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Immunizations - travel vaccinations - Management
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Definition
- Yellow fever is caused by an acute flavivirus infection spread by the bite of infected mosquitoes. It ranges in severity from non-specific, self-limited symptoms of fever, malaise, photophobia and headache to an illness of sudden onset with fever, vomiting and prostration which may progress to jaundice and haemorrhage.
When is yellow fever vaccination indicated?
- The following groups should be immunized:
- Laboratory workers handling infected material.
- People aged 9 months or older who are travelling to countries that require an International Certificate of Vaccination or Prophylaxis (ICVP) for entry.
- People aged 9 months or older who are travelling to, or living in, infected areas or countries in the yellow fever endemic zone, even if these countries do not require evidence of immunization on entry.
- Infants aged 6–9 months should only be immunized if the risk of yellow fever during travel is unavoidable; expert opinion should be sought in these situations.
- Infants under the age of 5 months old should not be given a yellow fever vaccine.
In depth
When is proof of yellow fever vaccination required?
- Proof of vaccination is required for all travellers coming from countries where yellow fever occurs, including transit through such countries.
- For a full list of countries that require a valid certificate see the WHO website, http://whqlibdoc.who.int (pdf).
In depth
What types of yellow fever vaccines are available?
- One (live) yellow fever vaccine is available in the UK.
In depth
What schedule is used for yellow fever vaccine?
- Immunization should be performed at least 10 days prior to travel at specialist centres. See www.nathnac.org for a full list of these centres.
- Give a booster dose after 10 years if there is a continued risk.
- A medical waiver letter can be issued if vaccination is contraindicated for medical reasons.
In depth
What are the adverse effects of yellow fever vaccine?
- Adverse reactions following yellow fever vaccine are typically mild and consist of headache, myalgia, low grade fever, and/or soreness at the injection site and will occur in 10–30% of recipients. Injection site reactions tend to occur from days 1–5 after immunization.
- Systemic adverse effects also occur early but may last up to 2 weeks.
- Rash, urticaria, bronchospasm, and anaphylaxis occur rarely (estimated to be 1 case per 130,000 doses of vaccine).
- Post-vaccine encephalitis may occur rarely in infants under 6 months old (0.5 to 4 cases per 1000 infants under 6 months old).
In depth
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