Vaccination is the most effective way of preventing yellow fever.
Yellow fever vaccination
In the UK, Stamaril (Sanofi Pasteur MSD) is the only licensed yellow fever vaccination. A single dose of the yellow fever vaccine will protect you against yellow fever for at least 10 years. It's recommended that you have a booster dose every 10 years if you're still at risk of infection.
Who should be vaccinated?
You should receive the yellow fever vaccination if:
- you're a laboratory worker and you handle infected material
- you're travelling to a country that requires you to have an International Certificate of Vaccination or Prophylaxis (ICVP) before letting you into the country; the certificate proves that you've been vaccinated against yellow fever
- you're travelling to, or living in, an area or country where yellow fever is found – see Yellow fever - risk areas for a list of these countries
You must have a yellow fever vaccination at least 10 days before you travel. This will allow enough time for your body to develop protection against the yellow fever infection.
Your certificate will only become valid 10 days after you have the yellow fever vaccination.
Where do I get vaccinated?
The yellow fever vaccination can only be given at designated and registered centres. For a centre to become a designated yellow fever vaccination centre, it must register with the appropriate authority, which in the UK is either:
- the National Travel Health Network and Centre (NaTHNac)
- Health Protection Scotland (HPS)
See the NaTHNaC website to find your nearest yellow fever vaccination centre.
Certificate of proof
Under regulations set out by the World Health Organization (WHO), anyone travelling to a country or area where the Aedes aegypti mosquito is found must have a Certificate of Vaccination or Prophylaxis (ICVP).
You can find a list of all the countries that require you to have an ICVP in the WHO International travel and health guide. You can also search the country information on NATHNaC to find out if the country you're visiting requires an ICVP.
If you've been travelling in an ‘at risk’ area during the past month, it might be a good idea to carry your certificate with you. This will help to avoid potential problems with immigration. It's possible for travellers without a valid yellow fever vaccination certificate to be vaccinated and held in isolation for up to 10 days. An ICVP isn't required for entry into the UK.
If you lose your certificate, you may be able to get another one re-issued as long as you have details of the vaccination batch number and the date that you had the vaccination.
Seeking medical advice
Always consult staff at a designated vaccination centre if you're planning to travel to an area where there's a risk of getting yellow fever. If you tell them where you're travelling to, they will be able to advise you about whether you need to be vaccinated against yellow fever and whether you need an ICVP.
Who should not be vaccinated
People who shouldn't have the yellow fever vaccination include:
- babies under nine months old – babies who are six to nine months old should only be vaccinated if the risk of yellow fever during travel is unavoidable
- pregnant women – unless the risk of yellow fever is unavoidable
- women who are breastfeeding – unless the risk of yellow fever is unavoidable
- people whose immune systems are lowered (immunosuppressed), such as those with HIV and people receiving chemotherapy or radiotherapy
- people who are allergic to eggs (the vaccine contains small amounts of egg)
- people who've had a severe allergic reaction (anaphylaxis) to a previous dose of the yellow fever vaccine
- people who are allergic to any of the ingredients in the vaccine
- people who have a condition affecting the thymus gland (part of your immune system, which is located in your upper chest)
- people who are currently severely unwell (e.g. with a high fever) – this is to avoid confusing the diagnosis of your current illness with any side effects from the vaccine
- yellow fever naive travellers (those who haven't been previously exposed to the vaccine) who are 60 years old or over (unless the risk of yellow fever is unavoidable)
Exemption letters
In cases where having a yellow fever vaccination is not advised, your GP may be able to issue with you an exemption letter. The letter should be written on headed notepaper, including the practice details. It may be accepted by some immigration authorities.
If you're travelling from an area where there's a risk of yellow fever without a valid yellow fever certificate, immigration officials are legally entitled to quarantine travellers for a period of at least seven days at the point of arrival into a country.
Side effects of the vaccine
After having the yellow fever vaccine, 10-30% of people will have mild side effects, such as:
- headache
- muscle pain
- soreness at the injection site
- mild fever
Reactions at the injection site usually occur one to five days after being vaccinated, although other side effects may last for up to two weeks.
An allergic reaction to the vaccine occurs in one case out of every 130,000 doses of the vaccine that are given.
Yellow fever vaccine-associated neurological disease (YEL-AND)
Rarely, the yellow fever vaccine is associated with a neurological disease, known as yellow fever vaccine-associated neurological disease (YEL-AND). Neurological means that it affects the nerves and the nervous system, including the brain and spinal cord.
YEL-AND occurs in around four cases out of every 1 million doses given. However, for people who are 60 years old or over and are yellow fever vaccine naïve, the incidence of YEL-AND increases to around 1 in every 50,000. This represents the highest risk for any vaccine currently in use.
The symptoms of YEL-AND include:
- a high temperature (fever) of 38ºC (100.4ºF) or above
- headache
- confusion
- problems with your nerves – for example, a problem with the nerves in your tongue, which affects your ability to speak (focal neurological deficit)
- coma
- inflammation of the network of nerves that control the body's senses and movements (Guillain-Barré syndrome)
Yellow fever vaccine-associated viscerotropic disease (YEL-AVD)
The yellow fever vaccine is also associated with a viscerotropic disease that's known as yellow fever vaccine-associated viscerotropic disease (YEL-AVD). Viscerotropic means that it affects the viscera (your internal body organs, such as the heart or lungs).
YEL-AVD occurs in around three cases out of every 1 million vaccines that are given. However, for people who are 60 years old or over and are yellow fever vaccine naïve, the incidence of YEL-AVD increases to just over 1 in every 50,000. This represents the highest risk for any vaccine currently in use.
Symptoms of YEL-AVD include:
