Travel Health: Vaccinations

Understanding the Yellow Fever Vaccination Requirements
Yellow fever is a viral disease found in parts of Africa and South America. It is transmitted to humans by a mosquito bite.

Although there is no risk of becoming infected with yellow fever while traveling in countries outside of tropical South America or sub-Saharan Africa (i.e., Central, East, Southern, and West), certain countries REQUIRE a yellow fever vaccination. Some countries require a Yellow Fever Vaccination for all travelers, while others only require a vaccination if a traveler is coming FROM either areas infected with yellow fever or areas where yellow fever transmission has occurred, called endemic areas. The endemic areas are found in tropical South America and Africa. Read Summary of Health Information for International Travel (the Blue Sheet) for the current list of yellow fever-infected countries.

Who Must Receive the Yellow Fever Vaccination
In general, if you are traveling only from the United States to countries in Western or Eastern Europe, North Africa, the Middle East, the Indian subcontinent, East or Southeast Asia, Australia and the South Pacific, the Caribbean, most of Central America, or temperate South America, CDC does not recommend and you are not required to have a yellow fever vaccination.

However, if your travel plans include traveling to or from a South American or African country that is infected with yellow fever or is located in areas where yellow fever transmission has occurred (endemic areas), then the easiest and safest thing to do is to get a yellow fever vaccination and a signed yellow fever certificate. Be aware, the age requirements for vaccination can vary from country to country. Be sure to read the Yellow Fever Certificate information on this page.

How the Yellow Fever Vaccination Is Administered
Yellow fever vaccination, a 1-dose shot, may be administered to adults and to children over 9 months of age. This vaccine is administered only at designated yellow fever centers, usually your local health department. If at continued risk, a booster is needed every 10 years.

Who Should Not Receive the Yellow Fever Vaccination

• Infants under 4 months must not be immunized.
• If you are severely allergic to eggs you should not receive the vaccine. Generally, persons able to eat eggs or egg products can safely receive the vaccine.
• If you are pregnant, it is prudent on theoretical grounds to avoid receiving the vaccination and to postpone travel to epidemic areas until after delivery. However, if you must must travel to high-risk areas you should be vaccinated.
• In general, if your immune system is suppressed due to HIV infection or other conditions, if you are undergoing treatments for cancers (e.g., leukemia and lymphoma), or are being treated with corticosteroids, alkylating drugs, antimetabolites, or radiation, you should not be vaccinated unless traveling to an area of known yellow fever transmission. (Patients with suppressed immune systems have a theoretical risk of encephalitis due to the yellow fever vaccine virus.)

Getting and Using the Yellow Fever Certificate or Medical Waiver

After immunization, an International Certificate of Vaccination is issued. It becomes valid 10 days after vaccination to meet entry and exit requirements for all countries. The Certificate is good for 10 years. You must take the Certificate with you.

Travelers who have a medical reason not to receive the yellow fever vaccine should obtain a medical waiver. Most countries will accept a medical waiver for persons with a medical reason not to receive the vaccine. When required, CDC recommends obtaining written waivers from consular or embassy officials before departure. A physicians letter clearly stating the medical reason not to receive the vaccine might be acceptable to some governments. It should be written on letterhead stationery and bear the stamp used by a health department or official immunization center to validate the International Certificate of Vaccination. Check embassies or consulates for specific waiver requirements.

For More Information...
See the following links:

• Disease and vaccine information: see Yellow Fever and the Diseases section
• Recommendations by region: see the Destinations section

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