Yellow Fever Vaccination Guidelines

Disease Characteristics

Yellow fever remains a disease with potentially severe consequences, including a 20-50% case-fatality ratio for severe cases with hepatorenal dysfunction 1

The risk of acquiring yellow fever varies based on multiple factors including immunization status, use of personal protective measures against mosquito bites, location of travel within the country, duration of exposure, occupational and recreational activities, and local rate of virus transmission at the time of travel 1, 2, 3
For unvaccinated travelers, the estimated risk of illness and death from yellow fever during a 2-week stay in endemic areas of West Africa is 50 and 10 cases per 100,000 population, respectively; for South America, the risks are 5 cases and 1 case per 100,000 population 4

The Centers for Disease Control and Prevention recommends that yellow fever vaccination should be administered at least 10 days before travel to be valid for entry requirements 2
Vaccination may still be required if arriving from a country with risk of yellow fever transmission or if transiting through a country with yellow fever risk for more than 12 hours 3, 4

The vaccine should not be given to immunocompromised individuals, including those with symptomatic HIV infection, leukemia, lymphoma, or generalized malignancy, or those immunosuppressed by corticosteroids, alkylating drugs, antimetabolites, or radiation 4, 5, 6
Pregnant women should only receive the vaccine if travel to a high-risk area cannot be avoided, and adults aged 60 years and older have an increased risk of serious adverse events following vaccination and should discuss risks and benefits with their healthcare provider 6

All travelers should take precautions to avoid mosquito bites by using insect repellent, wearing permethrin-impregnated clothing, and staying in accommodations with screened or air-conditioned rooms 3
If vaccination is needed, it must be administered at an approved Yellow Fever Vaccination Center, and travelers should receive an International Certificate of Vaccination or Prophylaxis (ICVP) as proof 3