Adult Dosing
Active immunization for yellow fever
Primary Vaccination
- 0.5 mL SC x 1, 10 days prior to exposure
Booster Doses
- 0.5 mL SC q10 yrs for those at continuing risk of exposure and as per International Health Regulations
Note:
- Reconstitute the vaccine using only the diluent supplied
Desensitization
- Administer the following successive doses at an interval of 15-20 minutes
- 0.05 mL of 1:10 dilution SC
- 0.05 mL of full strength SC
- 0.10 mL of full strength SC
- 0.15 mL of full strength SC
- 0.20 mL of full strength SC
Notes:- Use desensitization procedure to administer the vaccine if immunization is imperative and the individual has a history of severe egg sensitivity and has a positive skin test to the vaccine
- Perform desensitization procedure under the direct supervision of a physician experienced in the management of anaphylaxis with necessary emergency equipment immediately available
Pediatric Dosing
Active immunization for yellow fever (>9 months)
Primary Vaccination
- 0.5 mL SC x 1, 10 days prior to exposure
Booster Doses
- 0.5 mL SC q10 yrs for those at continuing risk of exposure and as per International Health Regulations
Note:
- Reconstitute the vaccine using only the diluent supplied
Desensitization (>9 months)
- Administer the following successive doses at an interval of 15-20 minutes
- 0.05 mL of 1:10 dilution SC
- 0.05 mL of full strength SC
- 0.10 mL of full strength SC
- 0.15 mL of full strength SC
- 0.20 mL of full strength SC
Notes:- Use desensitization procedure to administer the vaccine if immunization is imperative and the individual has a history of severe egg sensitivity and has a positive skin test to the vaccine
- Perform desensitization procedure under the direct supervision of a physician experienced in the management of anaphylaxis with necessary emergency equipment immediately available
[Outline]
See Supplemental Patient Information
- The dry natural latex rubber of the vial stopper may cause allergic reactions
- Anaphylaxis may occur following vaccine administration even in individuals with no prior history of hypersensitivity to the vaccine components. Epinephrine injection (1:1000) and other appropriate agents should be readily available in case of an unexpected anaphylactic or other serious allergic reaction
- Yellow fever vaccine may be a possible, but rare, cause of vaccine-associated viscerotropic disease (previously referred to as multiple organ system failure) that is similar to fulminant yellow fever caused by wild-type yellow fever virus
- Vaccine-associated neurotropic disease, earlier described as post-vaccinal encephalitis, may occur as a rare adverse event with yellow fever vaccines. Possible risk factors include immunosuppression and age below 9 months
- Prior to administering any vaccine, review the patient’s immunization history, current health status, and medical history for possible hypersensitivity reactions and other adverse events related to vaccines and for possible sensitivity to dry natural latex rubber
- Do not administer to an individual with a history of acute hypersensitivity to egg or chicken protein. If a person is suspected as being an egg-sensitive individual, perform a scratch/prick/puncture test or an intradermal test to check for sensitivity
- If immunization is deemed essential in a patient with history of severe egg sensitivity and a positive skin test to yellow fever vaccine, then desensitization should be considered to administer the vaccine
- Yellow fever vaccine poses a risk of encephalitis or other serious adverse reactions to patients with illnesses that commonly result in immunosuppression or whose immunologic responses are suppressed by drug therapy or radiation. Hence, immunosuppressed individuals should not be immunized and their travel to yellow fever endemic areas should be avoided or postponed
Cautions: Use with caution in
- Latex sensitivity
- Asymptomatic HIV infection
- Elderly patients
Supplemental Patient Information
- Inform all potential vaccinees or their parents/guardians of the risks and benefits of immunization and potential for adverse events that have been associated with vaccine administration
- Instruct vaccinees or their parents/guardians to report all serious adverse events that occur up to 30 days following vaccine administration to their physician
- Advise all travelers to seek information regarding vaccination requirements by consulting local health departments, the CDC, and WHO. Such requirements may be strictly enforced, especially for persons traveling from Africa or South America to Asia
Pregnancy Category:C
Breastfeeding: Administration of yellow fever vaccine to breast-feeding women should be avoided except in situations where exposure to yellow fever viruses cannot be avoided or postponed, as it may cause yellow fever encephalitis in breastfed newborns. Exposure to yellow fever vaccine via breastmilk would not increase the risk to an infant who receives the vaccination him/herself. Infants <6 months are at an increased risk of encephalitis from the vaccine and should not be vaccinated. Infants over 9 months of age should be vaccinated if they will be traveling with their mother to a yellow-fever endemic area. This information is based on LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 31 Aug 20011). As per manufacturer's data, vaccination is contraindicated during breastfeeding, particularly when infants are <9 months of age due to the risk of encephalitis. As there is a theoretical risk of transmission of vaccine components to the infants from breast-feeding mothers, the risks and benefit should be assessed before making the decision as to whether to immunize a nursing woman.
4.74 log10 PFU/0.5 mL
