Yellow fever vaccination

General information on yellow fever recommendations:

Yellow fever immunisation is required for two different purposes:

  • To prevent the spread of the disease from one country to another
  • To protect the traveller from contracting the disease

Vaccination requirements are now categorized as follows:

1. Vaccination recommended – for all travellers aged nine months and older

2. Vaccination generally not recommended – for most travellers there will be minimal risk, however, people at greater risk due to a prolonged stay in an affected area may require vaccination

3. Vaccination not recommended – no risk to any traveller

Certain countries require proof of vaccination as a condition of entry to the country and this should be confirmed before travel. Some countries do not require proof of vaccination, however, there may still be a risk of yellow fever transmission.

Transmission 

Yellow fever is caused by a flavivirus, present in infected monkeys and humans; it is transmitted by bites from infected female Aedes spp.or Haemagogous spp. mosquitoes between dawn and dusk (daylight hours).

Vaccination schedule

Brand Vaccine information Primary course Booster

Stamaril
(live)

  • Live, attenuated
  • Licensed from nine months of age — from six months of age in exceptional cases
  • Single dose
  • Effective after at least ten days

Lasts ten years

  • Single dose — every ten years if continued/repeated exposure to keep certificate validated 

Yellow fever vaccine is administered at designated centres only – contact the NPA Pharmacy Services Team for the nearest centre or use the contacts below:

The ICVP is valid for ten years according to the International Health Regulations (IHR) 2005; however, in July 2016, the requirement to extend the validity will come into force, although some countries have already started to extend the certificate validity. Refer to the Travel Health Pro website for individual country pages for any certificate expiry changes.   

The information below is based on Public Health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands.

 Acute illness

If a patient is suffering from an acute illness, immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule.

Administration with other vaccines 

Live vaccines Yellow fever vaccine can be administered at the same other live vaccines; however, if MMR also needs to be administered then it should be given 28 days apart

Inactivated vaccines No interval is required between the administration of inactivated vaccines and yellow fever vaccine; however, they should be administered at different sites.

Immunocompromised patients

Yellow fever vaccine is contraindicated in patients who are immunocompromised.

Pregnancy and breast-feeding

Because of the theoretical risk of fetal infection, yellow fever vaccine should not be administered during pregnancy. When travel to a high risk area is unavoidable, the risk/benefit must be assessed individually. The WHO states that where there is a high risk of exposure to yellow fever, vaccination may be considered in early pregnancy depending on the risk.

Public Health England has updated its guidance with regards to breast-feeding and now states that expert advice should be sought before the vaccine is administered to those breast-feeding children under nine months of age. This is because of evidence of transmission of the live vaccine from breast milk to infants under two months of age. It should be noted that the vaccine should not be given to infants six months and under. For those aged six to nine months of age, vaccination should only be given following expert advice if travel is unavoidable.

People aged over 60 years

Those travellers aged over 60 years are at a higher risk of yellow fever vaccine-associated neurological and viscerotropic side effects. These risks need to be considered when assessing the vaccine requirements of the traveller.