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Yellow fever is a serious disease caused by a virus that is spread through the bite of an infected mosquito. Yellow fever can cause fever and flu-like illness, jaundice (yellowing of the eyes and skin), liver failure, lung failure, kidney failure, vomiting of blood, and possibly death.
Yellow fever vaccine is recommended for people who plan to live in or travel to areas where yellow fever is known to exist, or those who are otherwise at high risk of coming into contact with the virus.
This vaccine is used to help prevent yellow fever in adults and children who are at least 9 months old. The vaccine works by exposing you to a small dose of the virus, which causes the body to develop immunity to the disease. Yellow fever vaccine will not treat an active infection that has already developed in the body.
You should receive the vaccine at least 10 days prior to your arrival in an area where you may be exposed to the virus.
This vaccine is also recommended for people who work in a research laboratory and may be exposed to yellow fever virus through needle-stick accidents or inhalation of viral droplets in the air.
Like any vaccine, the yellow fever vaccine may not provide protection from disease in every person.
You should not receive a booster vaccine if you had a life threatening allergic reaction after the first shot.
You should not receive this vaccine if you have ever had a life-threatening allergic reaction to a yellow fever vaccine, or if you have:
an allergy to gelatin, eggs, or egg product;
cancer, leukemia, or lymphoma;
weak immune system (caused by disease or by using certain medicine);
a disorder such as myasthenia gravis, DiGeorge syndrome, or tumor of the thymus gland;
if your thymus has been surgically removed; or
if you are breast-feeding a baby.
If you have a high risk of exposure to yellow fever, you may need to receive the vaccine even if you have an allergy to eggs or chicken products. Your doctor can give you the vaccine in several small doses to avoid an allergic reaction.
Children younger than 9 months old should not receive this vaccine, and should not travel to areas where yellow fever is known to exist.
You can still receive a vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.
To make sure yellow fever vaccine is safe for you, tell your doctor if you have:
a history of seizures;
a neurologic disorder or disease affecting the brain (or if this was a reaction to a previous vaccine);
a history of Guillain Barré syndrome; or
an allergy to latex rubber.
It is not known whether yellow fever vaccine will harm an unborn baby. However, if you are at a high risk for infection with yellow fever during pregnancy, your doctor should determine whether you need this vaccine.
You should not receive this vaccine if you are breast-feeding a baby.
This vaccine is given as an injection (shot) into a muscle.
Yellow fever vaccine is given every 10 years to people who are at risk of exposure to yellow fever. The first shot can be given to a child who is at least 9 months old. Your individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by your local health department or the Centers for Disease Control and Prevention (CDC).
After receiving the vaccine, you will be given an International Certificate of Vaccination (yellow card) from the office or clinic where you receive your yellow fever vaccine. You will need this card as proof of vaccination to enter certain countries. This card becomes valid 10 days after you receive the vaccination and remains valid for 10 years.
In addition to receiving yellow fever vaccine, use protective clothing, insect repellents, and mosquito netting around your bed to further prevent mosquito bites that could infect you with the yellow fever virus.
This vaccine can cause false results on a skin test for tuberculosis for up to 6 weeks. Tell any doctor who treats you if you have received a yellow fever vaccine within the past 4 to 6 weeks.
If you continue to travel or live in areas where yellow fever is common, you should receive a booster dose of yellow fever vaccine every 10 years.
Talk with your doctor if you are receiving this vaccine less than 10 days prior to your arrival in an area where you may be exposed to the yellow fever virus.
Be sure you receive a booster dose of yellow fever vaccine every 10 years if you continue to travel or live in areas where yellow fever is common. If you do not receive the vaccine every 10 years, you may not be fully protected against the disease.
An overdose of this vaccine is unlikely to occur.
Follow your doctor's instructions about any restrictions on food, beverages, or activity.
Get emergency medical help if you have any of these signs of an allergic reaction: pale skin, hives; weakness, dizziness, difficulty breathing, rapid heart rate; swelling of your face, lips, tongue, or throat.
You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first vaccine. Keep track of any and all side effects you have after receiving this vaccine. If you ever need to receive a booster dose, you will need to tell your doctor if the previous shot caused any side effects.
Becoming infected with yellow fever is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.
Call your doctor at once if you have any of these rare but serious side effects (may occur up to 30 days after you receive the vaccine):
flu symptoms, stiff neck or back, vomiting, confusion, memory loss, irritability, loss of balance or coordination;
weakness or prickly feeling in your fingers or toes, sensitivity to light;
problems with walking, breathing, speech, swallowing, vision, or eye movement;
severe lower back pain, loss of bladder or bowel control;
muscle weakness or loss of movement in any part of your body; or
behavior changes, seizure (black-out or convulsions).
Common side effects (may occur for 5 to 10 days after you receive the vaccine) include:
low fever, mild headache, general ill feeling;
mild rash, muscle pain, weakness; or
pain, tenderness, swelling, or a lump where the shot was given.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
See also: Side effects (in more detail)
Usual Adult Dose for Yellow Fever Prophylaxis:
0.5 mL subcutaneously at least 10 days before travel. Booster doses are recommended every 10 years if there is continued risk of exposure.
Usual Pediatric Dose for Yellow Fever Prophylaxis:
>= 9 months: 0.5 mL subcutaneously at least 10 days before travel. Booster doses are recommended every 10 years if there is continued risk of exposure.
Before receiving this vaccine, tell the doctor about all other vaccines you have recently received.
Also tell the doctor if you have recently received drugs or treatments that can weaken the immune system, including:
an oral, nasal, inhaled, or injectable steroid medicine;
medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders; or
medicines to treat or prevent organ transplant rejection.
This list is not complete and other drugs may interact with this vaccine. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01. Revision Date: 2014-03-25, 12:36:42 PM.
It is possible that some side effects of yellow fever vaccine may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.
Applies to yellow fever vaccine: subcutaneous injectable, subcutaneous powder for solution, subcutaneous powder for suspension
As well as its needed effects, yellow fever vaccine may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking yellow fever vaccine, check with your doctor or nurse immediately:Rare
Some yellow fever vaccine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:Less common
Applies to yellow fever vaccine: subcutaneous powder for injection
Minor side effects have included mild headache, myalgia, malaise, asthenia and low-grade fever for 5 to 10 days after vaccination in < 5% to 30% of vaccinees. The incidence of minor adverse events was lower in vaccinees > 60 years than in younger subjects.[Ref]
Local side effects have included edema, erythema, hypersensitivity, pain, or mass at the injection site.[Ref]
Hypersensitivity reactions have infrequently included immediate reactions characterized by rash, urticaria, and/or asthma. These mainly occur in vaccinees with histories of egg allergy.[Ref]
Nervous system side effects have very rarely included neurotropic disease (YEL-AND, post-vaccinal encephalitis) which has been fatal in rare instances. Symptoms have included diaphoresis, rigors, fever, malaise, headache, confusion, expressive aphasia, arm numbness, loss of fine motor control, severe dysarthria, loss of consciousness, elevated WBCs and protein in CSF, and/or leukocytosis. Immunosuppression and age < 9 months are known risk factors. The estimated incidence for all ages is 5.3 cases per million vaccinees.[Ref]
Fifteen cases of neurotropic disease were reported before 1960, 13 of these occurred in infants < 4 months and 2 in infants 6 and 7 months old. Six cases were reported worldwide between 1960 and 1996, 3 of these occurred in adults, and the other 3 in a 1-month-old infant, a 3-year-old, and a 13-year-old. A genetic variant of the vaccine virus was isolated from the brain of the 3-year-old, who died of encephalitis.
Four nonfatal cases of probable 17D vaccine-associated neurotropic disease were reported in the U.S. between 2001 and 2002. High levels of yellow fever-specific IgM antibody were observed in these patients' CSF; however viral isolation was negative or not performed.[Ref]
Seven cases of YEL-AVD were reported between 1996 and 2001, 4 of them in U.S. residents. All patients (ages 5 to 79 years old) were considered healthy and did not have immunodeficiency. Six of these patients died 8 to 11 days after vaccination (1 had been vaccinated with the 17D-204 strain and 2 with the 17DD strain). A liver biopsy revealed rare yellow fever virus antigen within Kupffer cells. In 3 of the fatal cases, hepatic midzonal necrosis, microvesicular fatty change, and Councilman bodies were observed, which are characteristic of wild-type yellow fever. Vaccine-type yellow fever virus was isolated from blood and autopsy material.[Ref]
Vaccine-associated viscerotropic disease (YEL-AVD, multiple organ system failure), which may be fatal, has been reported rarely. It is characterized by initial symptoms of a nonspecific febrile syndrome with fatigue, myalgia, and headache. It quickly progresses to severe illness including respiratory failure, elevated hepatocellular enzymes, lymphocytopenia, thrombocytopenia, hyperbilirubinemia, hypotension with poor tissue perfusion, and/or renal failure requiring hemodialysis. Causality has not been clearly established. The syndrome may be related to unknown host factors rather than virulence of the 17D yellow fever strain. Recent reports suggest that a history of thymic dysfunction (e.g., myasthenia gravis, thymoma, thymectomy, DiGeorge syndrome) and age > 60 years may be risk factors for developing YEL-AVD. The estimated incidence is 1 per 400,000 doses.[Ref]
Health care providers should report any allergic or unusual adverse reactions to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967 (USA) and the manufacturer.[Ref]
1. "Product Information. YF-Vax (yellow fever vaccine)." Connaught, Swiftwater, PA.
2. "Adverse events associated with 17D-derived yellow fever vaccination--United States, 2001-2002." Morb Mortal Wkly Rep 51 (2002): 989-993
3. CDC. Centers for Disease Control and Prevention. National Center for Infectious Diseases Travelor's Health "Yellow fever vaccine risk and updated yellow fever vaccine information statement (VIS). Available from: URL: http://www.cdc.gov/travel/other/yf_vacc_2004.htm." ([2004 Dec 3]):
4. "Fever, jaundice, and multiple organ system failure associated with 17D-derived yellow fever vaccination, 1996-2001." MMWR Morb Mortal Wkly Rep 50 (2001): 643-5
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