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Yellow Fever Vaccine

Yellow fever

Yellow fever is a hemorrhagic viral illness transmitted by Aedes mosquitoes in sub-Saharan Africa and tropical South America. Approximately 15% of patients who develop severe yellow fever will die. The disease can cause jaundice (hence 'yellow' fever), kidney failure, internal bleeding, and multi-organ failure. Vaccination is required for entry to many endemic countries.

📅
85+ yrs
Years in Use
💉
Over 500 million doses globally
Doses Administered
🛡️
99% vs severe disease
Effectiveness
👶
9 months and older; required for travel to endemic countries; only at certified travel clinics
Age Window

Overall Benefit Score

21/ 100
? Discuss With Provider

Default scenario · 12-month-old · US community (92% vax rate)

Score for your child →
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The risk-benefit balance in your specific scenario suggests a detailed conversation with your child's provider before deciding.

📊 Evidence Scores

Scores computed from peer-reviewed data using VaxFact's evidence model. Based on default scenario (12-month-old, standard US community).

Net BenefitBenefit minus risk, weighted by exposure probability
21
Exposure RiskLikelihood of encountering the disease
9
Disease ConsequenceSeverity of outcomes if disease is acquired
100
Vaccine BenefitProtection provided against disease and death
99
Vaccine HarmRisk from the vaccine itself (adverse events)
93
Evidence ConfidenceQuality and consensus of the scientific evidence
82

🦠 Disease Burden

Yellow fever is a hemorrhagic viral illness transmitted by Aedes mosquitoes in sub-Saharan Africa and tropical South America. Approximately 15% of patients who develop severe yellow fever will die. The disease can cause jaundice (hence 'yellow' fever), kidney failure, internal bleeding, and multi-organ failure. Vaccination is required for entry to many endemic countries.

🔄
Mosquito-borne (Aedes aegypti primarily). Not transmitted person-to-person. Risk highest in forested areas and rural settings in endemic regions.
Transmission
moderate
Outbreak Potential
🏥
15% of infected
Hospitalization Rate
⏱️
0.5% of infected
Long-term Complications
📈
50 per 100,000/yr
Incidence (unvaccinated)
📉
1 per 100,000/yr
Incidence (vaccinated)
Quality of Life Impact

Mild cases: fever, headache, muscle pain — resolves in 3–4 days. Severe cases (15% of initial cases progress): toxic phase with jaundice, hemorrhage, and multi-organ failure. Case fatality in toxic phase: 30–60%.

🛡️ Vaccine Effectiveness

🦠
99%
Against Infection
🏥
99%
Against Severe Disease
💚
99%
Against Death
Waning Immunity

Single dose provides lifelong immunity for the vast majority of recipients. WHO revised its position in 2013 — a single dose is now considered sufficient for life; boosters are no longer required. International Certificate of Vaccination (required for some country entry) is now valid for life.

Breakthrough Infections

Vaccine failures are extremely rare. The live attenuated 17D strain generates robust, lifelong neutralizing antibodies in >99% of recipients.

⚠️ Adverse Events & Side Effects

All probabilities are per 100,000 doses administered, sourced from VAERS, Vaccine Safety Datalink, and post-licensure surveillance studies.

Common Side Effects

Injection site pain/headache
Common; resolves in 1–2 days
25,000 / 100k
per dose
Mild fever/malaise (days 5–10)
Due to attenuated viral replication; self-limiting
10,000 / 100k
per dose

Rare Serious Events

Anaphylaxis (egg allergy)
Vaccine produced in eggs — contraindicated in severe egg allergy
10 / 100k
per dose
Yellow Fever Vaccine-Associated Neurotropic Disease (YEL-AND)
~0.8 per 100,000 doses. Encephalitis from vaccine strain. Risk higher in infants <9 months (contraindicated) and adults 60+. Fatal in rare cases.
0.8 / 100k
per dose
Yellow Fever Vaccine-Associated Viscerotropic Disease (YEL-AVD)
~0.4 per 100,000 doses. Vaccine virus replicates like wild-type — multi-organ failure. Risk increases significantly with age 60+ (up to 1.0–1.8 per 100,000). Case fatality: 50–60%.
0.4 / 100k
per dose

📅 Vaccine Schedule

Dosing Schedule
1Single dose at least 10 days before travel to endemic area
Key Info
Minimum interval
N/A (single dose for life)
Can co-administer with
Typhoid, HepA, Rabies
Catch-Up Notes

Only administer at CDC-designated yellow fever vaccination centers. Contraindicated: age <9 months, severe egg allergy, immunocompromised, thymus disorders. Adults 60+: carefully weigh risk vs. benefit given higher YEL-AVD risk.

⚖️ Benefits vs. Considerations

✓ Benefits

  • Single dose — lifelong protection against a hemorrhagic fever with 30–60% case fatality
  • 85 years of use with well-characterized safety profile
  • Required for entry to many endemic countries — mandatory for travelers
  • 99% effectiveness against a disease with limited treatment options
  • Eliminates risk of importing disease to non-endemic countries

↕ Considerations

  • YEL-AVD (viscerotropic disease) can be fatal — risk increases dramatically with age 60+
  • Contraindicated in infants under 9 months, immunocompromised individuals, severe egg allergy
  • Only administered at authorized travel medicine centers — access limitation
  • Produced in eggs — concerns for egg-allergic individuals

🔬 What Some Researchers Question

These are legitimate scientific debates — not fringe claims. They represent areas of ongoing research or policy disagreement among credentialed experts.

  • The risk of YEL-AVD (yellow fever vaccine-associated viscerotropic disease) increases with age — reaching approximately 1–1.8 per 100,000 doses in adults over 60, compared with 0.4 per 100,000 in younger adults. With case fatality of 50–60%, this represents a meaningful risk for older travelers to low-risk destinations. Some travel medicine specialists advocate for careful individual risk assessment for older travelers rather than uniform recommendation (Thomas et al., 2011).

🌫️ Scientific Uncertainties

Honest acknowledgment of what we don't yet know with confidence.

  • Exact mechanism and predictors of YEL-AVD — why some individuals develop this catastrophic reaction is not fully understood; thymus history and genetic factors suspected
  • Risk-benefit balance for adults over 60 in non-endemic travel settings — where disease risk is low but adverse event risk is elevated

🌍 International Policy Comparison

How different countries approach this vaccine — revealing where global consensus is strong vs. where policy diverges.

US
United StatesVaries / Optional
Required for travel to endemic areas; restricted to authorized centers
Travel requirement only; not a routine immunization.
BR
Brazil✓ Recommended
Universal childhood vaccination in endemic regions
Major 2016–2018 outbreak prompted expanded vaccination campaigns.
CM
endemic African nations✓ Recommended
Routine infant vaccination in endemic countries
WHO recommends routine vaccination in all countries with endemic risk.

Brand Names

YF-VaxStamaril

Evidence Quality

Years of Study88/100
Long-Term Safety80/100
Evidence Confidence82/100
In use since1941

Key Sources

WHO Position Paper on Yellow Fever Vaccines
REVIEW · 2013 · Global · high confidence
Lindsey et al. — Adverse Event Reports for Yellow Fever Vaccination (Vaccine)
SURVEILLANCE · 2016 · USA · moderate confidence
🎯

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