Yellow fever vaccine

Short description: Vaccine that protects against yellow fever

Yellow fever vaccine

Yellow fever vaccine vials (Brazil)

Vaccine description
Target disease| Yellow fever
Type| Attenuated virus
Clinical data
Trade names| YF-Vax, Stamaril
Other names| 17D vaccine
AHFS/Drugs.com| Monograph
MedlinePlus| a607030
Pregnancy
category|

* AU: B2[1]

Routes of
administration| Subcutaneous injection
ATC code|

* J07BL (WHO)

Legal status
Legal status|

* UK: POM (Prescription only) [2]
* US: ℞-only [3]

Identifiers
ChemSpider|

* none

UNII|

* PY4EET359T

NY (what is this?) (verify)

Yellow fever vaccine  is a vaccine that protects against yellow fever.[4] Yellow fever is a viral infection that occurs in Africa and South America.[4] Most people begin to develop immunity within ten days of vaccination and 99% are protected within one month, and this appears to be lifelong.[4] The vaccine can be used to control outbreaks of disease.[4] It is given either by injection into a muscle or just under the skin.[4][5]

The World Health Organization (WHO) recommends routine immunization in all countries where the disease is common.[4] This should typically occur between nine and twelve months of age.[4] Those traveling to areas where the disease occurs should also be immunized.[4] Additional doses after the first are generally not needed.[6]

The yellow fever vaccine is generally safe.[4] This includes in those with HIV infection but without symptoms.[4] Mild side effects may include headache, muscle pains, pain at the injection site, fever, and rash.[4] Severe allergies occur in about eight per million doses, serious neurological problems occur in about four per million doses, and organ failure occurs in about three per million doses.[4] It appears to be safe in pregnancy and is therefore recommended among those who will be potentially exposed.[4] It should not be given to those with very poor immune function.[7]

Yellow fever vaccine came into use in 1938.[8] It is on the World Health Organization's List of Essential Medicines.[9][10] The vaccine is made from weakened yellow fever virus.[4] Some countries require a yellow fever vaccination certificate before entry from a country where the disease is common.[4][5]

## Contents

* 1 Medical uses
* 1.1 Targeting
* 1.2 Duration and effectiveness
* 1.3 Schedule
* 2 Side effects
* 3 History
* 4 Manufacture and global supply
* 5 Travel requirements
* 6 References
* 7 External links

## Medical uses

A yellow fever vaccination certificate issued by the Soviet Union.

### Targeting

Medical experts recommend vaccinating people most at risk of contracting the virus, such as woodcutters working in tropical areas.[11] Insecticides, protective clothing, and screening of houses are helpful, but not always sufficient for mosquito control; medical experts recommend using personal insecticide spray in endemic areas.[12] In affected areas, mosquito control methods have proven effective in decreasing the number of cases.[13]

Travellers need to have the vaccine ten days prior to being in an endemic area in order to assure full immunity.[14]: 45

### Duration and effectiveness

For most people, the vaccine remains effective permanently. People who are HIV positive at vaccination can benefit from a booster after ten years.[15]

On 17 May 2013, the World Health Organization (WHO) Strategic Advisory Group of Experts on immunization (SAGE) announced that a booster dose of yellow fever (YF) vaccine, ten years after a primary dose, is not necessary.[16] Since yellow fever vaccination began in the 1930s, only 12 known cases of yellow fever post-vaccination have been identified, after 600 million doses have been dispensed.[17] Evidence showed that among this small number of "vaccine failures", all cases developed the disease within five years of vaccination.[18] This demonstrates that immunity does not decrease with time.[19]

### Schedule

The World Health Organization recommends the vaccine between the ages of 9 and 12 months in areas where the disease is common.[4] Anyone over the age of nine months who has not been previously immunized and either lives in or is traveling to an area where the disease occurs should also be immunized.[4]

## Side effects

The yellow fever 17D vaccine is considered safe, with over 500 million doses given and very few documented cases of vaccine associated illness (62 confirmed cases and 35 deaths as of January 2019).[20] In no case of vaccine-related illness has there been evidence of the virus reverting to a virulent phenotype.[21]

The majority of adverse reactions to the 17D vaccine result from allergic reaction to the eggs in which the vaccine is grown.[22] Persons with known egg allergy should discuss this with their physician prior to vaccination.[23] In addition, there is a small risk of neurologic disease and encephalitis, particularly in individuals with compromised immune systems and very young children. The 17D vaccine is contraindicated in (among others) infants between zero and six months,[24] people with thymus disorders associated with abnormal immune cell function, people with primary immunodeficiencies, and anyone with a diminished immune capacity including those taking immunosuppressant drugs.[25]

There is a small risk of more severe yellow fever-like disease associated with the vaccine. This reaction, known as yellow fever vaccine-associated acute viscerotropic disease (YEL-AVD),[26] causes a fairly severe disease closely resembling yellow fever caused by virulent strains of the virus.[27] The risk factors for YEL-AVD are not known, although it has been suggested that it may be genetic.[28] The 2'-5'-oligoadenylate synthase (OAS) component of the innate immune response has been shown to be particularly important in protection from Flavivirus infection.[29] Another reaction to the yellow fever vaccine is known as yellow fever vaccine-associated acute neurotropic disease (YEL-AND).[30]

The Canadian Medical Association published a 2001 CMAJ article entitled "Yellow fever vaccination: be sure the patient needs it".[31] The article begins by stating that of the seven people who developed system failure within two to five days of the vaccine in 1996–2001, six died "including 2 who were vaccinated even though they were planning to travel to countries where yellow fever has never been reported."[32] The article cites that "3 demonstrated histopatholic changes consistent with wild yellow fever virus."[33] The author recommends vaccination for only non-contraindicated travelers (see the articles list) and those travelers going where yellow fever activity is reported or in the endemic zone which can be found mapped at the CDC website cited below.[34] In addition, the 2010 online edition of the Center for Disease Control Traveler's Health Yellow Book states that between 1970 and 2002 only "nine cases of yellow fever were reported in unvaccinated travelers from the United States and Europe who traveled" to West Africa and South America, and 8 of the 9 died.[35] However, it goes on to cite "only 1 documented case of yellow fever in a vaccinated traveler.[36] This nonfatal case occurred in a traveler from Spain who visited several West African countries in 1988".[37]

## History

African tropical cultures had adopted burial traditions in which the deceased were buried near their habitation, including those who died of Yellow fever.[38] This ensured that people within these cultures gained immunity through a childhood case of "endemic" yellow fever through acquired immunity. This led to a lasting misperception first by colonial authorities and foreign medical experts that Africans have a "natural immunity"[39] to the illness. In the nineteenth century health provisioners forced abandonment of these traditional burial traditions, leading to local populations dying of yellow fever as frequently as those without such burial customs such as settler populations.[40]

The first modern attempts to develop a yellow fever vaccine followed the opening of the Panama Canal in 1912, which increased global exposure to the disease.[41] The Japanese bacteriologist Hideyo Noguchi led investigations for the Rockefeller Foundation in Ecuador that resulted in a vaccine based on his theory that the disease was caused by a leptospiral bacterium.[42] However, other investigators could not duplicate his results and the ineffective vaccine was eventually abandoned.[citation needed]

Another vaccine was developed from the "French strain" of the virus, obtained by Pasteur Institute scientists from a man in Dakar, Senegal, who survived his bout with the disease.[citation needed] This vaccine could be administered by scarification, like the smallpox vaccine, and was given in combination to produce immunity to both diseases, but it also had severe systemic and neurologic complications in a few cases.[43] Attempts to attenuate the virus used in the vaccine failed. Scientists at the Rockefeller Foundation developed another vaccine derived from the serum of an African named Asibi in 1927, the first isolation of the virus from a human.[44] It was safer but involved the use of large amounts of human serum, which limited widespread use.[45] Both vaccines were in use for several years, the Rockefeller vaccine in the Western hemisphere and England, and the Pasteur Institute vaccine in France and its African colonies.[46]

In 1937, Max Theiler, working with Hugh Smith and Eugen Haagen at the Rockefeller Foundation to improve the vaccine from the "Asibi" strain, discovered that a favorable chance mutation in the attenuated virus had produced a highly effective strain that was named 17D.[47] Following the work of Ernest Goodpasture, Theiler used chicken eggs to culture the virus. After field trials in Brazil, over one million people were vaccinated by 1939, without severe complications.[8] This vaccine was widely used by the U.S. Army during World War II.[48] For his work on the yellow fever vaccine, Theiler received the 1951 Nobel Prize in Physiology or Medicine.[49] Only the 17D vaccine remains in use today.[4]

Theiler's vaccine was responsible for the largest outbreak of Hepatitis B in history: infecting 330,000 soldiers and giving 50,000 jaundice between 1941 and 1942.[50] At the time, chronic infectious hepatitis was not known, so when human serum was used in vaccine preparation, serum drawn from a chronic Hepatitis B Virus (HBV) carrier would contaminate the Yellow Fever Vaccine.[51] In 1941, researchers at Rocky Mountain Laboratories developed a safer alternative, an "aqueous-base" version of the 17D vaccine using distilled water combined with the virus grown in chicken eggs.[52] Since 1971, screening technology for HBV has been available and is routinely used in situations where HBV contamination is possible including vaccine preparation.[53]

Also in the 1930s, a French team developed the French neurotropic vaccine (FNV), which was extracted from mouse brain tissue.[54] Since this vaccine was associated with a higher incidence of encephalitis, FNV was not recommended after 1961. Vaccine 17D is still in use, and more than 400 million doses have been distributed. Little research has been done to develop new vaccines. Newer vaccines, based on vero cells, are in development (as of 2018).[55][56][57]

## Manufacture and global supply

Increases in cases of yellow fever in endemic areas of Africa and South America in the 1980s were addressed by the WHO Yellow Fever Initiative launched in the mid-2000s.[58] The initiative was supported by the Gavi Alliance, a collaboration of the WHO, UNICEF, vaccine manufacturers, and private philanthropists such as the Bill & Melinda Gates Foundation.[59] Gavi-supported vaccination campaigns since 2011 have covered 88 million people in 14 countries considered at "high-risk" of a yellow fever outbreak (Angola was considered "medium risk"). As of 2013, there were four WHO-qualified manufacturers: Bio-Manguinhos in Brazil (with the Oswaldo Cruz Foundation), Institute Pasteur in Dakar, Senegal, the Federal State Unitary Enterprise of Chumakov Institute in Russia, and Sanofi Pasteur, the French pharmaceutical company.[60][61] Two other manufacturers supply domestic markets: Wuhan Institute of Biological Products in China and Sanofi Pasteur in the United States.[62]

Demand for yellow fever vaccine for preventive campaigns has increased from about five million doses per year to a projected 62 million per year by 2014.[63] UNICEF reported in 2013 that supplies were insufficient. Manufacturers are producing about 35 million of the 64 million doses needed per year.[64] Demand for the yellow fever vaccine has continued to increase due to the growing number of countries implementing yellow fever vaccination as part of their routine immunization programmes.[65]

The outbreak of yellow fever in Angola and in the Democratic Republic of Congo in 2016 has raised concerns about whether the global supply of vaccine is adequate to meet the need during a large epidemic or pandemic of the disease.[66] Routine childhood immunization was suspended in other African countries to ensure an adequate supply in the vaccination campaign against the outbreak in Angola.[67] Emergency stockpiles of vaccine diverted to Angola, which consisted of about 10 million doses at the end of March 2016, had become exhausted,[60][68] but were being replenished by May 2016.[69] However, in August it was reported that about one million doses of six million shipped in February had been sent to the wrong place or not kept cold enough to ensure efficacy, resulting in shortages to fight the spreading epidemic in DR Congo.[70] As an emergency measure, experts suggested fractional dose vaccination, using a fractional dose (1/5 or 1/10 of the usual dose) to extend existing supplies of vaccine.[71][67] Others have noted that switching manufacturing processes to modern cell-culture technology might improve vaccine supply shortfalls,[62] as the manufacture of the current vaccine in chicken eggs is slow and laborious.[72] On 17 June 2016, the WHO agreed to the use of 1/5 the usual dose as an emergency measure during the ongoing outbreak in Angola and the DR Congo.[65][73] The fractional dose would not qualify for a yellow fever certificate of vaccination for travelers. Later studies found that the fractional dose was just as protective as the full dose, even 10 years after vaccination.[74]

As of February 2021, UNICEF reported awarded contract prices of ranging from US$0.97 to US$1.444 per dose under multi-year contracts with various suppliers.[75]

## Travel requirements

Risk countries (WHO designation)

Partial risk countries (WHO designation)

Vaccination against yellow fever 10 days before entering this country/territory is required for travellers coming from...

All countries

Risk countries (including airport transfers)[note 1]

Risk countries (excluding airport transfers)[note 2]

No requirement (risk country)[note 3]

No requirement (non-risk country)

Travellers who wish to enter certain countries or territories must be vaccinated against yellow fever 10 days before crossing the border, and be able to present a vaccination record/certificate at the border checks.[14]: 45 In most cases, this travel requirement depends on whether the country they are travelling from has been designated by the World Health Organization as being a 'country with risk of yellow fever transmission'.[76] In a few countries, it does not matter which country the traveller comes from: everyone who wants to enter these countries must be vaccinated against yellow fever.[77] There are exemptions for newborn children; in most cases, any child who is at least 9 months or 1 year old needs to be vaccinated.[78]

Yellow fever vaccination requirements for international travel (July 2019)[78]

Country or territory  | Status  | Vaccination required for travellers coming from  | Traveller age
Albania  | No risk  | Risk countries  | 1 year or older
Algeria  | No risk  | Risk countries[note 4] | 1 year or older
Angola  | Risk country  | All countries  | 9 months or older
Antigua and Barbuda  | No risk  | Risk countries  | 1 year or older
Argentina  | Risk provinces:
Misiones, Corrientes  | No[note 3] | –
Aruba  | No risk  | Risk countries[note 4] | 9 months or older
Australia  | No risk  | Risk countries[note 4] | 1 year or older
Bahamas  | No risk  | Risk countries[note 4] | 1 year or older
Bahrain  | No risk  | Risk countries[note 4] | 9 months or older
Bangladesh  | No risk  | Risk countries[note 5] | 1 year or older
Barbados  | No risk  | Risk countries  | 1 year or older
Belize  | No risk  | Risk countries[note 5] | 1 year or older
Benin  | Risk country  | Risk countries[note 5] | 1 year or older
Bolivia  | Risk country  | Risk countries  | 1 year or older
Bonaire  | No risk  | Risk countries[note 4] | 9 months or older
Botswana  | No risk  | Risk countries[note 5] | 1 year or older
Brazil  | Risk country  | No[note 3] | –
Brunei  | No risk  | Risk countries[note 4] | 9 months or older
Burkina Faso  | Risk country  | Risk countries[note 5] | 9 months or older
Burundi  | Risk country  | Risk countries[note 5] | 9 months or older
Cabo Verde  | No risk  | Risk countries[note 4] | 1 year or older
Cambodia  | No risk  | Risk countries[note 4] | 1 year or older
Cameroon  | Risk country  | All countries  | 9 months or older
Central African Republic  | Risk country  | All countries  | 9 months or older
Chad  | Risk country  | All countries  | 9 months or older
China  | No risk  | Risk countries[note 5] | 9 months or older
Christmas Island  | No risk  | Risk countries[note 4] | 1 year or older
Colombia  | Risk country  | Risk countries[note 4] | 1 year or older
Congo-Brazzaville  | Risk country  | All countries  | 9 months or older
Congo-Kinshasa  | Risk country  | All countries  | 9 months or older
Costa Rica  | No risk  | Risk countries  | 9 months or older
Côte d'Ivoire  | Risk country  | All countries  | 9 months or older
Cuba  | No risk  | Risk countries[note 4] | 9 months or older
Curaçao  | No risk  | Risk countries[note 4] | 9 months or older
Dominica  | No risk  | Risk countries[note 4] | 1 year or older
Dominican Republic  | No risk  | Risk countries[note 4] | 1 year or older
Ecuador  | Risk country  | Risk countries[note 4] | 1 year or older
Egypt  | No risk  | Risk countries[note 4] | 9 months or older
El Salvador  | No risk  | Risk countries[note 4] | 1 year or older
Equatorial Guinea  | Risk country  | Risk countries  | 9 months or older
Eritrea  | No risk  | Risk countries[note 4] | 9 months or older
Eswatini  | No risk  | Risk countries[note 5] | 9 months or older
Ethiopia  | Risk country  | Risk countries[note 4] | 9 months or older
Fiji  | No risk  | Risk countries[note 4] | 1 year or older
French Guiana  | Risk country  | All countries  | 1 year or older
French Polynesia  | No risk  | Risk countries[note 4] | 9 months or older
Gabon  | Risk country  | All countries  | 1 year or older
Gambia  | Risk country  | Risk countries  | 9 months or older
Ghana  | Risk country  | All countries  | 9 months or older
Grenada  | No risk  | Risk countries[note 4] | 1 year or older
Guadeloupe  | No risk  | Risk countries[note 4] | 1 year or older
Guatemala  | No risk  | Risk countries[note 4] | 1 year or older
Guinea  | Risk country  | Risk countries  | 9 months or older
Guinea-Bissau  | Risk country  | All countries  | 1 year or older
Guyana  | Risk country  | Risk countries[note 5] | 1 year or older
Haiti  | No risk  | Risk countries  | 1 year or older
Honduras  | No risk  | Risk countries  | 1 year or older
India  | No risk  | Risk countries[note 5] | 9 months or older
Indonesia  | No risk  | Risk countries  | 9 months or older
Iran  | No risk  | Risk countries[note 4] | 9 months or older
Iraq  | No risk  | Risk countries[note 4] | 9 months or older
Jamaica  | No risk  | Risk countries[note 4] | 1 year or older
Jordan  | No risk  | Risk countries[note 4] | 1 year or older
Kenya  | Risk country  | Risk countries  | 1 year or older
Kyrgyzstan  | No risk  | Risk countries[note 4] | 1 year or older
Laos  | No risk  | Risk countries  | Unknown
Lesotho  | No risk  | Risk countries[note 4] | 6 months or older
Liberia  | Risk country  | Risk countries  | 9 months or older
Libya  | No risk  | Risk countries  | 1 year or older
Madagascar  | No risk  | Risk countries[note 4] | 9 months or older
Malawi  | No risk  | Risk countries[note 4] | 1 year or older
Malaysia  | No risk  | Risk countries[note 4] | 1 year or older
Maldives  | No risk  | Risk countries[note 4] | 9 months or older
Mali  | Risk country  | All countries  | 1 year or older
Malta  | No risk  | Risk countries[note 4] | 9 months or older
Martinique  | No risk  | Risk countries[note 4] | 1 year or older
Mauritania  | Risk country  | Risk countries  | 1 year or older
Mayotte  | No risk  | Risk countries[note 4] | 1 year or older
Montserrat  | No risk  | Risk countries[note 5] | 1 year or older
Mozambique  | No risk  | Risk countries[note 4] | 9 months or older
Myanmar  | No risk  | Risk countries[note 4] | 1 year or older
Namibia  | No risk  | Risk countries[note 4] | 9 months or older
Nepal  | No risk  | Risk countries[note 4] | 1 year or older
New Caledonia  | No risk  | Risk countries[note 4] | 1 year or older
Nicaragua  | No risk  | Risk countries  | 1 year or older
Niger  | Risk country  | All countries  | 1 year or older
Nigeria  | Risk country  | All countries  | 9 months or older
Niue  | No risk  | Risk countries  | 9 months or older
North Korea  | No risk  | Risk countries  | 1 year or older
Oman  | No risk  | Risk countries[note 4] | 9 months or older
Pakistan  | No risk  | Risk countries  | 1 year or older
Panama  | Risk country  | Risk countries[note 4] | 1 year or older
Papua New Guinea  | No risk  | Risk countries[note 5] | 1 year or older
Paraguay  | Risk country  | Risk countries  | 1 year or older
Peru  | Risk country  | No[note 3] | –
Philippines  | No risk  | Risk countries[note 4] | 1 year or older
Pitcairn Islands  | No risk  | Risk countries  | 1 year or older
Rwanda  | No risk  | Risk countries  | 1 year or older
Saint Barthélemy  | No risk  | Risk countries[note 4] | 1 year or older
Saint Helena  | No risk  | Risk countries  | 1 year or older
Saint Kitts and Nevis  | No risk  | Risk countries  | 1 year or older
Saint Lucia  | No risk  | Risk countries  | 9 months or older
Saint Martin  | No risk  | Risk countries[note 4] | 1 year or older
Saint Vincent and the Grenadines  | No risk  | Risk countries  | 1 year or older
Samoa  | No risk  | Risk countries[note 4] | 1 year or older
São Tomé and Príncipe  | No risk  | Risk countries[note 5] | 1 year or older
Saudi Arabia  | No risk  | Risk countries[note 4] | 1 year or older
Senegal  | Risk country  | Risk countries[note 5] | 9 months or older
File:Flag of the Seychelles.svg Seychelles  | No risk  | Risk countries[note 4] | 1 year or older
Sierra Leone  | Risk country  | All countries  | Unknown
Singapore  | No risk  | Risk countries[note 4] | 1 year or older
Sint Eustatius  | No risk  | Risk countries  | 6 months or older
Sint Maarten  | No risk  | Risk countries  | 9 months or older
Solomon Islands  | No risk  | Risk countries  | 9 months or older
Somalia  | No risk  | Risk countries[note 4] | 9 months or older
South Africa  | No risk  | Risk countries[note 4] | 1 year or older
South Sudan  | Risk country  | All countries  | 9 months or older
Sri Lanka  | No risk  | Risk countries[note 4] | 9 months or older
Sudan  | Risk country  | Risk countries[note 4] | 1 year or older
Suriname  | Risk country  | Risk countries[note 4] | 1 year or older
Tanzania  | No risk  | Risk countries[note 4] | 1 year or older
Thailand  | No risk  | Risk countries[note 4] | 1 year or older
Togo  | Risk country  | All countries  | 9 months or older
Trinidad and Tobago  | Risk region:
Trinidad  | Risk countries  | 1 year or older
Uganda  | Risk country  | All countries  | 1 year or older
United Arab Emirates  | No risk  | Risk countries[note 4] | 9 months or older
Venezuela  | Risk country  | Risk countries[note 4] | 1 year or older
Wallis and Futuna  | No risk  | Risk countries[note 4] | 1 year or older
Zambia  | No risk  | Risk countries[note 4] | 1 year or older
Zimbabwe  | No risk  | Risk countries[note 4] | 9 months or older

1. ↑ Also required for travellers having transited (more than 12 hours) through a risk country's airport.
2. ↑ Not required for travellers having transited through a risk country's airport.
3. ↑ 3.0 3.1 3.2 3.3 The WHO has designated (parts of) Argentina, Brazil and Peru as risk countries, but these countries do not require incoming travellers to vaccinate against yellow fever.
4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 4.36 4.37 4.38 4.39 4.40 4.41 4.42 4.43 4.44 4.45 4.46 4.47 4.48 4.49 4.50 4.51 4.52 4.53 4.54 4.55 4.56 4.57 4.58 4.59 4.60 4.61 4.62 4.63 Also required for travellers having transited more than 12 hours through a risk country's airport.
5. ↑ 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 5.11 5.12 5.13 Also required for travellers having transited any time through a risk country's airport.

## References

1. ↑ Use During Pregnancy and Breastfeeding
2. ↑ "Stamaril powder and solvent for suspension for injection in pre-filled syringe - Summary of Product Characteristics (SmPC)". 9 September 2019. https://www.medicines.org.uk/emc/product/1683/smpc.
3. ↑ "YF-Vax". 6 August 2019. http://www.fda.gov/vaccines-blood-biologics/vaccines/yf-vax.
4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 "Vaccines and vaccination against yellow fever. WHO position paper -- June 2013". Weekly Epidemiological Record 88 (27): 269–283. July 2013. PMID 23909008.
5. ↑ 5.0 5.1 "Yellow Fever Vaccine - an overview | ScienceDirect Topics". https://www.sciencedirect.com/topics/nursing-and-health-professions/yellow-fever-vaccine.
6. ↑ "Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015". MMWR. Morbidity and Mortality Weekly Report 64 (23): 647–650. June 2015. PMID 26086636.
7. ↑ "Yellow Fever Vaccine". Centers for Disease Control and Prevention (CDC). 13 December 2011. https://www.cdc.gov/yellowfever/vaccine/.
8. ↑ 8.0 8.1 "Yellow fever and Max Theiler: the only Nobel Prize for a virus vaccine". The Journal of Experimental Medicine 204 (12): 2779–2784. November 2007. doi:10.1084/jem.20072290. PMID 18039952.
9. ↑ World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
10. ↑ World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. WHO/MHP/HPS/EML/2021.02.
11. ↑ "How WHO is supporting ongoing vaccination efforts during the COVID-19 pandemic" (in en). https://www.who.int/news-room/feature-stories/detail/how-who-is-supporting-ongoing-vaccination-efforts-during-the-covid-19-pandemic.
12. ↑ "Combining indoor residual spraying and insecticide-treated nets for malaria control in Africa: a review of possible outcomes and an outline of suggestions for the future". Malaria Journal 10 (1): 208. July 2011. doi:10.1186/1475-2875-10-208. PMID 21798053.
13. ↑ "Joint Statement on Mosquito Control in the United States from the U.S. Environmental Protection Agency (EPA) and the U.S. Centers for Disease Control and Prevention (CDC)". Environmental Protection Agency. 3 May 2000. http://www.epa.gov/pesticides/health/mosquitoes/mosquitojoint.htm#programs.
14. ↑ 14.0 14.1 "International Travel and Health. Chapter 6 - Vaccine-preventable diseases and vaccines (2019 update)". World Health Organization. United Nations. 2020. https://www.who.int/ith/CHAPTER_6_For_Publication.pdf.
15. ↑ "Long-term immunity following yellow fever vaccination: a systematic review and meta-analysis". Lancet Glob Health. January 2024. doi:10.1016/S2214-109X(23)00556-9. PMID 38272044.
16. ↑ "Strategic Advisory Group of Experts on Immunization (SAGE)" (in en). https://www.who.int/groups/strategic-advisory-group-of-experts-on-immunization.
17. ↑ "Yellow fever vaccination booster not needed" (in en). https://www.who.int/news/item/17-05-2013-yellow-fever-vaccination-booster-not-needed.
18. ↑ "Vaccine Failure - an overview | ScienceDirect Topics". https://www.sciencedirect.com/topics/neuroscience/vaccine-failure.
19. ↑ "Vaccines" (Press release). World Health Organization (WHO). Archived from the original on 9 June 2013.
20. ↑ "What are the risks of dying from having the yellow fever vaccine?". 11 January 2019. https://www.newscientist.com/article/2190439-what-are-the-risks-of-dying-from-having-the-yellow-fever-vaccine/.
21. ↑ "SARS-CoV-2 variants, spike mutations and immune escape". Nature Reviews. Microbiology 19 (7): 409–424. July 2021. doi:10.1038/s41579-021-00573-0. PMID 34075212.
22. ↑ "Administration of yellow fever vaccine in patients with egg allergy". International Archives of Allergy and Immunology 161 (3): 274–278. 2013. doi:10.1159/000346350. PMID 23548550.
23. ↑ CDC (10 December 2021). "Flu Vaccine and People with Egg Allergies" (in en-us). https://www.cdc.gov/flu/prevent/egg-allergies.htm.
24. ↑ "Yellow Fever Vaccine Information Statement". U.S. Centers for Disease Control and Prevention (CDC). April 2020. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/yf.html.
25. ↑ "Yellow Fever". Centers for Disease Control and Prevention (CDC). http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/yellow-fever.htm#1977.
26. ↑ "Immune response during adverse events after 17D-derived yellow fever vaccination in Europe". The Journal of Infectious Diseases 197 (11): 1577–1584. June 2008. doi:10.1086/587844. PMID 18419548.
27. ↑ "Yellow fever" (in en). https://www.who.int/news-room/fact-sheets/detail/yellow-fever.
28. ↑ "Risk of yellow fever vaccine-associated viscerotropic disease among the elderly: a systematic review". Vaccine 31 (49): 5798–5805. December 2013. doi:10.1016/j.vaccine.2013.09.030. PMID 24079979.
29. ↑ "Activation of 2' 5'-oligoadenylate synthetase by stem loops at the 5'-end of the West Nile virus genome". PLOS ONE 9 (3): e92545. 20 March 2014. doi:10.1371/journal.pone.0092545. PMID 24651762. Bibcode: 2014PLoSO...992545D.
30. ↑ "Yellow fever vaccine-associated neurotropic disease (YEL-AND) - A case report". Neurologia I Neurochirurgia Polska 51 (1): 101–105. January 2017. doi:10.1016/j.pjnns.2016.09.002. PMID 27707454.
31. ↑ "Yellow fever vaccination: be sure the patient needs it". CMAJ 165 (7): 941. October 2001. PMID 11599337.
32. ↑ "Yellow fever". http://www.kidney.de/bdom/Yellow fever.php.
33. ↑ "Where are the Scientists of World Health Organization". Academia.edu. https://www.academia.edu/36969670.
34. ↑ "Yellow Fever in Nigeria - Alert - Level 2, Practice Enhanced Precautions - Travel Health Notices | Travelers' Health". https://wwwnc.cdc.gov/travel/notices/alert/yellow-fever-nigeria.
35. ↑ Centers for Disease Control Prevention (CDC) (October 2008). "Updated recommendations for isolation of persons with mumps". MMWR. Morbidity and Mortality Weekly Report 57 (40): 1103–1105. doi:10.1016/B978-070203481-7.50007-4. PMID 18846033.
36. ↑ "Yellow Fever - Chapter 4 - 2020 Yellow Book | Travelers' Health | CDC" (in en-us). https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/yellow-fever.
37. ↑ "Yellow Fever". Yellow Book: CDC Health Information for International Travel 2012.. New York: Oxford University Press, Incorporated. June 2011. ISBN 978-0-19-976901-8. http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/yellow-fever.htm.
38. ↑ Last refuge of Yellow Fever. 1956. https://unesdoc.unesco.org/ark:/48223/pf0000068636. Retrieved 28 April 2022.
39. ↑ "Types of Immunity to a Disease | CDC" (in en-us). 6 April 2022. https://www.cdc.gov/vaccines/vac-gen/immunity-types.htm.
40. ↑ Epidemics and History: Disease, Power, and Imperialism. New Haven: Yale University Press. 1997. p. 234. ISBN 0-300-07015-2.
41. ↑ "The yellow fever vaccine: a history". The Yale Journal of Biology and Medicine 83 (2): 77–85. June 2010. PMID 20589188.
42. ↑ "The yellow fever vaccine: a history". The Yale Journal of Biology and Medicine 83 (2): 77–85. June 2010. PMID 20589188.
43. ↑ "A nasally administered trivalent inactivated influenza vaccine is well tolerated, stimulates both mucosal and systemic immunity, and potentially protects against influenza illness". Vaccine 29 (10): 1921–1928. February 2011. doi:10.1016/j.vaccine.2010.12.100. PMID 21219987.
44. ↑ "Experimental transmission of yellow fever to laboratory animals". Am J Trop Med Hyg 8 (2): 103–104. 1928. doi:10.4269/ajtmh.1928.s1-8.103.
45. ↑ "Blood safety and availability" (in en). https://www.who.int/news-room/fact-sheets/detail/blood-safety-and-availability.
46. ↑ "Vaccines Through Centuries: Major Cornerstones of Global Health". Frontiers in Public Health 3: 269. 2015. doi:10.3389/fpubh.2015.00269. PMID 26636066.
47. ↑ Frierson, J. (June 2010). "The Yellow Fever Vaccine: A History" (in en). ResearchGate 83 (2): 77–85. PMID 20589188. PMC 2892770. https://www.researchgate.net/publication/44853136.
48. ↑ "Yellow Jack and Geopolitics: Environment, Epidemics, and the Struggles for Empire in the American Tropics, 1650–1825". OAH Magazine of History 18 (3): 9–13. 1 April 2004. doi:10.1093/maghis/18.3.9. http://maghis.oxfordjournals.org/content/18/3/9.extract.
49. ↑ "Max Theiler – Biography". http://nobelprize.org/nobel_prizes/medicine/laureates/1951/theiler-bio.html.
50. ↑ "World War II Hepatitis Outbreak Was Biggest in History". Associated Press. 16 April 1987. https://apnews.com/article/ce911d4f173f1c8ade810969005b9e57.
51. ↑ "Hepatitis B" (in en). https://www.who.int/news-room/fact-sheets/detail/hepatitis-b.
52. ↑ "Vaccine Production in the Bitterroot Valley during World War II: How Rocky Mountain Laboratory Protected American Forces from Yellow Fever". Montana The Magazine of Western History 62 (4): 56–57. Winter 2012. https://www.jstor.org/stable/24414669. Retrieved 1 April 2021.
53. ↑ "Protection Against Viral Hepatitis Recommendations of the Immunization Practices Advisory Committee (ACIP)". https://www.cdc.gov/mmwr/preview/mmwrhtml/00041917.htm.
54. ↑ "Analysis By Deep Sequencing of Discontinued Neurotropic Yellow Fever Vaccine Strains". Scientific Reports 8 (1): 13408. September 2018. doi:10.1038/s41598-018-31085-2. PMID 30194325. Bibcode: 2018NatSR...813408B.
55. ↑ "Mosquito-borne diseases". Current Problems in Pediatric and Adolescent Health Care 39 (4): 97–140. April 2009. doi:10.1016/j.cppeds.2009.01.001. PMID 19327647.
56. ↑ National Institutes of Health (27 July 2016). "NIH launches early-stage yellow fever vaccine trial" (Press release). United States Department of Health and Human Services. Retrieved 14 July 2019.
57. ↑ National Institute of Allergy and Infectious Diseases (NIAID) (1 June 2018), A Phase I Trial to Evaluate the Safety, Reactogenicity, and Immunogenicity of MVA-BN Yellow Fever Vaccine With and Without Montanide ISA-720 Adjuvant in 18-45 Year Old Healthy Volunteers (NCT number: NCT02743455), United States National Library of Medicine, https://clinicaltrials.gov/ct2/show/NCT02743455, retrieved 14 July 2019 .
58. ↑ "The Yellow fever initiative: an introduction". World Health Organization (WHO). https://www.who.int/csr/disease/yellowfev/introduction/en/.
59. ↑ "COVAX Facility" (in en). https://www.gavi.org/covax-facility.
60. ↑ 60.0 60.1 "Angolan yellow fever outbreak highlights dangerous vaccine shortage". 4 April 2016. https://www.science.org/content/article/angolan-yellow-fever-outbreak-highlights-dangerous-vaccine-shortage.
61. ↑ "Yellow Fever Vaccine: Current Outlook". Unicef. http://www.unicef.org/supply/files/YFV_Supply_Status_Update.pdf.
62. ↑ 62.0 62.1 "Yellow Fever in Angola and Beyond--The Problem of Vaccine Supply and Demand". The New England Journal of Medicine 375 (4): 301–303. July 2016. doi:10.1056/NEJMp1606997. PMID 27276108.
63. ↑ "Fever Vaccine: Current Outlook November 2013". UNICEF. http://www.unicef.org/supply/files/YFV_Supply_Status_Update.pdf.
64. ↑ "Complacency Led to Resurgence of Yellow Fever". http://www.globalhealthnow.org/news/complacency-led-to-resurgence-of-yellow-fever.
65. ↑ 65.0 65.1 Fractional dose yellow fever vaccine as a dose-sparing option for outbreak response: WHO Secretariat information paper. July 2016. WHO/YF/SAGE/16.1.
66. ↑ "Yellow Fever Deaths Reach 250 in Angola | HealthMap". http://www.healthmap.org/site/diseasedaily/article/yellow-fever-deaths-reach-250-angola-42616.
67. ↑ 67.0 67.1 "Yellow fever vaccine supply: a possible solution". Lancet 387 (10028): 1599–1600. April 2016. doi:10.1016/S0140-6736(16)30195-7. PMID 27116054.
68. ↑ "Angola extends yellow fever vaccination campaign to Huambo and Benguela provinces". World Health Organization (WHO) (Press release). Archived from the original on 23 April 2016. Retrieved 24 April 2016.
69. ↑ "Yellow fever threat is 'serious' but not an 'emergency,' WHO says". Science. 19 May 2016. doi:10.1126/science.aaf5736. ISSN 0036-8075.
70. ↑ "UN bungles response to Africa's yellow fever outbreak". http://bigstory.ap.org/article/c5be7d71b0cb4c99a05940f5adfc7166/ap-investigation-1-million-vaccines-vanished-angola.
71. ↑ "Yellow fever vaccine: WHO position on the use of fractional doses – June 2017". Weekly Epidemiological Record 92 (25): 345–350. June 2017. PMID 28643507.
72. ↑ "NIH launches early-stage yellow fever vaccine trial". 26 July 2016. https://www.nih.gov/news-events/nih-launches-early-stage-yellow-fever-vaccine-trial.
73. ↑ "Lower doses of yellow fever vaccine could be used in emergencies". World Health Organization (WHO) (Press release). 17 June 2016. Archived from the original on 18 June 2016. Retrieved 19 June 2016.
74. ↑ Soucheray, Stephanie (26 November 2018). "Study affirms fractional dosing with yellow fever vaccine" (in en). https://www.cidrap.umn.edu/news-perspective/2018/11/study-affirms-fractional-dosing-yellow-fever-vaccine.
75. ↑ "Yellow Fever vaccines prices 05-02-2021". Unicef. https://www.unicef.org/supply/media/11451/file/Yellow-fewer-vaccine-prices-10032022.pdf.
76. ↑ "Countries with risk of yellow fever transmission and countries requiring yellow fever vaccination (May 2021)" (in en). https://www.who.int/publications/m/item/countries-with-risk-of-yellow-fever-transmission-and-countries-requiring-yellow-fever-vaccination-(may-2021).
77. ↑ "Nigeria - Traveler view | Travelers' Health | CDC". https://wwwnc.cdc.gov/travel/destinations/traveler/none/nigeria.
78. ↑ 78.0 78.1 "Countries with risk of yellow fever transmission and countries requiring yellow fever vaccination (July 2019)". World Health Organization. United Nations. 4 July 2019. https://www.who.int/publications/m/item/countries-with-risk-of-yellow-fever-transmission-and-countries-requiring-yellow-fever-vaccination-(july-2019).

## External links

* Yellow Fever Vaccine at the US National Library of Medicine Medical Subject Headings (MeSH)
* "Yellow Fever Vaccine". Drug Information Portal. U.S. National Library of Medicine. https://druginfo.nlm.nih.gov/drugportal/name/yellow fever vaccine.

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Artificial induction of immunity / Immunization: Vaccines, Vaccination, Infection, Biology:Inoculat, Inoculation (J07)

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