Yellow Fever Dilemma

I'm sure this has been discussed but I could not find answer. I have seen two conflicting issues.

1) I am 69 and understand that those over 60 should not be vaccinated for Yellow Fever.
2) I understand that many countries do not allow entry from YF-infected countries (ex: Kenya and most of northern Africa as well as the Amazon regions of South America) without proof of YF vaccination.

Do I understand this right? Does this mean that travellers over 60 are not able to travel to these YF countries/regions?

Thanks for any insight on this issue.

Where did you find the info on people over 60 should not be getting a Yellow Fever shot? I had mine last year at the travel clinic, and was 67.

From among other places, the CDC website at http://www.cdc.gov/yellowfever/vaccine/index.html.

It states:
Precautions (conditions for which the risks of the vaccine and the disease should be carefully considered)
•Age 6 to 8 months
•Age ≥60 years
•Asymptomatic HIV infection and CD4+ T-lymphocytes 200 to 499/mm3 (15-24% of total in children aged <6 years)
•Pregnancy
•Breastfeeding

Our regional pharmacy, Walgreens, which provides travel vaccinations, has a policy that they will not administer YF shots for anyone over 60 years.

I've checked around a few government health related websites and found also that there is an issue for those over 60 years. However it is less of a problem for those over 60 who have previous had yellow fever vaccinations. I am therefore assuming that the next time I want to get one my travel doctor will note from my yellow health book that I have had yellow fever vaccinations before.

Always best I think we such things to check out with your own physician or a travel doctor.

this is what the Australian govt health site has to say

"Who can have a yellow fever vaccination?
The yellow fever vaccine is recommended for:

Travellers should seek medical advice on vaccination for their individual medical circumstances, particularly about the suitability of yellow fever vaccine for infants, pregnant women and those who are immuno-compromised."

This is what the UK government site says under the heading of who should not be vaccinated -

yellow fever naïve travellers – those who have not been previously exposed to the vaccine who are 60 years of age or over (unless the risk of yellow fever is unavoidable)

Hi Lhardem,
The CDC website does say Precaution for people over 60, which is not the same as a Contraindication.
If you are unable to take the YF Vaccine for medical reasons, your doctor can write an exemption. Really the best thing to do is discuss with your doctor, or even better, visit a Travel Clinic!

Happy Travels(even over 60!)
Fran

I usually hang out on the Health Branch, but I found this thread while searching for something else.

You can find more complete information on yellow fever & the vaccine here Travel Health--Yellow Fever from the CDC.

It's rather technical, but for older people, it boils down to: for the traveler's own protection, you have to look at the risk of getting the vaccine vs. the risk of getting yellow fever. Yellow fever is very rare in travelers. It is primarily a disease of primates, but can spread to people. Should an outbreak occur in a populated area, it could indeed result in a serious epidemic. YF can be fatal--there is no treatment other than symptomatic.

If you are going to a place where there has been no recent outbreak in humans, then it may indeed be prudent ot get an exemption rather than be vaccinated.

If you scroll about halfway down that web page, you'll come to Medical Waivers (Exemptions). That explains how to get the exemption. It is more than jut a letter; you also have the exemption section signed. It is best if you get this done at an official YF center, so the certificate can be stamped.

"We require a certificate" is not the same as "we always ask to see it," so you may never even have to produce it. But you should carry it. In some places, border officials may see the lack of a cert as an opportunity for fund raising. I have heard of this only in Africa and only at more obscure land crossings.

Before you go to a country that requires YF cert, you might want to ask on the appropriate destination branch to see if anyone has been having problems lately. You can also ask the Health Branch if there is a current outbreak somewhere. There is currently one in the Kasai-Oriental province of the DEmocratic Republic of the Congo, should that be on your current list.

Thanks to all for your helpful comments.

What you haven't said is whether you have had the jab before which I was advised makes a big difference. Me being difficult asked, How big a difference? but doctors don't do stats. so I don't know. I seem to remember that if you have had the jab before protection might last longer than previously thought so the choice is yours and maybe depends on the doc you meet. Mine gave me the jab at 68 knowing where I was likely to end up.

I seem to remember that if you have had the jab before protection might last longer than previously thought

See my thread on the Health Branch. Yellow fever vaccination booster not needed, says WHO, including the caveat that this does not change the legal requirement for a cert if a country wants to impose that.

There are two serious problems that occur more often in people over 60. I won't burden you with the whole medical rigmarole, just some statements from the CDC

One is called YEL-AND
>The onset of illness for documented cases is 3–28 days after vaccination, and almost all cases were in first-time vaccine recipients. YEL-AND is rarely fatal

The other is YEL-AVD and it is more serious
> YEL-AVD appears to occur after the first dose of yellow fever vaccine, rather than with booster doses.

And, for travelers over age 60
>The risk of YEL-AND and YEL-AVD is also increased in this age group, at 1.8 and 1.4 per 100,000 doses, respectively, compared with 0.8 and 0.4 per 100,000 for all vaccine recipients. Given that YEL-AND and YEL-AVD are seen almost exclusively in primary vaccine recipients, more caution should be exercised with older travelers who may be receiving yellow fever vaccine for the first time.

Thanks Nutrax and I think that is where I saw it.

To add my two cents worth - both husband and self have up-to-day yellow fever vaccinations (62 and 69), They were renewed at a Canadian travel clinic without comment just last year. But that said, over the last 15 years we've traveled to many countries that "required" the vaccination. I have NEVER, however been asked to produce my vaccination booklet. I'd still get all my vaccinations for my own protection but no border guard has ever been interested :)

On the other hand, husband and I were questioned at Melbourne airport some years ago after returning from 9 weeks in Peru. We spent about 20 mins speaking with a health official who not only checked our yellow health books but asked for details on where we had been.

And on yet another occasion (admittedly many years ago) we had an interesting debate with officials on the Indian side of the border with Pakistan who thoroughly checked the details of our various jabs.

I've never taken a single jab and have travelled to 75 countries on all continents.
Westerners (mostly merkins) tend to think that everywhere outside the the western world people die like flies if they don't vaccinate.

Well, I guess this Cajun sides with the merkins on this one. Vaccinations and immunizations are not only for our own protection, but also for those we come home to. Any children or elderly loved ones in your life? I sincerely wish you continued best of health in your travels, and hope your decision doesn't comeback and jab you in the..arm! :)

I am 68 and have just been revaccinated for the third time in uganda and have had no troubles. You must have the jab if you travel to south america and africa from australia and most countries insist on seeing the certificate.South African airways won't even let you on th eplane without it. so have it if you want to go and hope. I didn't know about the over 60 but it lasts for 10 years.By the way though the guard at the door of the vaccination clinic in uganda will arrange for a neatly stamped certificate book for you for a very small tip. I know becaise I was robbed in uganda and had to get another certificate to get on the ploane to get home!