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yellow fever vaccine (YF-VAX, Stamaril)

Available at Health Department. YF-VAX is the only U.S.-licensed yellow fever vaccine. Stamaril is an international yellow fever vaccine. Indications: - active indications against yellow fever - travelers to Espirito Santo State of Brazil (southern Atlantic coast of Brazil) [6,7] Contraindications: 1) sensitivity to egg or chicken embryo protein 2) do not vaccinate pregnant* women or children < 6 months of age except in high risk areas pregnancy-category - safety in lactation ? * specific information regarding effects on developing fetus are not available Dosage: - Single dose: 0.5 mL SC - generally, no booster needed (single dose provides lifelong immunity) [3] - some high-risk groups may benefit from a booster dose - pregnancy at the time of initial vaccination* - hematopoietic stem cell transplantation after initial vaccination* - HIV-infected when vaccinated: booster dose every 10 years if continued risk) [5] - travelers who received their last vaccine dose >= 10 years previously in high-risk settings based on season, location, activities, & length of travel [5] - lab workers who regularly handle wild-type yellow fever virus: re-vaccination every 10 years, depending on antibody titers [5] * additional dose before travel to endemic area [5] Injection: >= 5.04 Log[10] plaque-forming units (PFU)/0.5 mL Pharmacokinetics: - elimination: liver - Immunity develops by the 10th day. Adverse effects: 1) common (> 10%) - fever - malaise 2) less common (1-10%) - myalgia, headache 3) uncommon (< 1%) - encephalitis in very young infants (rare), anaphylaxis Drug interactions: 1) administer yellow fever vaccine at least 1 month apart from other live virus vaccines 2) defer vaccination for 3 weeks following transfusion of blood, plasma or immune globulin Mechanism of action: - live virus vaccine [8] Notes: - WHO requires revaccination every 10 years to maintain travelers' certificates - County Health Clinic performs vaccination [2] - vaccine shortage of YF-VAX expected in 2017; - FDA has authorized use of Stamaril [9]

Related

yellow fever

General

live virus vaccine

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. Veterans Administration, Infectious Disease, Mather, CA
  3. World Health Organization (WHO) May 17, 2013 Yellow fever vaccination booster not needed. http://www.who.int/mediacentre/news/releases/2013/yellow_fever_20130517/en/index.html
  4. Division of Global Migration and Quarantine, National Center for Infectious Diseases, CDC, USA. Yellow fever vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2002. MMWR Recomm Rep. 2002 Nov 8;51(RR-17):1-11; quiz CE1-4 PMID: 12437192 corresponding NGC guideline withdrawn Jan 2016
  5. Staples EJ et al Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015 MMWR Weekly. June 19, 2015 / 64(23);647-650 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a5.htm
  6. World Health Organization (WHO) Yellow Fever - Brazil. Disease outbreak news. March 6 2017 http://www.who.int/csr/don/06-march-2017-yellow-fever-brazil/en/
  7. Paules CI, Fauci AS Yellow Fever - Once Again on the Radar Screen in the Americas. N Engl J Med. March 8, 2017 PMID: 28273000 http://www.nejm.org/doi/full/10.1056/NEJMp1702172
  8. Omer SB Maternal Immunization. N Engl J Med 2017; 376:1256-1267. March 30, 2017 PMID: 28355514 http://www.nejm.org/doi/full/10.1056/NEJMra1509044
  9. Gershman MD, Angelo KM, Ritchey J, et al. Addressing a Yellow Fever Vaccine Shortage - United States, 2016-2017. MMWR Morb Mortal Wkly Rep. ePub: 28 April 2017 https://www.cdc.gov/mmwr/volumes/66/wr/mm6617e2.htm - Gershman MD, Sotir MJ. Update: Temporary Total Depletion of U.S. Licensed Yellow Fever Vaccine for Civilian Travelers Addressed by Investigational New Drug Use of Imported Stamaril Vaccine. MMWR Morb Mortal Wkly Rep 2017;66:780 https://www.cdc.gov/mmwr/volumes/66/wr/mm6629a4.htm
  10. Centers for Disease Control & Prevention (CDC) Yellow Fever Vaccine. https://www.cdc.gov/yellowfever/vaccine/