Yellow Fever Vaccination: Requirements, Procedure, and Safety

• Hypersensitivity: Known systemic hypersensitivity reaction to any component of YF-VAX® (including egg proteins), or a life-threatening reaction after previous administration of the vaccine or a vaccine containing one or more of the same components.
• Altered Immune System:
  • Immunosuppressive therapies (e.g., high-dose corticosteroids, alkylating drugs, antimetabolites, or radiation).
  • Immunosuppression associated with AIDS or other manifestations of HIV infection, leukemia, lymphoma, thymic disease, or generalized malignancy.
• Nursing women with infants.
• Infants (generally under 9 months of age).

• Administration Route: Intramuscular or intradermal routes of administration are not to be utilized.
• Acute or Febrile Disease: Vaccination should be postponed in cases of an acute or febrile disease.
• Yellow Fever Vaccine-Associated Viscerotropic Disease (YFV-AVD) risk.
• Age 60 years old and older.
• Pregnant women.
• Nursing women with infants older than 9 months.

If a patient has a medical contraindication to the vaccine, document a medical waiver by completing the Certificate of Medical Contraindications to Vaccination card. This card will be provided by the Public Health Agency of Canada upon designation of your store.

Adverse reactions are more likely to occur in people over 60 years old. Therefore, Yellow Fever vaccination should be restricted to those who are traveling to or living in areas where Yellow Fever is endemic or epidemic (versus being given solely to meet travel requirements).

If international travel requirements are the only reason to vaccinate a pregnant woman, rather than an increased risk for infection, a waiver letter should be given.

• Reconstitute the vaccine using only the supplied diluent (0.9% Sodium Chloride Injection USP).
• Draw the entire volume of the diluent (0.6 mL vial) into a syringe of suitable size without removing the stopper or metal seal.
• Slowly inject the diluent into the vial containing the vaccine, let stand for 1–2 minutes, and then swirl the product vial well before withdrawing the dose.
• Avoid vigorous shaking as this tends to cause foaming of the suspension.
• Use the vaccine within 60 minutes following reconstitution.

• Clean the skin over the injection site and allow the skin to dry thoroughly before the vaccine is administered to prevent inactivation of the vaccine by the germicide.
• Administer the total volume of 0.5 mL subcutaneously.