Yellow Fever Vaccination - TravelDoc™

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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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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.

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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. 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) 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 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. 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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