Spain

Spain is a high-volume tourist destination with a genuine terrorism threat — the 2017 Barcelona La Rambla vehicle attack killed 13 people and demonstrated that iconic pedestrian zones are prime targets. Spain was recently removed from the CDC's active Polio Level 2 list (effective March 9, 2026), meaning the immediate polio concern has resolved, but measles vaccination should be current given the global resurgence. Healthcare quality in major cities is excellent; the gap between Barcelona or Madrid and rural Extremadura is significant. The prepared traveler has current MMR and Hepatitis A vaccinations, carries comprehensive travel insurance, and knows that regional separatist tensions — particularly in Catalonia — can trigger large, disruptive demonstrations on short notice., Spain's risk profile varies meaningfully by region. Catalonia (Barcelona) carries the highest terrorism risk among Spanish cities — it was the site of the 2017 attack and continues to have active separatist political tensions that periodically produce large demonstrations. The Basque Country has a history of ETA political violence, though the organization declared a ceasefire in 2011. The Canary Islands (Atlantic, off West Africa) and Balearic Islands (Mediterranean) are beach destinations with low security risk but more limited medical infrastructure. Ceuta and Melilla (Spanish enclaves in Morocco) have a distinct and elevated risk profile from irregular migration and cross-border tensions — treat separately from mainland Spain., None, CDC recommends routine vaccines (MMR, Tdap, varicella, flu, COVID-19); Hepatitis A (recommended for most travelers, particularly street food eaters); Hepatitis B (recommended for unvaccinated travelers under 60); Measles (ensure current — global measles alert active); Tick-borne Encephalitis (consider for travelers with extensive outdoor exposure in northern forests of Cantabria, Pyrenees, and Basque Country); Rabies (consider for wildlife workers or those with extended animal exposure), None, None