Dosing and uses of YF Vax (yellow fever vaccine)
Adult dosage forms and strengths
injection [17D-204 strain]
- ≥4.74 log10 plaque-forming units/0.5mL
Yellow Fever
Prophylaxis: 0.5 mL SC ≥10 days before traveL
A single, lifetime dose of yellow fever vaccine is sufficient for most people traveling to endemic areas, although some high-risk groups may benefit from a booster dose according to CDC's Advisory Committee on Immunization Practices
MMWR June 19, 2015:64(23);647-650
Booster/additional dose for high-risk groups
- A single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers
- Additional doses of yellow fever vaccine recommended for
- Women who were pregnant (regardless of trimester) when they received their initial dose of yellow fever vaccine should receive 1 additional dose before their next travel that puts them at risk for yellow fever virus infection
- Persons who received a hematopoietic stem cell transplant after receiving a dose of yellow fever vaccine and who are sufficiently immunocompetent to be safely vaccinated should be revaccinated before their next travel that puts them at risk for yellow fever virus infection
- Booster dose for high risk after 10 yr
- A booster dose may be given to travelers who received their last dose of yellow fever vaccine at least 10 yr previously and who will be in a higher-risk setting based on season, location, activities, and duration of their travel
- Persons who were infected with HIV when they received their last dose of yellow fever vaccine should receive a dose every 10 yr
- Travelers who plan to spend a prolonged period in endemic areas or those traveling to highly endemic areas such as rural West Africa during peak transmission season or an area with an ongoing outbreak
- Laboratory workers who routinely handle wild-type yellow fever virus should have yellow fever virus–specific neutralizing antibody titers measured at least every 10 yr to determine if they should receive additional doses of the vaccine
- For laboratory workers who are unable to have neutralizing antibody titers measured, yellow fever vaccine should be given every 10 yr as long as they remain at risk
Pediatric dosage forms and strengths
injection [17D-204 strain]
- ≥4.74 log10 plaque-forming units/0.5mL
Yellow Fever
>6 months (off-label): 0.5 mL SC x 1 dose ≥10 days before traveL
>9 months: 0.5 mL SC x 1 dose ≥10 days before traveL
A single, lifetime dose of yellow fever vaccine is sufficient for most people traveling to endemic areas, although some high-risk groups may benefit from a booster dose according to CDC's Advisory Committee on Immunization Practices
MMWR June 19, 2015:64(23);647-650
Booster/additional dose for high-risk groups
- A single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers
- Additional doses of yellow fever vaccine recommended for
- Persons who received a hematopoietic stem cell transplant after receiving a dose of yellow fever vaccine and who are sufficiently immunocompetent to be safely vaccinated should be revaccinated before their next travel that puts them at risk for yellow fever virus infection
- Booster dose for high risk after 10 yr
- A booster dose may be given to travelers who received their last dose of yellow fever vaccine at least 10 yr previously and who will be in a higher-risk setting based on season, location, activities, and duration of their travel
- Persons who were infected with HIV when they received their last dose of yellow fever vaccine should receive a dose every 10 yr
- Travelers who plan to spend a prolonged period in endemic areas or those traveling to highly endemic areas such as rural West Africa during peak transmission season or an area with an ongoing outbreak
YF Vax (yellow fever vaccine) adverse (side) effects
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967
1-10%
Headache (5-10%)
Chills (5-10%)
Low-grade fever (5-10%)
Myalgia (5-10%)
Frequency not defined
Meningoencephalitis
Seizures
Rash
Urticaria
Pain
Warmth
Erythema
Guillain-Barre syndrome
Warnings
Contraindications
Hypersensitivity to chicken eggs
Acute or febrile disease
Immunosuppressed patients (due to malignancy, radiation, or medications)
Infants <6 months (per CDC if exposure to the yellow fever virus is unavoidable)
Infants <9 months (per manufacturer due to risk of encephalitis)
Lactation
Cautions
Vial stopper contains natural latex rubber; epinephrine should be available when vaccine
Syncope accompanied by visual disturbances, tonic-clonic movements, or weakness reported with injectable vaccines
Hypersensitivity to egg or chicken protein may be tested with a 1:10 vaccine dilution utilizing a scratch, prick, or puncture test; if vaccine is essential, desensitize individual before administering full dose
Oral prednisone or other systemic corticosteroid therapy may have an immunosuppressive effect on recipients of yellow fever vaccine that potentially decreases immunogenicity and increases the risk of adverse events
Postpone immunization in acute or febrile illness; low grade fever not a reason to postpone vaccination
Risk of encephalitis may be increased (theoretically) in patients who are immunosuppressed
Following vaccination, wait two weeks before donating blood
Effective immunity may not occur in all vaccinated patients
Malnourished persons may have decreased response to vaccination
Pregnancy
Pregnancy category: C
Lactation: There is a theoretical risk of transmission of vaccine components to the infants from breast-feeding mothers, lactation constitutes a contraindication, particularly when infants are <9 months of age because of the risk of encephalitis
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of YF Vax (yellow fever vaccine)
Mechanism of action
Live, attenuated virus stimulates active immunity to Yellow fever; conveys active immunity via stimulation of production of endogenously produced antibodies
Pharmacokinetics
Onset: 7-10 days
Duration of immunity: 30 yr to life
Administration
SC Preparation
Reconstitute 1 dose vial with 0.6 mL supplied diluent and 5 dose vial with 3 mL supplied diluent
Store refrigerated at 2-8°C (35-46°F); do not freeze
Storage
Store refrigerated at 2-8°C (35-46°F)
Do not freeze
