Traveling Abroad: Latest Yellow Fever Vaccine Update

By Angela Evans-Morales, CRNP, contributing writer
Image of a mosquito sitting on a human

Yellow fever is most often transmitted via bite from an infected mosquito.

Earlier this month, the U.S. Centers for Disease Control and Prevention (CDC) released its list of clinics that are administering the yellow fever vaccine Stamaril, which has been made available to address the total depletion of the United States’ primary yellow fever vaccine, YF-VAX. These clinics will provide the vaccine to individuals preparing for international travel, including NCI at Frederick staff and scientists.

Until recently, only YF-VAX was licensed for use in the United States, but due to its depletion, public health officials and their partners collaborated in acquiring Stamaril, which is manufactured in France. In October 2016, Stamaril received approval through the U.S. Food and Drug Administration's Investigational New Drug program. The vaccine is only available through the limited number of clinics listed by the CDC.

The release was the result of a partnership between the CDC, the Food and Drug Administration, the U.S. Department of Defense, and Sanofi Pasteur—the manufacturer of both Stamaril and YF-VAX.

“[Stamaril] uses the same vaccine substrain as YF-VAX and has similar safety and efficacy,” a group of CDC and Sanofi Pasteur scientists reported in the CDC’s Morbidity and Mortality Weekly Report.

Yellow fever is an acute viral disease caused by infection with a flavivirus transmitted to humans through a mosquito bite. Most often, infected persons do not develop symptoms. However, the onset of symptoms can manifest within three to six days and may include fever, chills, headache, backache, or muscle aches. Approximately 15 percent of infected persons develop severe complications that can lead to jaundice, bleeding, organ failure, and sometimes even death.

The risk for contracting yellow fever varies based on factors such as the location and duration of travel. Nearly 200,000 cases of the disease and 30,000 deaths are reported annually. Yellow fever is not curable, but it can be prevented by a live-attenuated virus vaccine that produces adequate antibodies to protect the majority of recipients 10 days after vaccination.

Vaccination may be required for entry into certain countries and is often recommended for international travelers visiting endemic areas, such as sub-Saharan Africa and tropical South America; epidemic areas; or outbreak areas, which—according to the CDC—have recently included Angola, the Democratic Republic of the Congo, and Brazil. Nearly 500,000 military and civilian travelers are vaccinated annually in the U.S.

At NCI at Frederick, Occupational Health Services (OHS) has partnered with a local Stamaril clinic to provide yellow fever vaccinations for employees who are traveling for business. OHS is also dedicated to providing employees with the most up-to-date information on travel advisories, safety tips, and immunization requirements for specific destinations. Please consult OHS at least two to three weeks prior to your trip for more information.

For additional information, the CDC has created an interactive map on its website that allows travelers and clinicians to easily search for clinics with Stamaril. There are currently 20 locations in the District of Columbia, Maryland, and Virginia areas offering the vaccine.

YF-VAX is expected to be available by the end of 2018.

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