Yellow Fever Vaccination

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Yellow Fever Vaccination
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• Yellow Fever is a serious viral infection thats
  usually spread by a type of daytime biting
  mosquito known as the Aedes aegypti. It can be
  prevented with a vaccination.
• Yellow fever mainly occurs in sub-Saharan Africa
  (countries to the south of the Sahara desert),
  South America (especially the Amazon) and in
  parts of the Caribbean.
• Yellow fever can be fatal. About 8 of people who
  get yellow fever die from it.

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Luckily, there is a very effective vaccination
for yellow fever. Some countries require proof of
vaccination (a certificate) against yellow fever
before they let you enter the country. Vaccinatio
n is the single most effective way of preventing
yellow fever.In the UK, Stamaril (produced by
Sanofi Pasteur MSD) is the only licensed yellow
fever vaccine. A single dose of the yellow fever
vaccine will protect against yellow fever for
life. It is no longer recommended to have a
booster dose every 10 years (WHO, World Health
Organisation, July 2016). Ideally, you should
have the yellow fever vaccination at least 10
days before your travel. This will allow enough
time for your body to develop protective
antibodies against the yellow fever infection.
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The yellow fever vaccination is recommended
for

• Anyone traveling to, or living in, areas or
  countries where yellow fever is endemic
• Anyone traveling to a country where an
  International Certificate of Vaccination or
  Prophylaxis (ICVP) against yellow fever is
  required for entry.
• You must have a yellow fever vaccination at least
  10 days before you travel. This will allow enough
  time for your body to develop protective
  antibodies against the yellow fever infection.

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Certificate of Proof of Vaccination
Under regulations set out by the World Health
Organization (WHO), anyone traveling to a country
or area where the Aedes aegypti mosquito is found
must have the vaccine or have an International
Certificate of Vaccination or Prophylaxis
(ICVP). You can find a list of all the countries
that require you to have an ICVP in the WHO
International travel and health guide. You can
also search the country information on NaTHNaC to
find out whether the places you are visiting
require an ICVP. If you have been traveling in
an at-risk area during the past month, it is a
good idea to carry your certificate with you.
This will help avoid potential problems with
immigration. It is possible for travelers without
a valid yellow fever vaccination certificate to
be vaccinated and held in isolation for up to 10
days. An ICVP is not required for entry into the
UK.
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If you lose your certificate, you may be able to
get another one reissued as long as you have
details of the vaccination batch number and the
date you had the vaccination. Always consult
staff at a designated vaccination centre if you
are planning to travel to an area where there is
a risk of getting yellow fever. If you tell them
where you are traveling to, they will be able to
advise you about whether you need to be
vaccinated against yellow fever and whether you
need an ICVP.
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Who should not be vaccinated?
People who should not have the yellow fever
vaccination include

• Babies under nine months of age babies who are
  six to nine months old should only be vaccinated
  if the risk of getting yellow fever during travel
  is unavoidable
• Pregnant women unless the risk of yellow fever
  is unavoidable
• Breastfeeding women unless the risk of yellow
  fever is unavoidable
• People whose immune systems are lowered
  (immunosuppressed) such as people with HIV and
  those receiving chemotherapy or radiotherapy
• People who are allergic to eggs the vaccine
  contains small amounts of egg white protein,
  albumin.

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• People who have had a severe allergic reaction
  (anaphylaxis) to a previous dose of the yellow
  fever vaccine.
• People who are allergic to any of the ingredients
  in the vaccine (including eggs).
• People who have a condition that affects the
  thymus gland (part of your immune system that is
  located in your upper chest).
• People who are currently very unwell (such as
  with a high fever) this is to avoid confusing
  the diagnosis of your current illness with any
  side effects from the vaccine
• Yellow fever naïve travellers those who have
  not been previously exposed to the vaccine who
  are 60 years of age or over should be
  individually assessed by the travel doctor or
  nurse.

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Exemption letters In cases where having a yellow
fever vaccination is not advised, your GP may be
able to issue you with an exemption letter. The
letter should be written on headed notepaper and
include the practice details. It may be accepted
by some immigration authorities although this is
not guaranteed. If you are traveling from an area
where there is a risk of yellow fever without a
valid yellow fever certificate, immigration
officials are legally entitled to quarantine you
for a period of at least seven days at the point
of arrival into a country.
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Side Effects of the Vaccine
After having the yellow fever vaccine, 10-30 of
people will have mild side effects such as
headache, muscle pain, soreness at the injection
site and mild fever. Reactions at the injection
site usually occur one to five days after being
vaccinated, although other side effects may last
for up to two weeks. An allergic reaction to the
vaccine occurs in one case out of every 130,000
doses of the vaccine that are given. Yellow fever
vaccine-associated neurological disease
(YEL-AND).
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Rarely, the yellow fever vaccine is associated
with a neurological condition known as yellow
fever vaccine-associated neurological disease
(YEL-AND). Neurological means that it affects the
nerves and the nervous system, including the
brain and spinal cord. YEL-AND occurs in around
four cases out of every 1 million doses given.
However, for people who are 60 years of age or
over and yellow fever vaccine naïve, the
incidence of YEL-AND increases to around one in
every 50,000. This needs to be balanced against
the risk of acquiring the disease.
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Preventing mosquito bites As well as getting the
yellow fever vaccination before traveling, you
should also take steps to avoid being bitten by
mosquitoes. The mosquitoes that carry yellow
fever bite during daylight hours. Although it may
not always be possible, you should try to
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• Avoid places where mosquitoes live, such as
  swamps, forests and jungles
• Choose air-conditioned accommodation. Mosquitoes
  do not like air-conditioned spaces.
• Choose accommodation with mesh screening over the
  windows and doors.
• Wear loose fitting, long-sleeved tops and
  trousers, even in the heat of day.

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• Use insect repellent containing DEET on exposed
  skin, such as Jungle Formula. 50 DEET is
  sufficient.
• Burn a mosquito coil or use a plug-in device that
  releases insecticide in your accommodation.
• Use a mosquito net where possible, especially in
  bedrooms that are not air-conditioned.

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Thank you
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