depending on the number of cruise ship arrivals will be required to have Covid-19 management infrastructure in place including treatment and quarantine space;

– crowding should be avoided and distancing measures enforced at all times and at all spaces including sites, attractions etc;

– all passengers will be required to fill in a PLF form;

– mask wearing is obligatory at all times.

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After 500 days without cruising, Norwegian Cruise Line is back in action with Greece sailing

Norwegian Cruise Line is back in action. 

Because of the COVID-19 pandemic, Norwegian hadn't sailed with passengers for 500 days, according to the company, and the Norwegian Jade became the cruise line's first ship to resume service when sailed Sunday from Athens, Greece. 

Norwegian Jade will sail to the Greek Isles on voyages from Athens to Crete, Mykonos, Rhodes and Santorini through November. 

The ship is the first of the 17-ship Norwegian fleet to recommence voyages. On Aug. 7, Norwegian Encore will be the first ship to return to cruising in U.S. waters after the COVID-19 hiatus with Alaska cruises from Seattle .

"Welcoming our guests and crew on board has been one of the most memorable moments of my over 30-year career," Harry Sommer, president and chief executive officer of Norwegian Cruise Line, said in a statement. 

Greek Minister of Tourism Harry Theoharis added: "We are overjoyed to welcome Norwegian Jade and her guests to Greece. The planned itineraries will offer unique experiences that combine our rich history, bustling culture and famous gastronomy."

Norwegian Cruise Line Holdings Ltd., parent company to Norwegian Cruise Line, Regent Seven Seas Cruises and Oceania Cruises, announced in April that it would require all passengers and crew on its ships to be fully vaccinated  two weeks before boarding. The requirement stands for voyages through Oct. 31.

The company filed suit in Florida this month over the state’s law prohibiting "vaccine passports," a term referring to proof of vaccination.   

Norwegian Cruise Line expands Europe presence

The Norwegian Jade is the first of the Norwegian Cruise Line’s ships to home port in Athens. The new home port has been established as part of the line’s strategy to increase its presence in Europe. Through 2023, the company plans to position nine ships in the region, with seven of those scheduled to sail in Greece. 

Sommer said Norwegian Jade’s first Greek Isles voyages sold out quickly. 

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Greece: Cruise ship cleared to go after COVID scare

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ATHENS, Greece (AP) — Health inspectors in Greece said Tuesday that an emergency docking order for a cruise ship near Athens can now be lifted after crew members suspected of having been infected with COVID-19 tested negative.

The Maltese-flagged Mein Schiff 6, carrying more than 1,500 people, was rerouted from a Greek island cruise and ordered to sail to the port of Piraeus after sample testing of the crew indicated that 12 staff were positive for coronavirus but asymptomatic.

Gkikas Magiorkinis, a member of the government’s pandemic expert committee, said that all 12 crew members tested negative Tuesday, using rapid and confirmatory tests, along with 24 other people they had come into contact with.

“So there is now no concern over this particular cruise ship. We also tested surfaces on the ship and all surfaces tested are negative,” Magiorkinis told reporters.

Officials at the Merchant Marine Ministry said the cruise ship would remain in Piraeus, near the Greek capital, overnight. The ship was expected to continue its journey Wednesday after port authorities had received formal notification of the health inspection.

The vessel, operated by TUI Cruises, has 922 passengers and 666 crew members on board and began its trip late Sunday from the port of Iraklio, on the island of Crete.

Passengers had undergone coronavirus tests before boarding.

Greece has seen a rise in confirmed COVID-19 infections in recent weeks, registering 416 new ones on Tuesday and 5 new deaths. More than half of the new infections were in the greater Athens region, which has become the main hotspot in the country.

Greece has seen over 18,000 infections and 388 confirmed virus-related deaths, but experts say all figures undercount the true toll of the pandemic due to missed cases and limited testing.

Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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Coronavirus Updates

People should avoid cruise travel regardless of their vaccination status, the cdc says.

Jonathan Franklin

The Carnival Cruise Line's Carnival Sunrise ship is seen in the port of Miami on Dec. 23, 2020, amid the coronavirus pandemic. Daniel Slim/AFP via Getty Images hide caption

The Carnival Cruise Line's Carnival Sunrise ship is seen in the port of Miami on Dec. 23, 2020, amid the coronavirus pandemic.

The Centers for Disease Control and Prevention issued a new advisory Thursday that travelers should avoid traveling by cruise ship, regardless of vaccination status, after a recent surge in positive COVID-19 cases onboard ships.

The agency increased its travel warning for cruises to Level 4 — the highest level — following investigations of dozens of ships that have had outbreaks of the virus.

"Even fully vaccinated travelers may be at risk for getting and spreading COVID-19 variants," the CDC said on its website .

Shots - Health News

Tracking the coronavirus around the u.s.: see how your state is doing.

Following the identification of the omicron variant, there has been an increase in the number of COVID-19 cases among cruise passengers and crew reported to the agency, the CDC said.

More cruise ships have reached "level yellow" — the level where the CDC investigates a ship's COVID outbreak.

"It is especially important that travelers who are at an increased risk of severe illness from COVID-19 avoid travel on cruise ships, including river cruises, worldwide, regardless of vaccination status," the agency added.

More cruise ships are under CDC investigation following COVID-19 outbreaks on board

There are 91 cruise ships currently under investigation or observation, according to the CDC website. However, the agency has not specified how many COVID-19 cases have been reported, according to The Associated Press .

An additional three ships are being monitored.

The CDC advised that those who choose to travel on a cruise should get vaccinated against COVID-19 before their trip and, if eligible, receive a booster dose.

In addition, masks should also be worn in shared spaces and passengers who are not fully vaccinated against COVID should self-quarantine for five days after travel, in addition to getting tested three to five days after their return, the CDC said.

Goats and Soda

The goal: at least 40% vaxxed in all nations by year-end. this map shows how we stand.

In an email to NPR, a spokesperson for the Cruise Lines International Association said the trade group was "disappointed" by the CDC's latest advisory against cruise ship travel.

"While we are disappointed and disagree with the decision to single out the cruise industry—an industry that continues to go above and beyond compared to other sectors—CLIA and our ocean-going cruise line members remain committed to working collaboratively with the CDC in the interest of public health and safety," the trade group said .

Most cruise lines require adult passengers to show proof of vaccination against COVID-19, according to AP.

For now, CDC guidanc e allows cruise ships to relax measures — such as mask usage — if at least 95% of passengers and 95% of the cruise ship crew are fully vaccinated against the coronavirus.

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What to Know Before Your Cruise

Travel requirements, required travel documentation and information for cruise vacations, last updated: october 6, 2023.

CRUISE THE USA WITH NO RESTRICTIONS: The United States Department of Homeland Security has announced that end of day May 11, 2023, vaccination requirements for international travelers will be lifted, allowing open travel within the U.S. to non-citizens regardless of vaccination status. We’re thrilled to welcome all international guests back on our U.S. based ships and we look forward to making more vacation dreams come true all around the world.

Country Specific Travel Requirements Note:

Norwegian Cruise Line works closely with local government and health authorities to gather travel requirements for the destinations we visit. While this information is provided as a courtesy to our guests, destinations we travel to may have very specific entry requirements due to health and safety protocols.

Currently, there are no active protocol requirements specific to cruise line guests in any of the destinations we embark in and/or call to. However, we strongly encourage all guests to check back frequently for updates as protocols are always subject to change.

If traveling internationally, the countries you are flying to and/or connecting through may have different testing and vaccination/booster stipulations. We encourage you to visit the government and airport websites of every country you will be traveling to throughout your journey to familiarize yourself with their requirements. It is the responsibility of the guest to ensure they meet the entry requirements for each destination. Guests may be denied boarding if all country-specific requirements are not met.

For All Sailings

As you prepare for your upcoming sailing, we want to ensure that your embarkation process runs smoothly and inform you of the following important requirements.

Norwegian Cruise Line recommends for all guests to follow, and where possible, sign up for notifications from their local government on international travel regulations that may prevent, restrict, or require additional documentation when traveling to another country for embarkation or during their cruise. Please note, hotels booked through NCL for a pre and/or post hotel cruise stay may have additional protocols and requirements. Please check with the hotel directly for further information.

To learn more about our protocols and pre-cruise requirements check out our Sail Safe™ Health & Safety Program page.

The below country specific protocols apply to cruises departing from or calling on specific countries identified unless otherwise specified. Effective January 5, 2023, enhanced health screening is required for all guests that have recently visited Mainland China, Hong Kong, or Macau.

Countries Without Additional Travel Restrictions

The following Countries do not have any additional regulations. All guest are still required to follow Norwegian's Health and Safety Protocols.

• North America: Canada, United States
• Central America: Belize, Honduras, Mexico
• Europe: Belgium, Denmark, England, Estonia, Faroe Island, Finland, France, Germany, Iceland, Ireland, Malta, Netherlands, Northern Ireland, Norway, Poland, Scotland, Shetland Island, Sweden, Turkey
• Caribbean: Antigua, Bahamas, British Virgin Islands, Dominican Republic, Puerto Rico, St. Maarten, U.S Virgin Islands

The following Countries do not have any additional regulations. All guests are still required to follow Norwegian's Health and Safety Protocols.

All unvaccinated guests under the age of 12 will be required to bring proof of a negative NAAT test (i.e. PCR) result administered by a verified third party within three days prior to embarkation date. Failure to comply will result in denial of boarding .

Additionally, unvaccinated guests under the age of 12 on sailings from or to a U.S. or Canada port will be subject to additional testing at embarkation and disembarkation administered and paid for by the cruise line, as part of the U.S Centers for Disease Control (CDC) Voluntary COVID-19 Program for Cruise Ships Operating in U.S. Waters.

• Luggage tags must be attached to each piece of luggage when arriving at the port to expedite the baggage drop-off process.

At time of check-in, all guests will be required to provide proof of a negative COVID-19 antigen or NAAT test (i.e. PCR) result administered by a verified third party or via medically supervised home test two days prior to embarkation date for cruises originating in a U.S. or Canadian port and within three days prior for voyages departing from a non-U.S. port.

• Guests must bring digital or printed proof of negative test results. Test results need to be in English and include the following information:
• Your name, which should match the name on your travel documents
• Your date of birth
• The result of the test
• The date the test sample was collected
• The name of the test provider
• Confirmation of the type of test provided
• In order to facilitate, Norwegian has partnered with Inspired Diagnostics lab to ensure that guests have access to a quick, efficient and easy way to access the required FDA-approved proctored in-home antigen test prior to embarkation from the comfort of their own home. Inspired Diagnostics is a subsidiary of Inspire Health Alliance, a leader in best-in-class health services. Testing at home is safe, simple, and convenient. Purchasing in-home testing kits is simple.
• Sign up on the testing site https://inspirediagnostics.com/ncl/
• Receive the test kit(s) by UPS
• Schedule an on-line proctoring consultation
• Receive certified results via email
• Guests are also responsible for complying with all local health and safety requirements which may include additional pre-embarkation testing at the terminal. On select sailings where local government or health authorities may require guests to partake in additional COVID-19 testing prior to boarding, NCL will provide free testing at the terminal. Please refer to Cruise Travel Requirements by Country for country specific requirements.
• All unvaccinated guests under the age of 12 on sailings from or to a U.S. or Canadian port will be required to bring proof of a negative NAAT Test (i.e. PCR) result administered by a verified third party within three days prior to embarkation date. Failure to comply will result in denial of boarding. Additionally, these guests will be subject to additional testing at embarkation and disembarkation administered and paid for by the cruise line, as part of the U.S Centers for Disease Control (CDC) Voluntary COVID-19 Program for Cruise Ships Operating in U.S. Waters.
• Other available pre-embarkation testing services: Additionally, the following services offer a verified third party or medically supervised at home testing: https://www.emed.com/ or BioReference-Scarlett Concierge testing service – BioReference sends a trained Scarlet Health Professional to your home to collect your COVID-19 test specimen.
• Locate a Covid-19 Testing Provider Prior to Your Cruise: Should you need to locate a testing provider prior to beginning travel or while traveling prior to your cruise, please visit TestForTravel.com , an easy-to-use online tool for locating COVID-19 testing providers around the world. Simply enter your zip code, or city and country, and the website will display locations, contact information, and testing hours. It also allows you to search by test type – PCR or Antigen.

To understand the earliest you should test prior to your cruise vacation, see below:

FOR ALL CRUISES:

Mandatory Vaccinations

All guests age 12 and over must be fully vaccinated at least 2 weeks prior to departure, acknowledge vaccination status prior to sailing and present proof of vaccination at the pier at embarkation.

Failure to comply with the requirements will unfortunately result in denial of embarkation. Guests who are denied embarkation or re-boarding for failure to comply with Norwegian Cruise Line's COVID-19 Policies and Procedures shall not be entitled to a refund or compensation of any kind. For more information, please click here .

It is the responsibility of the guest to be aware of any local protocols and/or travel restrictions in place at the visiting destinations at the time of sailing. Some ports of call may require guests to carry their proof of vaccine when going ashore.

Face coverings may be required in certain settings to comply with local requirements, for example in terminals for embarkation and disembarkation or at ports of call.

For additional information on all you need to know to prepare for an amazing vacation ahead, click here .

Protocols may vary by itinerary; we will do our very best to communicate itinerary specific protocols with you as soon as the information becomes available. On certain sailings, guests should be prepared for the possibility of an additional COVID-19 test prior to boarding, which will be provided in the terminal on a complimentary basis.

As government regulations evolve, our health and safety protocols will evolve as needed to ensure compliance. This may mean different protocols from ship to ship based on local state or port requirements or in an abundance of caution to keep our guests and crew as safe as possible.*

*Please note, in the event a port included as part of an itinerary requires additional COVID-19 testing in order for guests to disembark, Norwegian Cruise Line will facilitate the testing onboard.

Testing Requirements:

• An antigen test will be administered at the terminal and a negative result is required – this test will be paid for and administered by Norwegian Cruise Line.

Testing must be administered by a verified third party.

Below only applies for sailings visiting Tasmania.

•  Vaccinated guests are required to provide proof of negative COVID-19 test in addition to vaccination documentation, as listed above, only for sailing to Tasmania.

•  Antigen tests may be self-administered. Guests choosing to use a self- administered COVID-19 antigen test must provide a timestamped photo showing the negative test result, the antigen test packaging displaying the batch number, and an I.D. (e.g., passport).

• At this time, the Bahamas Government will only be accepting vaccines by Pfizer-BioNTech, Moderna, Johnson & Johnson Janssen, AstraZeneca/Oxford, Sinopharm and Covaxin or Sinovac. Refer to https://www.bahamas.com/travelupdates for most up to date vaccine requirements.
• Guests must present government issued vaccination card in order to disembark.

For sailings September 3, 2022 and beyond:

• Tours approved for sale by tour operators through a Norwegian Cruise Line booked shore excursion.
• Guests exercising this option must take approved taxis dispatched from secured designated taxi facilities within the Bridgetown port, or must have a pre-booked tour confirmed by email from an approved tour operator for pick-up in the Bridgetown port.

FOR ALL SAILINGS VISITING BERMUDA ON OR BEFORE NOVEMBER 13, 2022

PLEASE NOTE: All guests must complete Bermuda Travel Authorization (TA) within 30 days of sailing. The cost of the Travel Authorization is $40 per guest. Link to form: https://www.gov.bm/cruise-travel-authorisation

For sailings through September 2, 2022:

• Pre-cruise:
• All guests over the age of 2 must provide proof of negative test per standard Sail Safe testing requirements apply.
• Bermuda government does not allow certificate of recovery in lieu of negative test result. 
• If the ship takes longer than 5 days to arrive in Bermuda,  all guests , regardless of vaccination status, will be required to take an additional antigen test onboard no more than 2 days prior to disembarking in Bermuda. This test will be paid for and administered by our onboard medical team.

All guests must have an approved Travel Authorization before embarkation.

• A travel authorization number will be issued by Bermuda once approved.
• If you have any issues with the process, please contact:
• Bermuda Tourism Authority: 1.833.570.2594 (toll-free)
• Norwegian Cruise Line: 1.800.327.7030

Valid proof of health insurance for travel to Bermuda includes:

• Guests who have purchased BookSafe Standard, BookSafe Platinum, or Essentials travel protection through Norwegian Cruise Line may upload their cruise confirmation that shows travel protection coverage type as their proof of travel health insurance.
• Insurer name and address
• insured traveller’s name
• confirmation medical expenses are covered, including COVID-19 coverage (or "all medical expenses covered")
• Period of coverage: insurance coverage, start and end date
• Note: Unvaccinated children 11 years and under travelling with fully vaccinated parents/guardians can upload their guardian’s vaccination certificate instead of proof of travel health insurance.

FOR ALL SAILINGS VISITING BERMUDA ON OR AFTER NOVEMBER 14, 2022

• Nothing required
• ** Approximate cost per Covid-19 Antigen test is $95. Approximate cost per PCR is $199. This cost may vary and is the responsibility of the guest. We will share guests’ test results in the Bermuda Maritime Declaration and those guests with a negative result will be able to go ashore.

FOR ALL SAILINGS BEFORE OCTOBER 22, 2022

** Approximate cost per Covid-19 Antigen test is $95. Approximate cost per PCR is $199. This cost may vary and is the responsibility of the guest. We will share guests’ test results in the Bermuda Maritime Declaration and those guests with a negative result will be able to go ashore.

For Sailings on or after September 30, 2022:

Canada has removed all COVID-19 entry restrictions for all travelers regardless of citizenship. Guests will no longer have to:

• submit public health information through the ArriveCAN app or website
• provide proof of vaccination
• undergo pre- or on-arrival testing
• carry out COVID-19-related quarantine or isolation
• monitor and report if they develop signs or symptoms of COVID-19 upon arriving to Canada.

For Sailings on or before September 29, 2022:

PLEASE NOTE: All guests must complete ArriveCAN submission within 72 hours of embarkation. ArriveCAN receipt must be presented at check in on embarkation day. Guests must select "Arriving by Ship."

For cruises originating from or sailing to a Canadian port (which may include Alaska itineraries):

Vaccination Requirements:

• All guests age twelve and older must be fully vaccinated at least two weeks prior to arrival.
• Embarkation:  all guests must provide proof of negative NAAT test (i.e. PCR) taken within 72 hours prior to embarkation, or negative antigen test taken within 48 hours of embarkation.
• All unvaccinated guests ages 5-11 will also be required to take an additional test at embarkation. This test will be paid for and administered by Norwegian Cruise Line.
• Please note, any embarkation testing in Vancouver will be administered at an offsite location, a 5 minute walk from the port at 757 West Hasting Street. There are no embarkation testing services available in the terminal.
• Mid Cruise Testing: required for unvaccinated guests ages 5-11. This test will be paid for and administered by Norwegian Cruise Line.
• Disembarkation Testing (for cruises ending in a Canadian port only): unvaccinated guests ages 5-11 will be tested onboard at disembarkation. This test will be paid for and administered by Norwegian Cruise Line.

Face Coverings:

Required ashore in business establishments based on local requirements.

Itineraries that include Croatia require a booster: All guests over the age of 18, whose primary COVID-19 vaccination will be beyond 270 days at the time of disembarkation from their voyage, must have a COVID-19 booster prior to embarkation.

• In lieu of a booster 270 days after the primary series, guests may present a government recognized or official medical Certificate of Recovery.
• For European Citizens, this would include an EU Green Pass or comparable certificate.
• For all others unable to present an EU Green Pass (i.e. U.S. citizens) a doctor’s note, plus a laboratory confirmed PCR test result with the proper information (i.e. name, date, date of birth, positive result, etc.) will be accepted.

*  Approximate cost per COVID-19 antigen test is $95. The approximate cost per PCR is $199. These costs may vary and are the responsibility of the guest.

For guests having recently visited Mainland China, Hong Kong, or Macau:

As a result of growing concerns regarding COVID-19 in China, and recently implemented travel restrictions by countries including the United States, we are proactively implementing preventative health and safety measures beginning January 5th for all sailings embarking between Jan 5 – Feb 28, 2023.

• Guests who have visited Mainland China, Hong Kong, or Macau within 10 days prior to embarkation will be required to submit proof of a negative medically supervised COVID-19 PCR test taken within 48 hours prior to the beginning of travel from their place of residence or place they had been visiting immediately prior to their cruise. This also applies to guests transiting through an airport in one of the aforementioned countries within 10 days prior to embarkation.
• Additionally, these guests will be required to take a medically supervised COVID-19 PCR test at the embarkation port within 8 hours of embarkation, and will be required to test onboard the ship every 48 hours until 10 days have passed from their last time in China, Hong Kong, or Macau.
• These guests must also be fully vaccinated and boosted with a World Health Organization approved vaccine prior to embarkation.
• Guests that hold a Chinese, Hong Kong, or Macau passport will be subject to the same protocols unless they can provide proof they have not visited these regions within 10 days prior to embarkation.

Expenses related to all required COVID-19 tests will be the guest’s responsibility. Testing onboard ships is currently offered at $99 per person per test.

* Please note, a COVID-19 Recovery Certificate may be presented as an alternative to the testing requirement as noted above.

• For European citizens, this would include an EU Green Pass or comparable certificate.
• For guests unable to present an EU Green Pass (i.e. U.S. citizens), a doctor’s note, plus a laboratory-confirmed PCR or antigen test result with the proper information (i.e. name, date, date of birth, positive result etc.) will be accepted.

Masks are required for all visitors

For cruises originating from a Greece port ( i.e. Piraeus and Crete ):

** Approximate cost per COVID-19 antigen test is $95. The approximate cost per PCR is $199. These costs may vary and are the responsibility of the guest.

*** All guests age 18 and over, whose primary COVID-19 vaccination will be beyond 270 days at the time of disembarkation from their voyage, must have a COVID-19 booster prior to embarkation to be considered up-to-date.

• In lieu of a booster 270 days after the primary series, guests may present a government recognized or official medical Certificate of Recovery (dated no less than 10 days and no more than 180 days before embarkation).

• Effective on 5/7/22 and beyond masks are optional on all sailings, unless visiting ports in Italy. In these ports, masks are required while indoors.
• Italian ports specifically require KN95/FFP2 type masks.
• Adhere to local regulations when visiting ports.
• Puerto Caldera, Costa Rica: Guests are required to wear a mask ashore. Only authorized vaccines Pfizer/BioNTech, AstraZeneca/Oxford, Moderna or Johnson & Johnson are accepted.

• Colon, Panama: Guests must show proof of vaccination to go ashore.

Travel requirements may vary from country to country in Europe.

Embarkation Requirements

For cruises embarking in Greece: all guests ages 2 and older must show proof of negative NAAT (PCR) performed 72 hours prior to embarkation or Antigen test performed 48 hours prior to embarkation. Medically supervised or proctored self-tests will not be accepted. If guest does not show proof of a valid test, an antigen test will be administered at the terminal covered by Norwegian.

• For cruises originating from Piraeus, Greece:
• Negative COVID-19 antigen administered by a verified third party within 2 days of the embarkation date (Proctored Self-administered home test not accepted)
• Negative NAAT (PCR) test administered by a verified third party within 3 days of the embarkation (Proctored Self-administered home test not accepted)
• COVID-19 Recovery Certificate*

* Individuals who test positive within 180 days of their scheduled embarkation date, do not require pre-arrival testing.

• EU Green Pass or comparable certificate for European citizens
• A doctor’s note, plus a laboratory-confirmed PCR test result with the proper information (i.e. name, date, date of birth, positive result etc.), for all others unable to present an EU Green Pass (i.e. US Citizens)
• For Sailings to Bermuda, the government does not allow certificate of recovery in lieu of negative test result. 
• France: In order to be eligible to enter France as a vaccinated person for guests who received a one shot vaccine (Johnson & Johnson), at least four weeks must have passed after the shot.

All guests age 12 and over must present proof of full vaccination against COVID-19.

EU Healthy Gateways currently defines individuals as "Fully Vaccinated" against COVID-19 if they carry proof of vaccination with at least 14 days and no more than 270 days passed since the last dose of the primary vaccination series or if they have received a third or booster dose. To clarify, guests that have received a booster dose can travel regardless of the amount of time that has passed since their booster dose. Booster requirements vary by country as follows:

Booster Requirements:

• Northern Europe/Baltic Itineraries (Baltic, British Isles & Iceland) do not require a booster.
• Itineraries that include Italy, Spain, Greece, France, and Portugal require a booster, for all individuals 18 years or older , if their original vaccine course was taken more than 270 days prior to embarkation.
• For itineraries which require boosters, in lieu of a booster 270 days after the primary series, guests may present a government recognized or official medical Certificate of Recovery.
• For all others unable to present an EU Green Pass (i.e. US Citizens) a doctor’s note, plus a laboratory confirmed PCR test result with the proper information (i.e. Name, Date, Date of Birth, Positive Result, etc.) will be accepted.
• Children and Teens between the ages of 12 and 17: Full vaccination protocol at least two weeks after receipt of the final dose of Pfizer-BioNTech, Moderna or any WHO approved vaccine . Children under the age of 12 are not required to show proof of vaccination.

Guests who cannot meet the above requirements should not travel to the ship as they will be unable to board.

Effective 6/12/22, guests will no longer be required to show proof of negative Covid test to return to the United States.

Disembarkation Testing for all Norwegian Dawn and Jade sailings beginning June 12,2022 and beyond and for all Norwegian Epic, Escape, and Gem sailings beginning June 17, 2022 and beyond:

In order to best comply with local regulations, all guests who require proof of a negative COVID-19 test in order to return to their home country, will now have the following options:

• Purchase an easy-to-use telemedicine kit onboard (subject to availability)
• Visit a local clinic

For an easy-to-use online tool for locating COVID-19 testing providers around the world, please visit www.TestForTravel.com .

MALTA FORMS

Going Ashore:

All Guests who do not hold an EU-COVID certificate and intending to go ashore will need to use VeriFLY.  

• After creating a secure profile on their mobile device, passengers will upload vaccine information and other documentation as required directly into the VeriFLY app.
• Under the "Add other" section, select “Malta arrivals”. Once the information is completed and vaccine picture is uploaded, you have successfully submitted for review.
• The VeriFLY app will verify that the passenger's information matches the requirements set by Malta and displays a simple pass or fail message.
• Following that, the passenger will be guided to fill in the Passenger Locator Form for entry into Malta.
• The VeriFLY app is available on Google Play and on the Apple App Store, and users shall be able to activate their “Trip to Malta” pass, which encapsulates the requirements for entry into Malta. It is highly recommended that guests download the app and complete the required information prior to embarkation.

The above will not be required for guests opting to remain onboard the ship and not proceed ashore.

EU Healthy Gateways currently defines individuals as “Fully Vaccinated” against COVID-19 if they carry proof of vaccination with at least 14 days and no more than 270 days passed since the last dose of the primary vaccination series or if they have received a third or booster dose.  To clarify, guests that have received a booster dose can travel regardless of the amount of time that has passed since their booster dose.

• For EU sailings Pfizer-BioNTech vaccine will be accepted for vaccinated children and teens between the ages of 5 and 17 and Moderna (Spikevax) for children 12-17 years of age.

Guests who cannot meet the EU Healthy Gateways definition of “Fully Vaccinated” should not travel to the ship as they will be unable to board.

• All guests must provide proof of negative antigen test within 24 hours prior to embarkation. This test will be paid for and administered by Norwegian Cruise Line.

Required on shore in public areas of Greece based on local requirements. Face coverings must be KN95/FFP2.

Includes the following ports of call: Papeete, Moorea, Bora Bora, Raiatea

French Polynesia currently defines individuals as "Fully Vaccinated" against COVID-19 if they carry proof of vaccination with at least 14 days and no more than 270 days passed since the last dose of the primary vaccination series or if they have received a third or booster dose. To clarify, guests that have received a booster dose can travel regardless of the amount of time that has passed since their booster dose.

• Please note that any guest whose primary COVID-19 vaccination will be beyond 270 days at the time of disembarkation from their voyage MUST HAVE a COVID-19 "booster" prior to embarkation if sailing out of Papeete. Guests arriving with the vessel, are not required to have the booster shot.
• Booster requirement from authorities in French Polynesia only applies to travelers over 18 years old.
• Unless with French Polynesian High Commission endorsement, there is no exemption for the adult travelers whose second dose is over 9 months.

Guests who cannot meet French Polynesia definition of "Fully Vaccinated" should not travel to the ship as they will be unable to board.

• All guests visiting Grenada must apply for a "Pure Safe" travel authorization prior to travel. The authorization form should be completed prior to commencing travel and can be found here: https://covid19.gov.gd/
• All guests over the age of 12 must be fully vaccinated and provide proof of vaccination when going ashore.
• Guests will be required to wear a face covering ashore.
• All guests visiting Grenada must be booked on a Norwegian Cruise Line shore excursion, a pre-booked independent tour, or use an authorized taxi in order to go ashore.

Guests will be required to take a Norwegian Cruise Line organized shore excursion for ports in Italy as guests will not be allowed to explore on their own.

Richard’s Bay has no entry restrictions therefore is exempt from below

• Guests are not permitted to walk off the port of Ocho Rios, Jamaica . In order to go ashore while in Ocho Rios, guests must comply with one of the following:
• Book a Norwegian Cruise Line shore excursion.
• Book a restricted or controlled freelance tour. This is the traditional Taxi Freelance Line.
• Walk or take transportation to Island Village, Harbour Shops & Taj Mahal Shopping Centre. These shops are closed to the public on ship days and opened exclusively for cruise passengers.

All guests must complete a Passenger Locator Form (PLF) within 96 hours prior to the estimated time of arrival into Portugal. A QR code will be generated that may be presented upon arrival.

• At this time, the Madeira islands are only accepting the following vaccines: AstraZeneca, Pfizer, Moderna, Johnson & Johnson/Janssen, Sinovac, Instituto, Buntantan, Instituto Gambaleya (Sputnik V) Sinopharm (VeroCell)

All guests age 12 and older must provide proof of negative NAAT test (I.e. PCR) taken within 72 hours prior to embarkation or antigen test taken within 24 hours of embarkation.

Going Ashore and Testing Requirements:

• Fully vaccinated guests do not require additional testing beyond their standard pre-embarkation test. To go ashore, guests must bring approved document of vaccination, EU COVID certificate, or CDC card.
• Unvaccinated guests must be show proof of negative PCR test (72 hours prior to arrival) or Antigen Test (24 hours prior to arrival). This test will be facilitated and paid for by NCL onboard.

• Residents of Puerto Rico:
• Complete the Online Travel Declaration Form (TDF) from the Puerto Rican Department of Health and Safety, which can be found here, https://www.travelsafe.pr.gov . This must be completed PRIOR to disembarking the ship and guests must show proof of the resulting QR code at disembarkation. Passengers must select option number two (2) which establishes that the passenger will perform a molecular or antigen test at an authorized facility in Puerto Rico within 48 hours after disembarkation. Passengers who do not comply with the prior arrival test requirement will be imposed a $300 fine.
• San Juan, Puerto Rico:
• Effective 1.16.2022, Puerto Rico will implement post-cruise testing requirements for guests who are disembarking in Puerto Rico as follows:
• Must have a COVID-19 test performed within 48 hours after disembarking the ship.
• Non-residents of Puerto Rico departing the same day of disembarkation:
• No additional testing is required to disembark the ship.
• Non-residents of Puerto Rico staying overnight in Puerto Rico after the cruise:
• Must complete the Travel Declaration Form (TDF) prior to disembarkation at https://www.travelsafe.pr.gov
• Must have a COVID-19 antigen test performed within 48 hours prior to disembarking the ship.
• Norwegian Cruise Line will facilitate the test that is required (cost may apply).
• Guests who secured their flights and/or post cruise hotel stay with Norwegian Cruise Line will not be charged for the test.
• Guests who secured their flights and/or post cruise hotel stay independently will be responsible for the cost of the COVID-19 test:
• $99 per person for an antigen test
• $150 per person for a PCR test (if required)  

• For cruises originating from a U.S. port:
• negative COVID-19 antigen administered by a verified third party within 2 days of the embarkation date or
• negative NAAT (PCR) test administered by a verified third party within 3 days of the embarkation
• Negative NAAT test (i.e., PCR) result administered by a verified third party within three days of the embarkation date, as well as additional antigen testing at embarkation and disembarkation administered and paid for by NCL. Failure to comply will result in denial of boarding.
• unvaccinated children under the age of 12 will be subject to additional testing at embarkation and disembarkation administered and paid for by NCL. 
• All unvaccinated guests under the age of 2 do not need to complete a pre-cruise test.
• All unvaccinated guests age 12 and above are unable to cruise

*Individuals who test positive within 90 days of their scheduled embarkation date, do not require pre-arrival testing.

• A doctor's note, plus a laboratory-confirmed PCR test result with the proper information (i.e. name, date, date of birth, positive result etc.), for all others unable to present an EU Green Pass (i.e. US Citizens)
• For Sailings to Bermuda, the government does not allow certificate of recovery in lieu of negative test result.

Testing Requirements to Return to US:

• Effective 6/12/22, fully vaccinated guests will no longer be required to show proof of negative Covid-19 test or documentation of recovery from COVID-19 prior to return to the United States.
• Only unvaccinated guests ages 2-12 require a disembarkation test. Individuals under 2 years of age are exempt from any testing requirements.

Booster Requirement

• To be considered fully vaccinated on itineraries that include Spain, guests age 18 and over must have a booster if their original vaccine was received 270 days or more prior to embarkation.
• For all others unable to present an EU Green Pass (i.e. US Citizens) a doctor's note, plus a laboratory confirmed PCR or antigen test result with the proper information (i.e. Name, Date, Date of Birth, Positive Result, etc.) will be accepted.
• Guests who cannot meet the above requirements will need to follow the requirements for "unvaccinated" guests.
• Tours and activities within the bubble tour arrangements provided through a Norwegian Cruise Line booked shore excursion.
• Walk-around activities within the port's restaurant and bars areas.
• Visiting designated taxi booths to arrange for certified taxi operators to take them to a certified area that's been approved by the local government.

At this time, the Croatian Government will only consider guests to be fully vaccinated if they received their vaccines less than 365 days prior to arriving in Croatia i.e. guests with a 2 dose vaccine, the 2nd dose must have been received less than 365 days prior to arrival in Croatia; guests with a 1 dose vaccine, the vaccine must have been received less than 365 days prior to arrival in Croatia. Guests who have had their 2nd dose of a 2 dose vaccine, or their 1 dose vaccine more than 365 days prior to arriving in Croatia will not be able to go ashore while in port.

Guests must show proof of vaccination to go ashore.

On Europe sailings, the EU Healthy Gateways guidance requires all guests to wear masks while onboard while indoors except for when actively eating or drinking or when in their stateroom.

• Guests will be required to wear masks outdoors when social distancing is not possible.
• Guests will also be required to adhere to local regulations when visiting ports of call.

• For guests embarking in Civitavecchia (Rome), Italy : The Italian government requires all travelers entering Italy to complete an EU Digital Passenger Location Form (dPLF) before entering the country.
• For guests embarking or disembarking in Civitavecchia (Rome), Italy: Guests who have received the Sinovac vaccine will only be permitted to sail on cruises that embark or disembark in Civitavecchia (Rome) if they have not been to a “List E” country (as defined on the Italian government’s website) for at least 15 days prior to arriving in Italy.
• For more information, click here .
• For guests embarking in Barcelona, Spain : The Spanish government requires all travelers entering Spain to complete a Health Control Form before entering the country.
• For guests embarking in Piraeus (Athens), Greece: The Greek government requires all travelers entering Greece to complete a Passenger Location Form (PLF) before entering the country. This must be completed no later than 11:59 p.m. the day before entering Greece and only one PLF should be submitted per family. After completing the PLF, travelers will receive a unique QR code.

Due to local government regulations, guests are required to take a Norwegian Cruise Line shore excursion while visiting ports in Italy as guests will not be allowed to explore on their own. Book your shore excursions through your MyNCL account.

Guests must wear a face mask when going ashore.

• For guests that are boarding our ship immediately upon arrival in Argentina: At the time of check-in, guests will be required to provide proof of a negative COVID-19 PCR test result administered by a verified third party within three days prior to sail date.  As you are embarking the ship on Sunday, the test must be taken no earlier than Thursday. 
• For guests that live in Argentina or who are staying in Argentina in a hotel prior to boarding our ship: At the time of check-in, guests will be required to provide proof of a negative COVID-19 PCR test results administered by a verified third party within 2 days prior to sail date . As you are embarking the ship on Sunday, the test must be taken no earlier than Friday.
• Argentina: All guests must complete a sworn affidavit for arrival to and departure from all ports in Argentina. The form can be found here: https://ddjj.migraciones.gob.ar/app/home.php
• Uruguay: All guests must complete an online Health Declaration form prior to entering all ports in Uruguay. The form can be found here: https://declaracionjurada.ingresoauruguay.gub.uy/ING
• Chile: All guests must complete a sworn affidavit and mobility pass form. The sworn affidavit can be found here: www.c19.cl and the mobility pass form can be found here: https://mevacuno.gob.cl/
• All of the above can be completed up to 15 days prior to arrival in each port.

Vessels repositioning to the United States must undergo full guest COVID-19 testing prior to arrival. All guests sailing to the United States on a transatlantic voyage will receive a COVID-19 test while onboard. This test will be paid for by the Cruise Line.

A COVID-19 Recovery Certificate may be presented as an alternative to the testing requirement as noted above in select countries.

• At check in, these guests must have one of the below acceptable forms of COVID-19 Recovery available (dated no less than 10 days and no more than 90 days (US, Caribbean, Central and South America) and 180 days (EU and Canada) before embarkation):
• This excludes all voyages visiting Bermuda.

Do You Need to Be Vaccinated to Cruise? It Depends on the Ship and Destination

While most cruise lines have scrapped covid vaccine and testing requirements, some companies and international cruise ports still have vaccination and testing rules in place..

• Copy Link copied

If you’re planning on sailing with Viking anytime soon, you’d better track down that COVID-19 vaccine certificate.

Courtesy of Viking

When cruising restarted in spring 2021, after a nearly 15-month pandemic-spurred shutdown imposed by the U.S. Centers for Disease Control and Prevention (CDC), cruisers faced a barrage of rules, including strict requirements for COVID-19 vaccinations and precruise COVID-19 testing. Later, the rules started to go by the wayside, and it was hard to keep track of who was requiring what. Not anymore.

Most cruise lines have now dropped or are soon dropping rules for both vaccinations and precruise testing, with at least one notable exception. Viking —on its river, ocean, and expedition ships—still requires everyone on board be fully vaccinated .

Another line that was still requiring COVID vaccinations, small-ship line Windstar Cruises, will be scrapping its vaccine mandate as of June 1, 2023. “We’ve invested in and improved our health and safety processes, including upgrading the HVAC systems on all of our ships, which has led to a cleaner and safer environment on board,” says Windstar president Christopher Prelog. “When combined with the widespread availability of vaccines and medical treatments, the risk factors are considerably lower now, giving us the confidence to lift the requirement.”

Are COVID vaccinations and testing still required for cruises?

Most cruise lines have dropped both their vaccine and testing requirements. Those that have lingered into 2023—mostly lines operating smaller ships—have been quietly scaling back their requirements.

The result: While there was a time after cruising restarted that you could be assured that your fellow passengers, at least those age 12 and up, were both fully vaccinated and tested for COVID-19 before getting on the ship, that is not the case anymore.

That said, specific countries have their own requirements, and several countries still require that cruise ship passengers are vaccinated and/or tested before arrival. If you are doing an itinerary outside of the Caribbean or Europe (where most vaccine and testing requirements have been dropped)—including to select countries in Central and South America or to Australia—you still have to read your cruise line’s precruise health and safety information carefully to make sure you comply with the latest requirements.

Contact your cruise line or check the U.S. State Department’s travel advisories for the latest.

What to know before you cruise

Vaccine and pretrip testing requirements can be confusing, especially if you are cruising internationally. Cruise lines have their own rules; countries have their own rules.

Before your trip, you will need to review your cruise line’s health and safety protocols. If a precruise test is required by a certain country, you will find that noted. In this case, you may be required to arrive at your ship with a negative COVID-19 test result in hand or not. (If testing is required, it can typically be either a PCR test or tele-health-monitored antigen test , paid for by the passenger. The cruise line may also require a test at the pier, paid for by the cruise line.)

If being fully vaccinated is required, that means having received the original series of vaccines at least 14 days prior to your cruise, or the original series plus a booster shot or shots.

As was the case even before the pandemic, you will be asked at embarkation to fill out a questionnaire inquiring about your current health status and whether you currently have any symptoms of illness.

You are free to pack and wear masks on your cruise. Most cruise lines suggest you do wear masks in crowded indoor situations—but it’s not enforced.

A quick cruise line guide to COVID requirements

Here’s a rundown of the basic rules for some leading cruise lines. Note: There may be additional requirements if you are traveling internationally. Be sure to review the latest requirements prior to boarding.

American Queen Voyages

On American Queen Voyages’ river, ocean, Great Lakes, and expedition ships, there are no longer any precruise testing or vaccinations required. Face coverings are optional, though masks may be required of any passengers showing symptoms.

Precruise testing is no longer required for vaccinated guests sailing with Azamara , except in ports where testing is required. No vaccination is necessary for cruises departing from or returning to the United States or Europe. In Australia, all guests 12 years and older must be fully vaccinated at least 14 days before sailing with all required COVID-19 vaccine doses (including a booster shot). Children under 12 years old are not required to be vaccinated.

Celebrity Cruises

No vaccination or testing is required on the majority of Celebrity Cruises sailings. Destinations with stricter requirements include: the Galápagos, Australia and New Zealand, transatlantic crossings, and select Central and South America itineraries. Unvaccinated guests need to be tested in Brazil, Chile, and Colombia.

As of April 23, 2023, on the Queen Mary 2 and Queen Victoria , and as of June 8, 2023, on the Queen Elizabeth , vaccinations and testing will no longer be required by Cunard (until then, testing and vaccination requirements apply).

Disney Cruise Line

For sailings embarking from the United States, which are the bulk of Disney Cruise Line’s sailings, no vaccination or testing is required. Disney recommends all guests be vaccinated before sailing and take a test for COVID-19 two days prior to their cruise. There are additional requirements on repositioning cruises and in Australia, so it is important to check the line’s website before your cruise.

Holland America Line

There are no precruise testing or vaccination requirements on most Holland America Line itineraries. There are requirements on select voyages (you can look up a specific voyage’s requirements on the line’s website).

Lindblad Expeditions

For voyages embarking on or after May 11, 2023, Lindblad Expeditions will no longer require guests to be fully vaccinated, although the line recommends guests be fully vaccinated (for cruises prior to that time, all passengers age five and up must be vaccinated). Lindblad recommends, but does not require, passengers take a predeparture COVID-19 test within five days of the start of their expedition.

Oceania Cruises

Vaccine requirements are purely dependent on the destinations being visited on each Oceania cruise. Passengers are advised to be up to date on the latest regulations for all destinations on their cruise itinerary.

Paul Gauguin Cruises

Effective April 2023, Paul Gauguin Cruises no longer requires that passengers are vaccinated or tested for COVID prior to embarkation, but it continues to encourage vaccination. “Paul Gauguin Cruises’ officers, staff and crew will remain fully vaccinated,” the line states. Travelers will need to present a health declaration form at embarkation.

Regent Seven Seas Cruises

Vaccines and precruise testing are generally not required to sail with Regent Seven Seas Cruises . There are some requirements in place based on local health regulations in a specific country a ship is visiting. Regent notifies guests approximately 30 days prior to sailing of any country-specific protocols.

Royal Caribbean

No vaccine or precruise testing is required on the majority of Royal Caribbean itineraries, with a few exceptions: Cruises from Australia, transpacific and transatlantic sailings, and cruises from Hawai‘i to Vancouver.

No vaccine or testing required except on certain Seabourn itineraries where a country may have specific requirements.

No vaccination is required for Silversea passengers except as designated by the destination. Precruise testing is not required except when specified by a destination.

Viking Cruises

All passengers and crew are required to be vaccinated on Viking’s river, ocean, and expedition ships—without exception. Viking strongly recommends passengers receive a booster dose before departing. Viking recommends but does not require a predeparture COVID-19 test (except if required by a destination).

Virgin Voyages

Virgin Voyages has no precruise testing or vaccination requirements. Masks may be required at select times.

Windstar Cruises

Beginning June 1, 2023, Windstar will no longer require guests to be vaccinated. Crew will continue to be vaccinated. Masks are optional, with the line highly recommending guests wear masks in indoor public spaces. All guests fill out a health questionnaire on embarkation. A precruise COVID-19 test is not required unless you show symptoms.

This article was originally published in May 2022; it was most recently updated on April 19, 2023, with current information.

There's COVID-19 on nearly every cruise ship right now: Here's what cruisers need to know

Things are getting iffy again for cruisers -- at least for those with near-term bookings.

The ongoing surge in COVID-19 cases around the world is causing a growing number of disruptions to itineraries and even some last-minute cancellations of entire voyages.

The number of passengers being quarantined on ships (after testing positive for COVID-19) also is on the rise. And passengers who aren't COVID-19 positive are getting caught up in short-term quarantines for being "close contacts" of shipmates who are.

For more cruise guides, tips and news, sign up for TPG's cruise newsletter .

Meanwhile, just getting to ships is becoming increasingly stressful, as getting the pre-cruise COVID-19 test that's often required before cruising is getting more difficult . Plus, a "perfect storm" of soaring COVID-19 cases and rough winter weather has wreaked havoc with airline operations for weeks.

Still, the situation isn't anywhere near as dramatic or disruptive as what we saw at the start of the COVID-19 pandemic two years ago, when whole ships were being quarantined due to outbreaks of the illness and, eventually, the entire industry shut down.

As I saw myself during a cruise to Antarctica in recent weeks, many sailings are operating relatively normally, even when there are COVID-19 cases on board.

Here's a look at everything you need to know if you've got a cruise booked in the coming weeks -- or further out.

COVID-19 cases on ships are up a lot

While cruise ships have recorded relatively few cases of COVID-19 over the past year, in part due to unusually strict health protocols , the number of passengers and crew testing positive on ships has been rising sharply in recent weeks along with the greater surge on land.

At the end of December, the U.S. Centers for Disease Control and Prevention reported that 5,013 COVID-19 cases had been reported on cruise vessels operating in U.S. waters during the last two weeks of the month, up from just 162 cases during the first two weeks of the month.

That's a 3,094% increase.

Anecdotal reports are that the number of cases on ships is up even more in the first 10 days of the new year.

Notably, all 92 cruise vessels currently operating in U.S. waters have recorded at least a handful of COVID-19 cases in recent weeks, according to CDC data.

Still, it's important to note that most of these "cases" of COVID-19 are asymptomatic or mild, only discovered during routine testing. While some ships only are testing passengers who report feeling ill for COVID-19 (and close contacts of those who subsequently test positive), other ships are testing every single passenger at least once per voyage, sometimes more. One line, Viking , is testing every single passenger for COVID-19 every day.

Cruise lines also are testing all crew members regularly.

The result is the detection of many asymptomatic cases that otherwise would have gone undetected. This is a level of surveillance that is much greater than what is the norm for other travel venues such as land-based resorts or theme parks, and it can give the false impression that the positivity rate for COVID-19 on ships is unusually high as compared to other places.

If anything, the positivity rate is far lower on ships than on land, thanks to much stricter health protocols (more on that in a moment).

It's also important to note that the detection of COVID-19-positive passengers or crew on board your ship won't necessarily impact your sailing (unless you are among those testing positive).

Health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19. The current protocol on most ships is to isolate COVID-19-positive passengers and crew but otherwise continue on with voyages as planned.

Your itinerary could change

While health authorities no longer are quarantining whole ships when a few passengers or crew test positive for COVID-19, the presence of the illness on board a vessel still could result in notable disruptions to your itinerary.

Cruise lines in recent weeks have faced a growing number of ports that are balking at allowing ships with COVID-19-positive passengers or crew to dock.

Several ships recently had to skip port calls in Mexico , for instance, after passengers and crew on board the vessels tested positive for COVID-19. The ports have since reopened after Mexico's Health Department overruled the decisions of local port officials.

Cruise ships also have had to cancel stops recently at the islands of Aruba, Bonaire and Curaçao, and at San Juan, Puerto Rico, due to local worries about COVID-19-positive passengers and crew on board and/or tighter COVID-19-related entry requirements.

Lines also are dealing with a small but growing number of destinations -- India and Hong Kong, for example -- that are at least temporarily closing to cruising completely, even for ships where no one has tested positive for COVID-19.

Viking on Sunday was forced to announce a major revision of its soon-to-begin, 120-day world cruise after India notified the line it was closing to cruise ships. Viking's 930-passenger Viking Star will begin its world cruise this week by heading south from Los Angeles to Central America and South America instead of sailing westward toward Asia, where it was scheduled to spend a significant amount of time in India.

Your cruise could be canceled on short notice

A growing number of cruise lines are canceling sailings on short notice, citing the disruptions caused by COVID-19. The world's largest cruise operator Royal Caribbean on Friday canceled soon-to-depart sailings on four of its 25 ships, including the next three departures of the world's largest ship, Symphony of the Seas .

Norwegian Cruise Line on Wednesday canceled soon-to-depart voyages on eight of its 17 ships.

Other lines canceling one or more sailings in recent days include Holland America , Silversea , Atlas Ocean Voyages, Regent Seven Seas Cruises, MSC Cruises , Costa Cruises and Oceania Cruises .

The cancellations come as lines struggle to maintain adequate staffing levels on some ships due to crew members testing positive. When crew test positive, they and their close contacts must stop working and isolate, even if asymptomatic, leaving shipboard venues short-staffed.

You probably won't be quarantined, stranded or stuck

As noted above, health authorities no longer are quarantining whole ships when a few -- or even a lot -- of passengers and crew test positive for COVID-19.

The current protocol on most ships is to quickly isolate COVID-19-positive passengers and their close contacts. But only the COVID-19-positive passengers are being isolated long term.

As my colleague Ashley Kosciolek experienced first-hand on a cruise in 2021, close contacts only are being isolated for a short period while they are tested for COVID-19. If they test negative, they typically are allowed out of their rooms to rejoin the rest of their fellow cruisers on board.

This means that many sailings are going ahead as planned, with little disruption, even when some passengers and crew on the trips test positive for COVID-19. I experienced this myself in late December when on a Silversea vessel where four passengers tested positive for COVID-19. Some passengers who were deemed close contacts of the passengers who tested positive were isolated for a short period while being tested for COVID-19. But the positive cases had little impact on most of the passengers on board the vessel, and the voyage went ahead as planned.

Such a protocol comes at the recommendation of the CDC, which has set guidelines for how cruise lines should respond to COVID-19-positive cases on board ships, and it has worked well for the past year .

Of course, if you do test positive for COVID-19 on a ship, you will, unfortunately, face what could be several days of isolation in a cabin on a ship or on land. If you are an American cruising overseas, you also won't be able to return to the U.S. until you have tested negative for COVID-19 (or until you recover from the illness and are cleared in writing to travel by a licensed healthcare provider or a public health official).

This is one of the biggest risks of taking a cruise right now, and one reason you may consider canceling a sailing scheduled in the short term (see the section on more-flexible cancellation policies below).

Most COVID-19 cases on ships aren't serious

Cruise lines are reporting that the vast majority of passengers testing positive for COVID-19 in recent weeks are asymptomatic or have mild symptoms.

All major cruise lines currently are requiring all or nearly all passengers to be fully vaccinated for COVID-19, with some also starting to require booster shots , to boot. This creates an onboard population that is far less likely to experience serious symptoms of COVID-19 than a cross-section of people on land, according to CDC data.

For all adults ages 18 years and older, the cumulative COVID-19-associated hospitalization rate is about eight times higher in unvaccinated persons than in vaccinated persons, according to the latest CDC data.

You'll face lots of new health protocols

If you haven't cruised since before the pandemic, you might be surprised by how many new health- and safety-related policies cruise lines have implemented to keep COVID-19 off ships.

For starters, there are the vaccine mandates noted above. No other segment of the travel industry has been as uniform in requiring almost every customer to be fully vaccinated against COVID-19.

Related: Will I need a COVID-19 vaccine to cruise? A line-by-line guide

As noted above, cruise lines also are requiring passengers to undergo COVID-19 tests before boarding ships -- a screening process that is keeping many COVID-19 positive people from ever stepping on board a vessel.

When COVID-19 is detected on a ship, cruise lines sometimes then test passengers multiple times to ensure it isn't spreading. On my recent trip to Antarctica, I underwent six COVID-19 tests in just eight days -- three in advance of stepping on board the vessel (including a PCR test required by Chile, where my trip began) and three while on board.

In addition, most cruise lines now are requiring passengers to wear masks at all times while in interior spaces of vessels, and they have stepped up cleaning regimens, improved air filtration systems on ships and made other onboard changes.

The CDC says to avoid cruising for now

On Dec. 30, the CDC added cruise ships to its list of "Level 4" destinations you should avoid visiting for now due to high levels of COVID-19.

For what it's worth, more than 80 countries around the world -- including a good chunk of all the places you might want to travel -- are on this list. So, the CDC is basically telling you that now isn't a good time to travel. Fair enough. But the warning shouldn't be seen as a call-out on any elevated risk to cruising as opposed to visiting other places, per se.

Places on the Level 4 list currently include Canada, much of Europe and nearly every country in the Caribbean.

The cruise industry has been highly critical of the designation, arguing that cruise ships are far safer places to be right now than almost anywhere else, given their strict health protocols.

"The decision by the CDC to raise the travel level for cruise is particularly perplexing considering that cases identified on cruise ships consistently make up a very slim minority of the total population onboard — far fewer than on land — and the majority of those cases are asymptomatic or mild in nature, posing little to no burden on medical resources onboard or onshore," the main trade group for the industry, the Cruise Lines International Association, said in a statement to TPG.

You can cancel if you're worried (in many cases)

If you're booked on a cruise in the coming weeks, and you're having second thoughts, there's a good chance you can get out of your trip. Many lines continue to be far more flexible than normal about cancellations.

Take cruise giant Carnival Cruise Line . Its current flexible cancellation policy allows passengers to cancel as long as a public health emergency remains in effect and receive 100% of the cruise fare paid in the form of a future cruise credit. Passengers are also able to cancel if they test positive for COVID-19. (Proof of a positive test result is required.)

Another large line, Norwegian, just last week extended its pandemic-era Peace of Mind policy to allow passengers to cancel any sailing taking place between now and May 31. For now, the cancellation needs to be done by Jan. 31, and the refund would come in the form of a future cruise credit to be used on any sailing that embarks through Dec. 31.

That means you could call the line right now to back out of a cruise that is just days away. In normal times, you'd lose all your money if you backed out of a seven-night Norwegian cruise with fewer than 31 days' notice.

Planning a cruise? Start with these stories:

• A beginners guide to picking a cruise line
• The 5 most desirable cabin locations on any cruise ship
• The 8 worst cabin locations on any cruise ship
• A quick guide to the most popular cruise lines
• 21 tips and tricks that will make your cruise go smoothly
• 15 ways cruisers waste money
• What to pack for your first cruise

Coronavirus outbreak for crew on cruise ship in Greece

ATHENS, Greece (AP) — Greek authorities say 12 crew members on a Maltese-flagged cruise ship carrying more than 1,500 people on a Greek islands tour have tested positive for coronavirus and have been isolated on board.

The Mein Schiff 6, operated by TUI Cruises, began its trip in Heraklion on the southern Greek island of Crete on Sunday night, with 922 passengers and 666 crew members on board, Greece’s Shipping Ministry said Monday. It had been due to sail to Piraeus, the country’s main port near the Greek capital of Athens, and later to the western island of Corfu.

Sample tests for coronavirus were carried out on 150 crewmembers and 12 were positive but asymptomatic, the ministry said. The passengers had undergone coronavirus tests before boarding.

Greek health authorities said the ship would arrive at Piraeus on Tuesday and a National Public Health Organization team will re-test the 12 positive cases, as well as anyone else deemed necessary by the ship’s crew and doctor.

Greece on Monday recorded 269 new confirmed infections, most of them in the greater Athens region, and four coronavirus-related deaths. That brings the total cases in the country of 10 million to about 17,700, and the overall death toll to 383.

More on COVID-19

• Chinese scientist who published virus sequence allowed back in his lab
• Chinese scientist who first published COVID sequence stages protest after being locked out of lab
• ‘Don’t inject bleach’: Biden mocks Trump on anniversary of COVID comments
• Fauci agrees to testify in Congress on COVID origins, pandemic policies
• COVID can damage heart even without infecting it
• FDA authorizes new drug to protect high-risk patients from COVID
• Your 2024 guide to COVID symptoms and treatment
• Our collected list of stories about COVID-19

Follow AP pandemic coverage at http://apnews.com/VirusOutbreak and https://apnews.com/UnderstandingtheOutbreak

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• Section 8 - Road & Traffic Safety
• Section 8 - Motion Sickness

Cruise Ship Travel

Cdc yellow book 2024.

Author(s): Kara Tardivel, Stefanie White, Aimee Treffiletti, Amy Freeland

Cruise Ship Medical Capabilities

Illness & injury, infectious disease health risks, noninfectious health risks, travel preparation.

Cruise ship travel presents a unique combination of health concerns. Travelers from diverse regions brought together in the often crowded, semi-enclosed shipboard environment can facilitate the spread of person-to-person, foodborne, and waterborne diseases. Outbreaks on ships can be sustained over multiple voyages by crewmembers who remain onboard, or by persistent environmental contamination. Port visits can expose travelers to local diseases and, conversely, be a conduit for disease introduction into shoreside communities.

Some people (e.g., those with chronic health conditions or who are immunocompromised, older people, pregnant people) merit additional considerations when preparing for a cruise. Because travelers at sea might need to rely on a ship’s medical capabilities for an extended period, potential cruise passengers with preexisting medical needs should prepare accordingly by calling the cruise line’s customer service center to learn what type and level of health care services are (and are not) available on specific ships.

Medical facilities on cruise ships can vary widely depending on ship size, itinerary, cruise duration, and passenger demographics. Generally, shipboard medical centers can provide medical care comparable to that of ambulatory care centers; some are capable of providing hospitalization services or renal dialysis. Although no agency officially regulates medical practice aboard cruise ships, the American College of Emergency Physicians (ACEP) published consensus-based guidelines for cruise ship medical facilities in 1995, and updated the guidelines in 2013. ACEP guidelines , which most major cruise lines follow, state that cruise ship medical facilities should be able to provide quality medical care for passengers and crew; initiate appropriate stabilization, diagnostic, and therapeutic maneuvers for critically ill or medically unstable patients; and assist in the medical evacuation of patients in a timely fashion, when appropriate.

Cruise ship medical centers deal with a wide variety of illnesses and injuries; ≈10% of conditions reported to cruise ship medical centers are an emergency or require urgent care. Approximately 95% of illnesses are treated or managed onboard, with the remainder requiring evacuation and shoreside consultation for dental, medical, or surgical issues. Roughly half of all passengers seeking medical care are >65 years old.

Medical center visits are primarily the result of acute illness or injury. The most frequently reported diagnoses include respiratory illnesses (30%–40%); injuries from slips, trips, or falls (12%–18%); seasickness (10%); and gastrointestinal (GI) illness (10%); 80% of onboard deaths are due to cardiovascular events.

Infectious Disease Outbreaks

The most frequently reported cruise ship outbreaks involve GI infections (e.g., norovirus), respiratory infections (e.g., coronavirus disease 2019 [COVID-19], influenza), and other vaccine-preventable diseases (VPDs), such as varicella. Although cruise ships do not have public health authority, to reduce the risk of introducing communicable diseases, some ships conduct medical screening during embarkation to identify ill passengers, prevent them from boarding, or require isolation if permission to board is given.

Before travel, to help limit the introduction and spread of communicable diseases on cruise ships, prospective cruise ship travelers and their clinicians should consult the Centers for Disease Control and Prevention (CDC) Travelers’ Health website for updates on outbreaks and destination-specific travel health notices. People who become ill with a communicable disease before a voyage should consult their health care provider and delay their travel until they are no longer contagious. When booking a cruise, travelers should check the trip cancellation policies and consider purchasing trip cancellation insurance (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

Travelers who become ill during a voyage should seek care in the ship’s medical center; the onboard staff will provide clinical management, facilitate infection-control measures, and take responsibility for reporting potential public health events. For information on how to report travelers who become ill with suspected communicable diseases after they return home from a cruise, see Sec. 8, Ch. 8, Airplanes & Cruise Ships: Illness & Death Reporting & Public Health Interventions .

Gastrointestinal Illnesses

During 2006–2019, rates of GI illness among passengers on voyages lasting 3–21 days fell from 32.5 to 16.9 cases per 100,000 travel days. Despite the decrease, outbreaks continue to occur. CDC assists the cruise ship industry to prevent and control the introduction, transmission, and spread of GI illnesses on cruise ships. See information on cruise ship GI illnesses and updates on GI illness outbreaks involving ships with US ports of call, specifically.

On cruise ships, >90% of GI illness outbreaks with a confirmed cause are due to norovirus. Characteristics of norovirus that facilitate outbreaks include a low infective dose, easy person-to-person transmissibility, prolonged viral shedding, absence of long-term immunity, and the ability of the virus to survive routine cleaning procedures (see Sec. 5, Part 2, Ch. 16, Norovirus ). For international cruise ships porting in the United States during 2006–2019, an average of 12 norovirus outbreaks occurred each year.

Other Sources of Gastrointestinal Illness

GI outbreaks on cruise ships also have been caused by contaminated food or water; most outbreaks were associated with  Campylobacter ,  Clostridium perfringens , or enterotoxigenic  Escherichia coli .

Protective Measures

Travelers can reduce the risk of acquiring a GI illness on cruise ships by frequently washing hands with soap and water, especially before eating and after using the restroom. Travelers should call the ship’s medical center promptly, even for mild symptoms of a GI illness, and strictly follow cruise ship guidance regarding isolation and other infection-control measures.

Respiratory Illnesses

Respiratory illnesses are the most common medical complaint on cruise ships. During the pretravel visit, evaluate whether vaccines or boosters (e.g., COVID-19, influenza) are needed and emphasize the importance of practicing good respiratory hygiene and cough etiquette while onboard. As with GI illnesses, cruise ship passengers should report respiratory illness to the medical center promptly and follow isolation recommendations as instructed.

Coronavirus Disease 2019

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, spreads more easily between people in close quarters, and multiple studies have concluded that transmission rates of SARS-CoV-2 among travelers on ships are much greater than in other settings. Cruise ship COVID-19 outbreaks can tax onboard medical and public health resources. Ship-to-shore medical evacuations to facilities capable of providing higher levels of medical care can present logistical challenges and pose additional risks to ill patients.

Cruise passengers and crewmembers who are not up to date with their COVID-19 vaccines are at increased risk for severe illness, hospitalization, medical evacuation, and death. Since cruising will always pose some risk of SARS-CoV-2 transmission, ensure that people planning cruise ship travel are up to date with their vaccinations, and assess their likelihood for developing severe COVID-19. For people at increased risk of severe COVID-19 regardless of their vaccination status (e.g., pregnant people, people who are immunocompromised), discuss the potential health hazards associated with cruise ship travel. CDC has developed recommendations and guidance designed to help cruise ship operators provide a safer and healthier environment for crewmembers, passengers, port personnel, and communities.

Historically, influenza has been among the most often reported VPDs occurring on cruise ships. Because passengers and crew originate from all regions of the globe, shipboard outbreaks of influenza A and B can occur year-round, with exposure to strains circulating in different parts of the world (see Sec. 5, Part 2, Ch. 12, Influenza ). Thus, anyone planning a cruise should receive the current seasonal influenza vaccine ≥2 weeks before travel if vaccine is available and no contraindications exist. For people at high risk for influenza complications, health care providers should discuss chemoprophylaxis and how and when to initiate antiviral treatment.

See additional guidance on the prevention and control of influenza on cruise ships .

Legionnaires’ Disease

Less common on cruise ships, Legionnaires’ disease is nevertheless a treatable infection that can result in severe pneumonia leading to death (see Sec. 5, Part 1, Ch. 9, Legionnaires’ Disease & Pontiac Fever ). Approximately 10%–15% of all Legionnaires’ disease cases reported to CDC occur in people who have traveled during the 10 days before symptom onset. Clusters of Legionnaires’ disease associated with hotel or cruise ship travel can be difficult to detect, because travelers often disperse from the source of infection before symptoms begin. Data reported to CDC during 2014–2015 included 25 confirmed cases of Legionnaires’ disease associated with cruise ship exposures.

In general, Legionnaires’ disease is contracted by inhaling warm, aerosolized water containing the bacteria,  Legionella . Transmission also can sometimes occur through aspiration of  Legionella -containing water. Typically, people do not spread  Legionella  to others; a single episode of possible person-to-person transmission of Legionnaires’ disease has been reported. Contaminated hot tubs are commonly implicated as a source of shipboard  Legionella  outbreaks, although potable water supply systems also have been culpable. Improvements in ship design and standardization of water disinfection have reduced the risk for  Legionella  growth and colonization.

Diagnosis & Reporting

People with suspected Legionnaires’ disease require prompt antibiotic treatment. When evaluating cruise travelers for Legionnaires’ disease, obtain a thorough travel history of all destinations during the 10 days before symptom onset to assist in identifying potential sources of exposure, and collect urine for  Legionella  antigen testing. Most cruise ships have the capacity to perform this test, which detects  L. pneumophila  serogroup 1, the most common serogroup.

Perform culture of lower respiratory secretions on selective media to detect non– L. pneumophila  serogroup 1 species and serogroups. Culture also is used for comparing clinical isolates to environmental isolates during an outbreak investigation. Notify CDC of any travel-associated Legionnaires’ disease cases by sending an email to [email protected]. Quickly report all cases of Legionnaires’ disease to public health officials, who can determine whether a case links to previously reported cases and work to stop potential clusters and new outbreaks.

Other Vaccine-Preventable Diseases

Although most cruise ship passengers come from countries with routine vaccination programs (e.g., Canada, the United States), many of the crew are from low- or middle-income countries where immunization rates can be low. Outbreaks of hepatitis A, measles, meningococcal disease, mumps, pertussis, rubella, and varicella have all been reported on cruise ships. The majority (82%) of these outbreaks occur among crewmembers; prior to the COVID-19 pandemic, varicella was the most frequently reported VPD. Other VPDs (e.g., pertussis) occur more often among passengers.

Each cruise line sets its own policies regarding vaccinations for its crew; some have limited or no requirements. Thus, all passengers should be up to date with routine vaccinations before travel, as well as any required or recommended vaccinations specific for their destinations. People of childbearing age should have documented immunity to measles, rubella, and varicella (either by vaccination or titer) before cruise ship travel.

Vectorborne Diseases

Some cruise ship ports of call include destinations where vectorborne diseases (e.g., dengue, Japanese encephalitis, malaria, yellow fever, Zika) are known to be endemic. In addition, new diseases can surface in unexpected locations; chikungunya was reported for the first time in the Caribbean in late 2013, with subsequent spread throughout the region and numerous other North, Central, and South American countries and territories. Zika was first reported in Brazil in 2015, and subsequently spread across the Caribbean and Latin America, sparking concern because of its association with microcephaly and other congenital abnormalities in the fetus. For disease-specific information, see the relevant chapters of Section 5.

For guidance on how to avoid bites from mosquitoes and other disease-transmitting arthropod vectors, both onboard and while on shore at ports of call, see Sec. 4, Ch. 6, Mosquitoes, Ticks & Other Arthropods . For specific details on yellow fever vaccination and malaria prevention, see Sec. 2, Ch. 5, Yellow Fever Vaccine & Malaria Prevention Information, by Country .

Stresses of cruise ship travel include varying weather and environmental conditions, and unaccustomed changes to diet and levels of physical activity. Despite modern stabilizer systems, seasickness is a common complaint, affecting up to 25% of travelers (see Sec. 8, Ch. 7, Motion Sickness ). Note that travel is an independent risk factor for behaviors such as alcohol and illicit drug use and misuse (see Sec. 3, Ch. 5, Substance Use & Substance Use Disorders ), and unsafe sex (see Sec. 9, Ch. 12, Sex & Travel ).

Cruise ship travelers have complex itineraries due to multiple short port visits. Although most port visits do not include overnight stays off ship, some trips offer travelers the opportunity to venture off the ship for ≥1 night. These excursions can complicate decisions about exposures and the need for specific antimicrobial prophylaxis, immunizations, and other prevention measures.  Boxes 8-04  and  8-05  summarize recommended cruise travel preparations and healthy behaviors during travel for health care providers and cruise ship travelers.

Box 8-04 Healthy cruise travel preparation: a checklist for health care providers

Risk assessment & risk communication.

☐ Discuss itinerary, including season, duration of travel, and activities at ports of call. ☐ Review the traveler’s medical and immunization history, allergies, and any additional health needs. ☐ Discuss relevant travel-specific health hazards and risk reduction. ☐ Provide travelers with documentation of their medical history, immunizations, and medications.

VACCINATION & RISK MANAGEMENT

☐ Provide routinely recommended (age-specific), required (yellow fever), and recommended vaccines. ☐ Discuss safe food and water precautions. ☐ Discuss insect bite prevention. ☐ Provide older travelers with a baseline electrocardiogram, especially those with coronary artery disease.

MEDICATIONS BASED ON RISK & NEED

☐ Consider prescribing malaria chemoprophylaxis if itinerary includes stops in malaria-endemic areas. ☐ Consider prescribing motion sickness medications for self-treatment.

Box 8-05 Healthy cruise travel preparation: a checklist for travelers

☐ Carry prescription drugs in original containers with a copy of the prescription and a physician’s letter. ☐ Check the Centers for Disease Control and Prevention (CDC) Outbreak Updates for International Cruise Ships website for gastrointestinal outbreaks. ☐ Consider purchasing additional insurance coverage for overseas health care and medical evacuation. ☐ Consult medical and dental providers before cruise travel. ☐ Consult CDC Travelers’ Health website for travel health notices . ☐ Defer travel while acutely ill. ☐ Evaluate the type and length of the planned cruise in the context of personal health requirements. ☐ Notify the cruise line of additional health needs (e.g., dialysis, supplemental oxygen, wheelchair). ☐ Pack Environmental Protection Agency (EPA)–registered insect repellent; consider treating clothes and gear with permethrin. ☐ Pack sunscreen.

DURING TRAVEL

☐ Avoid contact with people who are ill. ☐ Follow safe food and water precautions when eating off ship at ports of call. ☐ Maintain good fluid intake and avoid excessive alcohol consumption. ☐ Practice safe sex. ☐ Report all illnesses to ship’s medical center and follow their recommendations. ☐ Use insect bite precautions during port visits, especially in vectorborne disease–endemic areas or areas experiencing outbreaks of vectorborne diseases (e.g., Zika, yellow fever) ☐ Use sun protection. ☐ Wash hands frequently with soap and water; if soap and water are not available, use ≥60% alcohol–based hand sanitizer.

POST TRAVEL

☐ See CDC’s latest post-cruise health guidance regarding coronavirus disease 2019.

Travelers with Additional Considerations

Travelers with chronic illnesses and travelers with disabilities who have additional needs (e.g., dialysis, supplemental oxygen, wheelchairs) should inform their cruise line before traveling. Highly allergic travelers and travelers with underlying medical conditions should carry a file that contains essential, pertinent health information (e.g., allergies, blood type, chest radiograph [if abnormal], chronic conditions, electrocardiogram, medication list, primary and/or specialty care provider contact information). Travelers also should bring any medications recommended by their health care provider (e.g., an epinephrine auto-injector) to help facilitate care during a medical emergency. For detailed information on preparing travelers who have additional considerations for international travel, including severe allergies, chronic illness, disabilities, or immune compromise, see Section 3.

Pregnant Travelers

Most cruise lines have policies that do not permit people to board after their 24th week of pregnancy. Contact cruise lines directly for specific guidance before booking. For additional information on preparing pregnant people for international travel, see Sec. 7, Ch. 1, Pregnant Travelers .

Insurance Coverage

All prospective cruise travelers should verify coverage with their health insurance carriers and, if not included, consider purchasing additional insurance to cover medical evacuation and health services received onboard cruise ships and in foreign countries (see Sec. 6, Ch. 1, Travel Insurance, Travel Health Insurance & Medical Evacuation Insurance ).

The following authors contributed to the previous version of this chapter: Kara Tardivel, Stefanie B. White, Krista Kornylo Duong

Bibliography

Hill CD. Cruise ship travel. In: Keystone JS, Kozarsky PE, Connor BA, Nothdurft HD, Mendelson M, editors. Travel medicine, 4th edition. Philadelphia: Saunders Elsevier; 2019. pp. 377–82. 

Jenkins KA, Vaughan GHJ, Rodriguez LO, Freeland AL. Acute gastroenteritis on cruise ships—United States, 2006–2019. MMWR Morb Mortal Wkly Rep. 2021;70(6):1–19. 

Kordsmeyer A-C, Mojtahedzadeh N, Heidrich J, Militzer K, von Münster T, Belz L, et al. Systematic review on outbreaks of SARS-CoV-2 on cruise, navy and cargo ships. Int J Environ Res Public Health. 2021;18(10):5195. 

Millman AJ, Kornylo Duong K, Lafond K, Green NM, Lippold SA, Jhung MA. Influenza outbreaks among passengers and crew on two cruise ships: a recent account of preparedness and response to an ever-present challenge. J Travel Med. 2015;22(5):306–11. 

Mouchtouri VA, Lewis HC, Hadjichristodoulou C. A systematic review for vaccine-preventable diseases on ships: evidence for cross-border transmission and for pre-employment immunization need. Int J Environ Res Public Health. 2019;16(15):2713. 

Payne DC, Smith-Jeffcoat SE, Nowak G, Chuwkwuma U, Geibe JR, Hawkins RJ, et al. SARS-CoV-2 infections and serologic responses from a Sample of U.S. Navy service members—USS Theodore Roosevelt, April 2020. MMWR Morb Mortal Wkly Rep 2020;69(23):714–21. 

Peake DE, Gray CL, Ludwig MR, Hill CD. Descriptive epidemiology of injury and illness among cruise ship passengers. Ann Emerg Med. 1999;33(1):67–72. 

Rice ME, Bannerman M, Marin M, Lopez AS, Lewis MM, Stamatakis CE, et al. Maritime varicella illness and death reporting, U.S., 2010–2015. Travel Med Infect Dis. 2018;23:27–33. 

Rocklöv J, Sjödin H, Wilder-Smith A. COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures. J Travel Med. 2020;27(3):taaa030. 

Stamatakis CE, Rice ME, Washburn FM, Krohn KJ, Bannerman M, et al. Maritime illness and death reporting and public health response, United States, 2010–2014. J Travel Med Inf Dis. 2017;19:16–21.

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These three words may reveal when kate middleton will return to public life: opinion.

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When members of the royal family talk to the public, the strangest trifles and details can come out of their mouths.

Last week, Prince William revealed that he thinks it is “very important” to talk to sheep, that he used to like lying down next to his horse and basically spooning it, and that after a hard day of handing out MBEs, he can be found cleaning his children’s guinea pig cage.

Hopefully William, despite having sold his polo ponies years ago, still has at least one filly to spoon because the latest news about his wife, Kate Middleton, suggests that she won’t be seen in public for a very long time.

On Tuesday, UK time, King Charles — who, like his daughter-in-law, is also being treated for cancer — returned to public duties with such grinning gusto, vim and vigor that scientists should think about bottling his pep.

So, with one Windsor patient cleared to return to work, when might the eager lenses of the press and the wall of iPhones being held aloft and the internet and the world get a peek at Kate again?

When might the princess be well enough to get back to her day job of being driven in an armored Range Rover to do her bit?

Ages. Ages and ages, it sounds like.

The Times’ assistant editor Kate Mansey has reported that “Kate is expected to be away from public duties for some time.”

And it’s those last three words, “for some time,” of which we need to take note.

If we run the numbers and look ahead, it could well be at least four months, if not five, at the very earliest that Kate will return to the public eye.

Next week will see the kickoff of royal garden party season, signaling the starting gun being fired on the royal family’s busiest season.

Between now and July, there will be, at the least, the palace garden parties in London and Edinburgh, the Chelsea Flower Show, Royal Ascot, the Order of the Garter day, Trooping the Colour, Wimbledon and the 70th anniversary commemoration of the D-Day landings in Normandy.

Normally, we would be looking at several months of peak Kate exposure.

This year, given the “for some time” line, it seems likely there will be no Kate, no Kate, no Kate, no Kate, no Kate, no Kate, and, you’ll never guess, no Kate at each of these events.

If this is what plays out, the very earliest we might see the Princess of Wales return to work would be in September, after the Windsors take their annual six-week-plus summer vacay, a portion of which it is mandatory for them to spend in Scotland doing battle with gorse prickles.

With Charles’ relaunch this week , what is clear is that Buckingham and Kensington palaces have adopted opposing strategies as their principals face down the C-word.

In February, with the king’s doctors having ruled out him going anywhere near the germy masses, His Majesty has ramped up his social media appearances, with the official royal family accounts spitting out a steady stream of shots showing the besuited (no elasticized lounging pants for a sick monarch) 75-year-old hard at it.

Meanwhile, the line being thrown around has been that even when the king is not doing these ambassadorial meet-and-greets (and an aide is patiently answering his question about what “an Instagram” is), he is busy gnawing away at state documents and having meetings with his private secretary and eminence grise, Sir Clive Alderton.

Now, after only three months, Charles has gotten the medical green light to throw himself back into the thick of it this week, with him and Queen Camilla visiting a London cancer center and looking happier than that one time an overeager equerry offered to burn down the Tate Modern for him.

This campaign of maintaining maximum visibility is the opposite of that adopted by Kate, who has been kept more firmly under wraps than someone who has gone into witness protection. (Windsor protection?)

Here we are in May and the princess has been seen on only four occasions: in that controversial Mother’s Day Franken-photo; as an indistinct, blobby shadow in the back of a car with William; in a short clip with William at the Windsor Farm Shop, the 21st century’s answer to the Zapruder footage; and in her March 22 video revealing that she has cancer and is undergoing preventive chemotherapy.

The princess now exists in a complete and utter informational black hole that probably requires the Hubble Telescope to penetrate.

Aside from the Princess of Wales’ March video, there has been a complete dearth of new information about how she is faring or when the world can tentatively expect to see her floating around a Hereford child care center in a turquoise McQueen blazer while tiny faces look up at her, agog.

Mansey’s “for some time” is the closest thing to even the most remote of pointers about how the rest of the year might unfold.

If ever there was a year that Kate deserved a truly excellent anniversary present, it’s this one, but given Prince Binoculars’ track record, I have my doubts.

The traditional gift for marrieds who have made it this long is lace.

Heaven forbid if he spent Sunday night gift-wrapping a set of doilies.

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7 amazing cruise itineraries to book in 2024

I don't know about you, but each year, as the weather turns cold, I start daydreaming about getting out of Dodge — or, in my case, Pennsylvania. My mind wanders to cruises that will take me to places where the temperature is warmer, but I also take a hard look at the (exceptionally lengthy) list of places I'm longing to visit.

After digging through what's new for 2024, I've come up with a shortlist of sailings that I think are noteworthy. They range from a standard Bahamas voyage with a new twist and an extended Alaska sailing that includes a foray across the Arctic Circle to more far-flung destinations in the Asia-Pacific region.

Dream on, dear reader, and add these to your list of 2024 cruise itineraries.

Note: All prices listed are per person, based on double occupancy, unless otherwise noted. Fares do not include taxes and fees.

For more cruise news, reviews and tips, sign up for TPG's cruise newsletter .

Seabourn's 'Kimberley Expedition: Waterfalls and Wandjinas' itinerary

Last year, the Australia and New Zealand cruise region gained momentum following the pandemic shutdown. In 2024, the hardly populated Australia region of The Kimberley is gaining popularity. Luxury cruise brand Seabourn will be offering a series of six 10-night voyages between Broome and Darwin on expedition vessel Seabourn Pursuit during what will be early winter in the southern hemisphere.

The line's " Kimberley Expedition: Waterfalls and Wandjinas " will take passengers to places along the coast few passengers are able to visit to see the stunning teal waters and horizontal waterfalls of Talbot Bay, sample wines in the Hunter River Region and check out nature preserves in Wyndham.

Details: The first sailing, from Darwin to Broome, embarks on June 12. The final voyage, from Broome to Darwin, departs on Aug. 1. Prices start from $6,134 per person ($613 per person, per night), double occupancy, for the July 2 cruise. All accommodations are suites with balconies.

Celebrity's 'Best of Japan' and 'Vietnam and Thailand' cruises

The number of voyages in Asia was trending upward notably prior to 2020, when the COVID-19 pandemic brought cruising in the region to an extended halt. And it's once again on the rise. Following that curve, Celebrity Cruises will be running new 11- to 13-night Asia sailings in 2024 on two ships — Celebrity Millennium and Celebrity Solstice — that bring stops in Japan, South Korea, Hong Kong, Vietnam and Thailand.

What's notable about the offerings is that they will aim to immerse passengers further into the destinations by including overnights in a total of 11 ports across all itineraries. That means more time to explore Hanoi's Old Quarter as the sun sets, indulge in nighttime gastronomy in Hong Kong, visit one of Bangkok's many markets, or learn why Osaka is known for street food.

Details: Celebrity Millennium's " Best of Japan " cruises run from early mid-March to early October. At press time, the least expensive fares — for a 12-night sailing — start from $1,330 per person ($111 per person, per night) for an inside cabin. It travels round-trip from Yokohama and visits Hiroshima, Pusan and other ports, including Osaka, where the ship will overnight.

Celerbrity Solstice's Vietnam and Thailand cruises kick off in mid-January and run through March. The ship will resume them again in the fall of 2024 and run through the winter season. Prices start from $1,255 per person ($105 per person, per night) for an inside cabin. The voyage sails from Hong Kong to Singapore with stops in Da Nang and Koh Samui, plus overnights in Hanoi and Bangkok.

SeaDream's 'Yachting the Adriatic & Greek Isles' sailing

Here's one to put on your radar if you're looking to book — but not necessarily sail — in 2024. It's a new Mediterranean itinerary that doesn't start up for nearly three more years, in 2026. The SeaDream routing brings stops at seven ports that are rarely visited by cruise passengers. During the seven-night voyages, there will be calls at Primosten, Croatia; Cesme, Turkey; Cetubal, Portugal; and Kythira, Kythnos, Syvota and Tinos, Greece — making these sailings unique and well-suited to anyone who loves the region but who's looking for new places to experience.

SeaDream's small ships, each of which carries just 112 people, are able to reach locales about which passengers on megaships can only fantasize. Couple that with excellent service, and you'll be visiting the Our Lady of Loretto statue in Primosten, touring the Cesme Castle and lounging on stunning Greek beaches from a home base that puts you squarely in the lap of luxury.

Details: An itinerary that includes three of the seven new ports is the 11-night " Yachting the Adriatic & Greek Isles " itinerary from Venice, Italy, to Athens, Greece, departing on Aug. 8, 2026, on SeaDream I. Prices start from $10,399 per person ($946 per person, per night) for a room with a porthole view.

Holland America's 'Alaska Arctic Circle Solstice' Legendary Voyage

Alaska is an absolute must for anyone who enjoys the vastness of untouched wilderness, the wildlife it houses and adventurous pursuits it provides. (Think whale-watching, hiking on glaciers and salmon fishing.) However, Holland America 's Westerdam is hosting a 28-day sailing that's anything but your standard cruise to the Last Frontier .

Passengers will visit the usual Alaska ports, such as Ketchikan, Sitka and Juneau, with scenic sailing through the Inside Passage, past Hubbard Glacier and to Glacier Bay. But they can also expect less-common stops at places like Nome, Kodiak, Anchorage (with an overnight) and Homer. Plus, about halfway through, this cruise crosses the Arctic Circle — a rite of passage for many travelers.

Details: Holland America's 28-day " Alaska Arctic Circle Solstice " cruise — one of the line's Legendary Voyages, known for longer durations and a unique mix of port calls — sails June 9-July 7, round-trip from Seattle. Inside cabins start from $5,299 per person (about $189 per person, per night).

Silversea's summertime French Polynesia cruises

Another consideration for future travel is Silversea Cruises , which is featuring its first full-summer season in French Polynesia in 2026. Silver Whisper will offer two immersive itineraries, including overnights, across 17 voyages between April and September.

Passengers can choose seven-night sailings that visit idyllic favorites like Tahiti, Moorea and Huahine and which also include overnights in Bora Bora. Or, they can cruise for twice as long by selecting a 14-night voyage that calls on the same ports as the seven-night option but with Fakarava, Nuku Hiva, Fatu Hiva, Atuona and Tahuata added.

Details: Silversea's seven-night voyages begin April 6, 2026, and start from $5,650 per person ($808 per person, per night) for an ocean-view cabin.

The line's 14-night sailings start on April 20, 2026. Fares start from $10,450 per person ($747 per person, per night) for ocean-view accommodations.

New Bermuda voyages on Carnival Venezia

Beginning in May of 2025, Carnival Cruise Line 's Carnival Venezia will sail a series of eight four- and five-night cruises to Bermuda from New York. These itineraries are notable because the line is aiming to increase its presence there but also because the style of the ship is new to even most of the brand's most dedicated passengers.

In 2022, Carnival announced its Costa by Carnival concept after revealing it would be transferring ships from its Costa sister brand to the Carnival fleet. Now, when travelers visit the Gibb's Hill Lighthouse or check out the island's renowned pink-sand beaches during a sailing on Carnival Venezia, they can enjoy both the Italian style of the ship and Carnival's fun atmosphere and high service standards.

Details: Voyages kick off on May 22, 2025. Prices start from $429 per person ($108 per person, per night) for an inside cabin on a four-night cruise departing Sept. 18, 2025.

Disney Cruise Line's Lighthouse Point itineraries

Disney Cruise Line 's new Lookout Cay at Lighthouse Point , a private destination on the Bahamian island of Eleuthera, is set to open in June with a three-night preview sailing on June 6 aboard Disney Magic. Following the initial voyage, the line will run regular three- to seven-night voyages to Lighthouse Point on Disney Magic, Disney Fantasy and Disney Dream.

The island will feature a dedicated family beach and water play area, an arts and culture pavilion focused on Bahamian culture, 20 family cabanas, an adults-only beach and a selection of shore excursion options.

Details: Prices for itineraries that include Lighthouse Point start from $624 per person ($208 per person, per night) for a three-night cruise on Disney Magic. The cruise departs Nov. 5 and sails from Fort Lauderdale's Port Everglades to San Juan, Puerto Rico.

Have cruise questions? TPG has answers:

• Banned items: What not to pack for a cruise
• Man overboard: Why do people fall off cruise ships?
• What is baked Alaska, and why is it paraded around cruise ships?
• What are the largest cruise ships in the world?
• What is a gentleman host on a cruise?
• What is the Jones Act and how does it affect cruise ships?
• What is a lido deck on a cruise ship?
• What's a cruise cabin guarantee and will it save you money?
• What's the difference between a cruise concierge and a butler?

Editorial disclaimer: Opinions expressed here are the author’s alone, not those of any bank, credit card issuer, airline or hotel chain, and have not been reviewed, approved or otherwise endorsed by any of these entities.