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Yellow fever is a serious disease caused by a virus that is spread through the bite of an infected mosquito. Yellow fever can cause fever and flu-like illness, jaundice (yellowing of the eyes and skin), liver failure, lung failure, kidney failure, vomiting of blood, and possibly death.

Yellow fever vaccine is recommended for people who plan to live in or travel to areas where yellow fever is known to exist, or those who are otherwise at high risk of coming into contact with the virus.

This vaccine is used to help prevent yellow fever in adults and children who are at least 9 months old. The vaccine works by exposing you to a small dose of the virus, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

You should receive the vaccine at least 10 days prior to your arrival in an area where you may be exposed to the virus.

This vaccine is also recommended for people who work in a research laboratory and may be exposed to yellow fever virus through needle-stick accidents or inhalation of viral droplets in the air.

Like any vaccine, the yellow fever vaccine may not provide protection from disease in every person.

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to a yellow fever vaccine, or if you have:

• an allergy to gelatin, eggs, or chicken proteins;

• cancer, leukemia, or lymphoma;

• a weak immune system caused by disease (such as cancer or HIV), or by taking certain medicines such as steroids;

• a disorder such as myasthenia gravis;

• a disease or tumor of the thymus gland, or if your thymus has been surgically removed; or

• if you have received a transplant.

If you have a high risk of exposure to yellow fever, you may need to receive the vaccine even if you have an allergy to eggs or chicken products. Your doctor can give you the vaccine in several small doses to avoid an allergic reaction.

In special cases, a doctor or health official may determine that a child between 6 and 9 months old should receive a yellow fever vaccine. Children younger than 6 months old should not receive this vaccine.

To make sure yellow fever vaccine is safe for you, tell your doctor if you have ever had:

• a seizure;

• a neurologic disorder or disease affecting the brain (or if this was a reaction to a previous vaccine);

• a bleeding or blood clotting disorder such as hemophilia;

• Guillain Barré syndrome; or

• an allergy to latex.

You can still receive a vaccine if you have a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

It is not known whether yellow fever vaccine will harm an unborn baby. However, if you are at a high risk for infection with yellow fever during pregnancy, your doctor should determine whether you need this vaccine.

You should not receive this vaccine if you are breast-feeding a baby.

Talk with your doctor if you are receiving this vaccine less than 10 days prior to your arrival in an area where you may be exposed to the yellow fever virus.

Be sure you receive a booster dose of yellow fever vaccine every 10 years if you continue to travel or live in areas where yellow fever is common. If you do not receive the vaccine every 10 years, you may not be fully protected against the disease.

No adjustment recommended

No adjustment recommended

The lyophilized vaccine must be kept frozen to maintain full potency. It cannot be refrozen. Reconstituted vaccine must be used within 1 hour.

Adverse reactions should be reported to the U.S. Department of Health and Human Services Vaccine Adverse Event Reporting System. Reporting forms and information regarding the completion of the form can be obtained at 1-800-822-7967.

The ACIP (Advisory Committee on Immunization Practices) recommends that live-virus vaccines not administered on the same day should be administered at least 30 days apart. There is concern that the vaccine given first could interfere with response to the vaccine given second. ACIP recommends that if two live parenteral vaccines are given less than 28 days apart, the vaccine given second should not be counted as valid and should be repeated at least 4 weeks later.

There are no data on the excretion of yellow fever vaccine into human milk. There have been no reports of viral transmission to, or adverse events in nursing infants. However, there is a theoretical risk of transmission of the 17D virus to breast-feeding infants, which could result in encephalitis. The manufacturer states that nursing mothers may be vaccinated if travel to high-risk areas cannot be avoided or postponed. The U.S. Centers for Disease Control and Prevention (CDC) consider the administration of live virus vaccines compatible with breast-feeding. However, it should be remembered that neonates are too young to be vaccinated and will not be protected against infection.