Protection for life

Yellow fever is a serious and potentially fatal viral disease that is spread by mosquitoes in parts of Africa, South America, Central America and Trinidad in the Caribbean. It occurs in both jungle and urban environments and is particularly common in the rainy season.

Yellow fever is currently known to affect people living in or travelling to 43 countries located on the African continent as well as South America.

African nations known to have a high occurrence of yellow fever include most central African nations, for example the Democratic Republic of the Congo, Nigeria, and Burkina Faso.

Travellers planning a trip to South America should consider a yellow fever vaccine if travelling to Brazil, Bolivia, Peru, Colombia or Venezuela.

The most common symptoms are fever, muscle pain with prominent backache, headache, loss of appetite, and nausea or vomiting. A small proportion of those infected with yellow fever will develop severe disease.

There’s a very effective vaccine that can stop you getting yellow fever if you’re travelling to an area where the infection is found.

Vaccination against yellow fever is advised if you’re travelling to areas where there’s a risk of getting yellow fever.

But even if you have been vaccinated, it’s important to prevent insect bites as mosquitoes can also spread other serious illnesses.

Some countries require a proof of vaccination certificate before they let you enter the country.

You will be issued with an International Certificate of Vaccination or Prophylaxis when you have the vaccine. This certificate is valid for life.

The good news is, protection has never been easier. Health Plus Pharmacy, which is a registered yellow fever centre, make the yellow fever vaccination convenient and accessible for all the community in Cardiff and Pontypool. Book an appointment with your local Health Plus Pharmacist to keep you safe.

Check the risks of a country you’re travelling to on the TravelHealthPro website

About the yellow fever vaccination

Stamaril® is the yellow fever vaccine that is available in the UK.  It is manufactured by Sanofi Pasteur and is made in chicken eggs. The vaccine can be given from 9 months of age, and may be given to infants from 6 months but only in special circumstances.

Patient information leaflet Stamaril®

Stamaril® is a live vaccine, which means that it contains a weakened form of the yellow fever virus. Live vaccines do not cause disease in healthy people but are not suitable for people with an impaired immune system, for example, caused by drug treatment or underlying illness. This is because the weakened viruses can multiply and may cause a yellow fever like disease in these individuals.

One dose of yellow fever vaccine provides lifelong protection in most people. A booster dose would only be recommended if you were previously vaccinated in one of the following circumstances:

• while pregnant
• less than two years old
• had a weakened immune system
• whilst infected with HIV
• before undergoing a bone marrow transplant

Yellow fever vaccination schedule

We advise that you should be vaccinated for yellow fever at least 10 days before you travel to allow enough time for the vaccine to work.

You will be given a single dose of the yellow fever vaccine, as an injection into your upper arm.

Please book early before you travel, to ensure that you get the yellow fever vaccination.

How effective is the yellow fever vaccine

The vaccine provides effective immunity within 10 days for 80-100% of people vaccinated, and within 30 days for more than 99% of people vaccinated.

A single dose of the yellow fever vaccine is thought to provide lifelong protection. For most people, a booster dose is no longer recommended.

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.

Who cannot have the yellow fever vaccine

There are some people who cannot have the yellow fever vaccine when it’s recommended.

People who cannot have the vaccine include:

• babies under 6 months old
• people with a weakened immune system, such as those with leukaemia or lymphoma
• people whose immune system is weakened by treatment, such as steroids and chemotherapy
• people who are allergic to any of the ingredients in the vaccine, including people with an egg allergy
• people who’ve had a severe reaction to a previous dose of yellow fever vaccine
• people with a thymus gland disorder or who’ve had their thymus gland removed
• people over the age of 60 who are travelling to areas where yellow fever vaccine is not generally recommended
• people who have a close relative who has had a severe reaction to the vaccine causing damage to the brain or other organs

If you need a vaccination certificate for the country you’re visiting but you’re not able to have the vaccine, contact a yellow fever vaccination centre.

They may provide you with an exemption letter, which may be accepted by officials in countries that usually require a vaccination certificate.

Who may be able to have the vaccine in some circumstances

If you’re not sure whether you can have the yellow fever vaccine, ask a travel health specialist at the vaccination centre. They’ll do a full risk assessment based on your or your child’s medical history and where you’re travelling to.

People who may be able to have the vaccine include:

• those aged 60 and over – only when travel to a high-risk area is unavoidable
• those who are pregnant – if travel to a high-risk area is unavoidable
• those who are breastfeeding – expert advice is needed for women who are breastfeeding babies under 9 months
• those with long-term (chronic) inflammatory conditions, such as rheumatoid arthritis – if on low-dose steroid therapy
• babies from 6 months to under 9 months of age – if travel is unavoidable and risk is high, expert advice is needed
• those living with HIV – only after specialist advice

Take extra care to prevent insect bites while travelling if you have not been vaccinated.

Cautions

Yellow fever vaccination should usually be avoided during pregnancy and when breastfeeding. A healthcare practitioner will discuss the risks and benefits of vaccination in these circumstances.

The vaccine can be given to those with HIV infection, but only if their CD4 counts are > 200 and they are stable on treatment.

Latex: the tip caps of the prefilled syringes contain a natural rubber latex derivative, which may cause allergic reactions in latex sensitive individuals.

Yellow fever vaccination certificate

Some countries require a certificate showing you have been vaccinated before you’re allowed entry.

This is known as an International Certificate of Vaccination or Prophylaxis (ICVP).

All vaccination certificates are now valid for life, including older ones with an expiry date on them. You’ll be given a certificate when you’re vaccinated at a yellow fever vaccination centre.

Check the country information on the TravelHealthPro website or with a yellow fever vaccination centre to see if you need a certificate for the area you’re visiting.

A certificate is not needed for entry into the UK.

Keep your certificate safe and make a copy for your records.

If you lose your certificate, you may be able to get another one reissued if you have a copy showing full details of the vaccination batch number and the date you had the vaccination.

Medical Exemption Certificates

A healthcare practitioner will decline to vaccinate you if there is a contraindication to the vaccine and may decline to vaccinate you if the risk of serious vaccine side effects is assessed as being higher than the disease risk. If the risk of disease is deemed low, and you agree, a medical exemption certificate can be issued in these circumstances.

A medical exemption certificate is only valid for one trip.

You must practice strict mosquito bite avoidance during travel because you will not have any protection from the vaccine against potential infection.

You must be reassessed on subsequent trips.

Yellow fever prevention

In addition to a timely yellow fever vaccination, you should protect yourself from mosquito bites while you are abroad.

Using a mosquito repellent and wearing long sleeved-tops as well as long trousers will deter mosquitoes and reduce your risk of catching an infection. You may also wish to take a mosquito coil or plug-in device with you, to use in your accommodation.

By avoiding swamps and other mosquito breeding grounds, you can minimise your exposure to insect bites. Ideally, you should stay in places with air conditioning or at least insect mesh screening in front of all windows.

Extra precautions when travelling abroad

The risk of becoming seriously ill from an insect bite or sting in the UK is small, but in some parts of the world insects can carry serious diseases such as malaria and you need to be extra careful.

It can help to:

• find out what the risks are where you intend to travel and check if you need any vaccinations before travelling – vaccines can prevent some illnesses spread by insects, such as yellow fever. You can use the Travel Health Pro website to do this
• speak to your GP about any extra precautions and medication you might need to take – for example, if you’re visiting an area where there’s a risk of malaria, you may be advised to bring a mosquito net and take antimalarial tablets to avoid malaria

Avoiding Travel to a Yellow Fever Risk Area

If you have a contraindication to the vaccine or the risk of serious side effects is high, and there is a significant risk of contracting yellow fever on your trip you are likely to be advised to cancel or change your travel plans. Healthcare practitioners are not obliged to administer yellow fever vaccine if they believe it unsafe to do so, or it is not required for your trip. If you have any medical conditions, it is best to seek travel advice before you book your trip.

If you have recently received the yellow fever vaccine and feel unwell please contact your GP or the 111 service if your GP practice is closed.

In a medical emergency, when someone is seriously ill and their life is at risk, dial 999.