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Is Yellow Fever Vaccine Good For Life

Vaccination In Those Older Than 60 Years Of Age

WHO: Yellow fever vaccines global stockpile – Questions and answers (Q& A)

If you are 60 years of age or older, you can receive yellow fever vaccine, but only if you are fit and well, understand the risks of vaccination and have a real risk of yellow fever virus at your destination . A healthcare practitioner will discuss your risk of disease at your destination and the potential risks of the vaccine, to help you to make an informed decision regarding vaccination.

Yellow Fever Vaccination For Travellers

On 16 June 2016, the Australian Government adopted the World Health Organization amendment to the International Health Regulations regarding the period of protection afforded by yellow fever vaccination, and the term of validity of the certificate. The period of protection and term of validity has changed from 10 years to the duration of the life of the person vaccinated. This is based on data demonstrating for the majority of recipients, a single dose of yellow fever vaccine results in life-long immunity.

International yellow fever vaccination certificates presented at Australias border will be accepted even if the vaccination was given more than ten years ago. Individuals who cannot provide a yellow fever vaccination certificate at the border will still be required to go through border control processes when entering Australia. As is current practice, entry to Australia will not be refused on the basis of non-compliance with yellow fever monitoring and control requirements.

Vaccination is still strongly recommended for travellers who have never been vaccinated for yellow fever and who intend to travel to countries where there is a risk of transmission. Border biosecurity processes will remain in place for unvaccinated travellers.

Very Rare Adverse Reactions Associated With Yellow Fever Vaccine

For most people, the balance between the benefits and possible side effects of the vaccine remains overwhelmingly favourable. However, because the vaccine contains a live, weakened strain of the yellow fever virus, adherence to contraindications and precautions is essential to reduce the risk of serious side effects, especially in patients with contraindications due to immunosuppression or thymus dysfunction or removal.

Very rare cases of yellow fever vaccine-associated viscerotropic disease and yellow fever vaccine-associated neurotropic disease are important identified risks associated with the yellow fever vaccine. In 2018 to 2019, two events of YEL-AVD with a fatal outcome were reported after yellow fever vaccination in UK. These events led the Commission on Human Medicines to introduce a series of recommendations to strengthen measures to minimise these risks.

These recommendations included a letter sent to vaccination clinics in 2019, changes to product information , and a standardised pre-vaccination screening checklist, which has now been agreed by the manufacturer and the MHRA.

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Where Can I Get A Yellow Fever Vaccination And Vaccination Certificate

Yellow fever vaccinations must be provided by an approved yellow fever vaccination clinic. These clinics will provide a vaccination certificate in the form approved and required by WHO. A single dose of yellow fever vaccine will provide life-long protection against the disease for most people. Travellers should ensure they are vaccinated no less than 10 days before entering the yellow fever risk area, due to protection beginning 10 days after vaccination. For details of your nearest yellow fever vaccination clinic, please contact your state or territory health department. Contact details for state or territory health departments can be found below.

Estimated 200 000 New Cases Each Year


There are an estimated 200 000 cases of yellow fever worldwide each year. About 15% of people infected with yellow fever progress to a severe form of the illness, and up to half of those will die, as there is no cure for yellow fever. The treatment is aimed simply at reducing patients discomfort.

The vast majority of reported cases and deaths occur in sub-Saharan Africa. In endemic regions of Africa, yellow fever natural immunity is acquired with age, putting children at highest risk of infection. Over the past two decades, the number of yellow fever cases worldwide has increased due to declining population immunity to infection, deforestation, urbanization, population movements and climate change.

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How Will Vaccination Records Be Kept

WHO recommends that countries using fractional dosing keep good vaccination records of people who receive it so that they can be followed up later to assess how long the vaccine protection lasts and be revaccinated if necessary. These people will need to be informed that they have received the fractional dose and will require a full dose of the vaccine if they wish to travel.

Initial Symptoms Of Yellow Fever

The clinical spectrum of yellow fever varies from a non-specific illness to fatal haemorrhagic fever.37 The disease begins abruptly with:

  • fever
  • eye congestion

The patient appears acutely ill.

The symptoms indicate a period of infection. During this time, there is an intense viraemia that lasts 34 days.37

This may be followed by the period of remission. During this time, the fever and symptoms settle over 2448 hours, and the immune response clears the virus.37

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What Are The Symptoms Of Yellow Fever

Initial symptoms of yellow fever include sudden onset of fever, chills, severe headache, back pain, general body aches, nausea and vomiting, fatigue, and weakness. Most people improve after these initial symptoms. However, roughly 15% of people will have a brief period of hours to a day without symptoms and will then develop a more severe form of yellow fever disease. In severe cases, a person may develop high fever, jaundice , bleeding , and eventually shock and failure of many organs. Roughly 20-50% of people who develop severe illness may die.

How Does The Vaccine Work

Researchers recruiting for a yellow fever vaccine clinical trial in St. Louis

The yellow fever vaccine causes your immune system to produce antibodies against the virus. Its administered as a relatively painless injection.

If youre in the United States and are planning to travel to an area where yellow fever is common, youll need to get vaccinated at an authorized yellow fever vaccination center.

You can find their locations here.

Originally, a single dose was meant to last for at least 10 years. But in 2013, the World Health Organization announced that a single injection should provide life-long immunity.

Keep in mind that this change still isnt reflected in the International Health Regulations, a legally-binding document put out by WHO. As a result, some countries may not accept a certificate thats more than 10 years old.

You can check regulations in specific countries

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Can I Be Exempt From Yellow Fever Vaccination

Travellers should seek medical advice on yellow fever vaccination for their individual medical circumstances, particularly about the suitability of yellow fever vaccine for infants, pregnant or breastfeeding women and those who are immuno-compromised.

If your health care practitioner is of the opinion that vaccination is contraindicated on medical grounds, they should supply you with a dated and signed letter detailing the reasons why you should not be vaccinated. You should contact the embassy of the country to which you are travelling to determine whether the letter needs to be in another language in addition to English in order to meet the entry requirements of the country.

Additional information on contraindications and precautions related to yellow fever vaccination can be found in The Australian Immunisation Handbook.

Assessment Of Risk Of Bias

We used the PRISMA guidelines to assess the risk of bias in individual studies and across studies. We did not use scales. Instead, we assessed the risk for different items separately. For RCTs, all three authors independently evaluated the quality of the study according to the Cochrane risk-of-bias approach. For the observational studies we used the GRADE approach. The authors were not biased with regard to journal, institution, or study results.

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When Should The Fractional Dosing Method Be Used

Using fractional dosing is the best way to stretch vaccine supplies and protect as many people as possible to stop the spread of yellow fever in emergency situations. Based on the available evidence, the Strategic Advisory Group of Experts on Immunization affirms that a fractional dose can be used as part of an exceptional response when there is a large outbreak and a shortage of vaccine.

Side Effects Of The Vaccine Against Yellow Fever

AIIMS Bhubaneswar starts vaccination for yellow fever ...

Immunisations against yellow fever are generally effective and safe, although all medications can have unwanted side effects.Side effects from the vaccine are uncommon and usually mild, but for up to five to 10 days after vaccination may include:

  • low-grade temperature
  • mild headache
  • muscle aches.

Many vaccine injections may result in soreness, redness, itching, swelling or a burning sensation at the injection site for one to two days. Paracetamol might be required to ease the discomfort.There are a number of treatment options that can reduce the side effects of the vaccine, including:

  • giving extra fluids to drink and not overdressing if there is a fever
  • although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given check the label for the correct dose or speak with your pharmacist, .

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Who Should Have The Yellow Fever Vaccine

The yellow fever vaccine is recommended for people from 9 months of age who are travelling to:

  • an area where yellow fever is found, including parts of sub-Saharan Africa, South America, Central America and Trinidad in the Caribbean
  • a country that requires you to have a certificate proving you have been vaccinated against yellow fever

You should be vaccinated at least 10 days before you travel to allow enough time for the vaccine to work.

If you or your child has had the MMR vaccine, you or they need to wait at least 4 weeks before having the yellow fever vaccine.

If it is not possible to leave a 4-week gap, the yellow fever vaccine should be given but an additional dose of MMR should be considered at a later date. Re-vaccination with the yellow fever vaccine can also be considered on an individual basis for those at on-going risk.

What Are Vaccine Experts Saying About Fractional Dosing

After reviewing evidence, WHOs Strategic Advisory Group of Experts on Immunization, determined that a fifth of a standard vaccine dose can provide full protection against the disease for at least 12 months and can be used to control outbreaks.

In a mass vaccination campaign in Democratic Republic of the Congo in 2016 the fractional dosing method was shown to be feasible and a promising approach to protect at-risk populations that would otherwise be left unprotected.

Fractional dosing is not proposed for routine immunization, as there is not enough data available to show that lower doses confer life-long protection. Studies are ongoing to determine the long-term protection provided by fractionated doses.

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Side Effects Of The Yellow Fever Vaccine

The yellow fever vaccine can cause some side effects, but the risk of not being vaccinated usually outweighs the risk of having side effects.

After having the vaccine, up to 1 in every 3 people gets:

  • soreness at the injection site

These side effects usually pass within 2 weeks.

Rarely, a person can get more serious side effects, including an allergic reaction to one of the ingredients in the vaccine.

A very rare side effect of the vaccine can cause problems with the brain or other organs, which can be fatal. This is more likely to affect:

  • people aged 60 or older
  • people with weakened immune systems
  • anyone who’s had their thymus gland removed or has a thymus gland disorder

Get medical advice if you feel very unwell within a few days or weeks of having the yellow fever vaccine.

Page last reviewed: 22 May 2020 Next review due: 22 May 2023

Yellow Fever: Proof Of Vaccination Valid For Life And The Exceptions

Ask the Expert: Yellow Fever


The WHO decided in June 2016 that the proof of vaccination against yellow fever is administratively valid for life. However, it is not certain that everyone is effectively protected for life after a single vaccination. Therefore, the Belgian Scientific Study Group on Travel Medicine, under the auspices of the Belgian High Health Council, proposes the following recommendation:

The column “recommendation” shows what we recommend in practice. The column “administration” shows what we write in the International Certificate of Vaccination or Prophylaxis.

Travellers to endemic regions Single reinforcing vaccination, at the occasion of a future travel to an endemic region° Lifelong
Children younger than 1 year Repeat vaccination after the age of 2 years Until the day of 2nd birthday
Children between 1 and 2 years Repeat next travel
Interval < 28 days between measles and yellow fever vaccination Repeat next travel
Lab worker manipulating live yellow fever virus Single reinforcing vaccinations° Lifelong

°The reinforcing vaccination can be administered at any time after the first dose , but at least 28 days after the first dose.

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Vaccination Is The Most Effective Measure

Vaccination is considered to be the most important and effective measure against yellow fever. Protective immunity develops within 30 days for 99% of people receiving the vaccination. For routine immunization programmes in Africa, home to 31 of the 44 yellow-fever endemic countries, the vaccine costs about $0.82 per dose.

SAGE is the principal advisory group to WHO for vaccines and immunization. It is charged with advising WHO on overall global policies and strategies, ranging from vaccines and technology, research and development, to delivery of immunization and its linkages with other health interventions. SAGE is concerned with all vaccine-preventable diseases including childhood vaccines and immunization.

For more information please contact:

Fadéla ChaibTelephone: +41 22 791 32 28Mobile: +41 79 475 55 56

Who Should Have A Yellow Fever Vaccination

The yellow fever vaccine is recommended for:

  • people who are nine months of age, or older, who are travelling or living in any country in West Africa, regardless of where they will be in that country and
  • people who are nine months of age, or older, travelling or living outside the urban areas of all other yellow fever endemic countries.

Exemptions can be made if necessary due to health or other reasons. Speak to your travel doctor about any concerns you may have regarding the yellow fever vaccine.

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People Who Should Not Receive Yellow Fever Vaccination

The vaccine is not suitable for everyone and should not be given to people who:

  • are under nine months of age
  • have had a severe allergic reaction to an earlier dose of the vaccine
  • have had severe allergic reaction to any component of the vaccine
  • have allergies to eggs
  • have a weakened immune system due to illness or medical treatment
  • have a history of a thymic disorder including myasthenia gravis, thymoma, thymectomy, DiGeorge syndrome, or cases of damage to the thymus from chemotherapy, radiotherapy or as a result of complications after transplantation.

How Long Should A Woman Wait To Conceive After Receiving A Yellow Fever Vaccination

Yellow Fever: 15 Facts You Need to Know About this Disease

Yellow fever vaccination has not been known to cause any birth defects when given to pregnant women. Yellow fever vaccine has been given to many pregnant women without any apparent adverse effects on the fetus. However, since yellow fever vaccine is a live virus vaccine, it poses a theoretical risk. While a two week delay between yellow fever vaccination and conception is probably adequate, a one month delay has been advocated as a more conservative approach. If a woman is inadvertently or of necessity vaccinated during pregnancy, she is unlikely to have any problems from the vaccine and her baby is very likely to be born healthy.

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Manufacture And Global Supply

The outbreak of yellow fever in Angola in January 2016 has raised concerns about whether the global supply of vaccine is adequate to meet the need during a large epidemic or pandemic of the disease. Routine childhood immunization has been suspended in other African countries to ensure an adequate supply in the vaccination campaign against the outbreak in Angola. Emergency stockpiles of vaccine diverted to Angola, which consisted of about 10 million doses at the end of March 2016, had become exhausted, but were being replenished by May 2016. However, in August it was reported that about one million doses of six million shipped in February had been sent to the wrong place or not kept cold enough to ensure efficacy, resulting in shortages to fight the spreading epidemic in DR Congo. As an emergency measure, experts have suggested using a fractional dose to extend existing supplies of vaccine. Others have noted that switching manufacturing processes to modern cell-culture technology might improve vaccine supply shortfalls. Manufacture of the current vaccine is slow and laborious. A new vaccine under investigation is made by a different means. On 17 June, the WHO agreed to the use of 1/5 the usual dose as an emergency measure during the ongoing outbreak in Angola and the DR Congo. The fractional dose would not qualify for a yellow fever certificate of vaccination for travelers.

Humoral Immunity In Adults

There are data on longer-term humoral immunity for at least eight distinct cohorts of adults in both YF endemic and non-endemic areas of the world who received a full dose of YF vaccine ,,,,,,,. Notably, there were no apparent differences between studies undertaken in endemic and non-endemic countries. In the first 5 years post-vaccination, seropositivity in the cohorts was > 90%. At 10 years post-vaccination, the rates of seropositivity were generally lower ranging from 67% to 88% using PRNT50PRNT90, except for a small cohort of healthy volunteers in the Netherlands where 97% of individuals vaccinated with a full-dose of the vaccine were seropositive at 10 years when measured with PRNT80. Interestingly, several of the studies saw higher rates of seropositivity 3035 years post-vaccination compared to rates at 1020 years post vaccination,. However, the number of individuals in the later vaccination time points are quite limited and they likely received an older vaccination formulation, which have differing quantities of vaccine virus, impacting the generalizability of these results. Several other factors likely impact the overall rates of seropositivity in these studies, such as proof of vaccination, different seropositivity cut-offs,,, different individuals at each time point post-vaccination often with different demographic ,,,, potential natural boosting for residents and travelers to endemic areas, and potentially receiving an additional doses of YF vaccine.

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