The Yellow Fever Vaccine
Dr. Julian Klapowitz of Travel Medicine Consultations can provide the yellow fever vaccine NYC residents seek as part of their travel plans.
For a list of yellow fever vaccine entry requirements by country, you may click the following link and then download the information provided: World Health Organization Yellow Fever Vaccine by Country List
What is yellow fever?
Yellow fever is a potentially deadly illness that affects the liver and other organs. Yellow fever is caused by a virus (Flaviviridae family) and is carried by mosquitoes. These mosquitoes bite infected humans or non-human primates (monkeys, for example). Then, they transmit the virus to other humans. It is called “Yellow Fever” because of jaundice (yellow skin and eye color) that develops when your liver is severely damaged.
Large epidemics of yellow fever occur when the virus is present in a community with a high number of mosquitoes and low rates of human vaccination.
What are the symptoms of yellow fever?
Some of the common symptoms of yellow fever include:
- muscle pain
This is also referred to as the “period of infection.” These symptoms usually improve after a few to several days.
A “period of remission” follows, where most symptoms resolve. This can last up to 48 hours. Most people then recover completely.
15% of people finish the “period of remission” and then enter the severe yellow fever stage.
Severe and life-threatening signs and symptoms at this stage include:
- Jaundice (yellow-colored skin and eyes due to liver failure)
- Abdominal pain
- Recurrent fever
- Vomiting of blood (hematemesis) or bloody diarrhea
- Kidney failure
- Irregular heartbeats
- Seizures and coma
- Bleeding from the eyes, mouth, and nose
Up to 50% of people who enter this stage die! This is why it’s important to get your yellow fever vaccine in NYC by a professional such as Dr. Julian Klapowitz of Travel Medicine Consultations.
What parts of the world have yellow fever?
Yellow fever is found in sub-Saharan Africa and South America. It occurs more frequently in Africa than in South America.
Am I at risk of getting yellow fever?
If you are unvaccinated and living in or visiting an area with mosquitoes that carry the yellow fever virus, you are at risk of getting yellow fever.
Am I required to get a yellow fever vaccine?
There are four main possibilities regarding your need for the yellow fever vaccine:
- It is not medically recommended in the countries you are traveling to AND is not required for entry. = NO yellow fever vaccine is needed.
- It is medically recommended in the countries you are traveling to (called yellow fever “risk” countries). However, the countries do not require you to have documentation of the shot (commonly called a “yellow card”) for a visa or for entry. = Yellow fever vaccine is needed ONLY IF YOUR TRAVEL DOCTOR RECOMMENDS IT.
- You are first traveling to a yellow fever risk country and, because of this, a yellow card is required by another country further along on your trip. = Yellow fever vaccine is REQUIRED.
- You are visiting a country that requires everyone to have a yellow card for a visa application (including people coming from the US) or requires a yellow card if you have a passport from a yellow fever risk country. Yellow fever vaccine is REQUIRED.
There are other less common scenarios, but those are the major ones.
What is a Yellow Card?
A yellow card (for vaccinations, not soccer fields!), is an International Certificate of Vaccination approved by the World Health Organization and recognized by the Centers for Disease Control and Prevention in the US. With the appropriate information and official stamp, it can be used to document your yellow fever vaccination in NYC.
“Yellow Card” example, CDC Yellow Book.
What are the side effects of the yellow fever vaccine?
Many of the side effects of the yellow fever vaccine are similar to other shots: arm soreness, muscle aches, low-grade fever, and rarely severe allergic reaction (anaphylaxis).
In a very small percentage of people, vaccine-associated neurotropic disease (YEL-AND) or vaccine-associated viscerotropic disease (YEL-AVD) can occur 3 to 4 weeks after vaccination. YEL-AND can cause brain inflammation and YEL-AVD can cause multiple organs in the body to fail. Both conditions can be fatal.
As you age, or if you have medical conditions (or are on medications) that interfere with your immune system, the risk of these side effects increases. For example, less than one in 300,000 young adults have these potentially deadly side effects. Over the age of 60, more than one person in 100,000 may have either side effect. This is why an experienced Travel Medicine practitioner should decide if the vaccine is appropriate for you.
Is the yellow fever vaccine dangerous?
The yellow fever vaccine has been given to travelers, military personnel, and others for decades. In rare circumstances, it can cause very serious side effects. This has been found to occur more often if you are over age 60, have a medical condition (or take medications) that compromises your immune system, have had your thymus (not thyroid) gland removed, or have a severe allergy to eggs or ingredients in the vaccination. Please see above “What are the side effects of the yellow fever vaccination?” and “Is the yellow fever vaccination live” below.
Is the yellow fever vaccine more dangerous if I am older?
The older you are, the more likely you are to have life-threatening side effects from the yellow fever vaccine. While a young adult may have less than a 1 in 300,000 chance of having such a reaction, people over age 60 may have more than a 1 in 100,00 chance.
Can infants get the yellow fever vaccine?
The yellow fever vaccine is not recommended for ages under 9 months.
I have a severe egg allergy, can I get the yellow fever shot?
Depending upon the severity of your reaction, you may not be able to tolerate a yellow fever vaccine in NYC. Please discuss this with your medical provider or a travel medicine specialist.
Is the yellow fever vaccine a live vaccine?
Yes. It is made by culturing a strain of the virus in chicken embryos. The virus is “attenuated,” meaning it causes an immune reaction without causing serious illness after injection, assuming the person injected has a normally-functioning immune system. To download more information about the yellow fever vaccine ingredients, please click FDA.gov.
Can I take the yellow fever vaccination if I am pregnant?
Since the yellow fever vaccination is “live,” it is not recommended for pregnant women. Live vaccines carry a risk of infecting an unborn fetus. In rare circumstances where a trip poses a very high risk of yellow fever and travel is unavoidable, a travel medicine practitioner or tropical/infectious disease specialist may determine the benefits of the shot outweigh the risks. For instance: You must attend a funeral and then take care of family affairs for weeks or longer in a high-risk-for-yellow-fever country. In this case, a vaccine may be determined to be acceptable.
Does the yellow fever vaccine interact with other shots?
After many years of experience with the yellow fever vaccination, it appears that the shot does not usually interact with other vaccines. However, since it is a “live” vaccination, it is generally recommended to get it either on the same day as other live vaccinations or four or more weeks away from other live vaccinations.
Who can give a yellow fever vaccine NYC?
Medical practitioners who have been registered as yellow fever vaccine providers with the (CDC) are the only people who can provide the yellow fever shot. This requires formal training and testing administered by the CDC.
Where can I get a yellow fever vaccine?
Usually, you can find the yellow fever vaccine in NYC at travel clinics where a travel doctor or other travel medicine practitioners are located.
Are there different types of yellow fever vaccinations?
YF-Vax, which was recently unavailable due to a manufacturing issue, is again available in NYC and elsewhere in the United States.
Stamaril is a yellow fever vaccination nearly identical to YF-Vax licensed outside the US. It was temporarily available in the US during the YF-Vax shortage that lasted three years and ended in 2021.
How long does it take the yellow fever vaccine to take effect?
It takes ten days after immunization for the yellow fever vaccination (and most other vaccinations) to take effect.
How long does the yellow fever shot last?
Up until several years ago, World Health Organization guidelines stated the yellow fever vaccine was considered effective for 10 years. After that time, you needed a booster. Now, as per the World Health Organization and the CDC, the yellow fever vaccine is considered effective for life. There are still some countries that do not always recognize the lifetime effectiveness of the vaccine. Therefore, they may require a booster every ten years to meet their entry requirements. Also, for some longer-term travelers to West Africa, it may be advisable to get a booster after ten years. This is due to the increased risk of contracting yellow fever in that particular part of the world.
Can I use a copy of my Yellow Card as proof of vaccination?
Yes and no.
The original card is sometimes required for visas, although many visa applications can be done online and therefore digital copies of your Yellow Card (and everything else) are usually acceptable.
However, passage into many countries still often requires the ORIGINAL card, not a copy or picture, to be shown at borders/airports.
I have lost my Yellow Card. What are my options?
If you have figured out your Yellow Card is REQUIRED for your trip but you have lost it. You can:
1) Contact whoever issued the card to you and ask them to create and send another one.
2) Ask another healthcare provider to issue you another card based on a copy of the card, assuming you have all of the correct information such as administration date and location, vaccine manufacturer, vaccine lot number, and signatures and stamp from the clinic. At our clinic, we also add a notation that we are not the actual vaccinating center but are certifying that a previous card appears in order.
3) Retake the vaccination.
4) Attempt to use a picture of the card or a copy if you have it, but this may not be adequate at border crossings/airports.
At our NY Travel Clinic, we usually remind our travelers to make a print and cellphone picture copy of their cards.
What if I had a yellow fever vaccine less than ten years ago and need another one because I have no records? Is it safe?
There is no significant increase in the risk of a bad reaction to the vaccine if you must repeat it less than ten years after your first shot.
What if I cannot take the yellow fever vaccine and it is required?
If you and your Travel Healthcare Professional decide that the risk of the vaccine is greater than the risk of yellow fever, he or she can issue you a medical waiver. Essentially, this uses the same yellow card but states your medical provider feels you should not receive the vaccine because of your age, a medical condition, or other reasons. Note: This waiver is NOT always accepted at border crossings or on visa applications.
Aside from vaccination, how do I prevent yellow fever?
Mosquito avoidance is important. Use of sprays on your skin and sometimes clothing can reduce your risk of mosquito bites and therefore reduce your risk of yellow fever.
We have the YF-Vax in stock. For a yellow fever vaccine in NYC, contact Travel Medicine Consultations, where you can schedule an appointment with Dr. Julian Klapowitz to discuss your vaccine needs for travel health.
For further information, please visit CDC/Yellow Fever.