yellow fever vaccine (YF-VAX, Stamaril)

Introduction

Available at Health Department. YF-VAX is the only U.S.-licensed yellow fever vaccine. Stamaril is an international yellow fever vaccine.

Indications

• active indications against yellow fever
• travelers to Espirito Santo State of Brazil (southern Atlantic coast of Brazil)

Contraindications

• sensitivity to egg or chicken embryo protein
• do not vaccinate pregnant* women or children < 6 months of age except in high risk areas

pregnancy-category -

safety in lactation ?

* specific information regarding effects on developing fetus are not available

Dosage

• Single dose: 0.5 mL SC
• generally, no booster needed (single dose provides lifelong immunity)
• some high-risk groups may benefit from a booster dose
  • pregnancy at the time of initial vaccination*
  • hematopoietic stem cell transplantation after initial vaccination*
  • HIV-infected when vaccinated: booster dose every 10 years if continued risk)
  • travelers who received their last vaccine dose >= 10 years previously in high-risk settings based on season, location, activities, & length of travel
  • lab workers who regularly handle wild-type yellow fever virus: re-vaccination every 10 years, depending on antibody titers

* additional dose before travel to endemic area

Injection: >= 5.04 Log[10] plaque-forming units (PFU)/0.5 mL

Pharmacokinetics

• elimination: liver
• Immunity develops by the 10th day.

Adverse effects

• common (> 10%)
  • fever
  • malaise
• less common (1-10%)
  • myalgia, headache
• uncommon (< 1%)
  • encephalitis in very young infants (rare), anaphylaxis

Drug interactions

• administer yellow fever vaccine at least 1 month apart from other live virus vaccines
• defer vaccination for 3 weeks following transfusion of blood, plasma or immune globulin

Mechanism of action

• live virus vaccine

Notes

• WHO requires revaccination every 10 years to maintain travelers' certificates
• County Health Clinic performs vaccination
• vaccine shortage of YF-VAX expected in 2017;
  • FDA has authorized use of Stamaril

More general terms

• live virus vaccine

Additional terms

• yellow fever