Yellow fever vaccine

How it works

The attenuated 17D-strain virus replicates to elicit durable neutralising antibody and cell-mediated immunity against yellow fever virus.

Prescribing in practice

• As a live vaccine it is contraindicated in significant immunosuppression, in infants below the recommended age, and generally in pregnancy and breastfeeding unless exposure risk is unavoidable, and rare serious viscerotropic and neurotropic reactions can occur particularly at older ages.
• It must be administered only at a registered yellow fever vaccination centre, with an International Certificate of Vaccination or Prophylaxis issued where required for entry.
• True egg allergy is a contraindication as the vaccine is produced in eggs.

Monitoring

No routine laboratory monitoring is required; counsel on and observe for the rare but serious viscerotropic and neurotropic adverse events in the days to weeks after vaccination.

Counselling the patient

• You will receive a certificate that may be required for entry to certain countries; carry it when travelling.
• Seek urgent medical attention if you develop high fever, severe headache or marked malaise in the weeks after vaccination.
• Tell the team about egg allergy, pregnancy, or any condition or medicine affecting your immune system.

Evidence & guidelines

Use is governed by International Health Regulations and UK travel immunisation guidance (the Green Book).