• Yellow Fever (YF) disease is an acute viral hemorrhagic disease having mortality between 40 - 60% in severe cases. It is transmitted primarily through the bite of infected mosquitoes, mainly the Aedes aegypti species.
• The list of YF Endemic Countries as amended by WHO from time to time. (Refer table for list of countries).
• The disease has no specific treatment, and vaccination is the only protection available.
• Yellow Fever Vaccine is a live attenuated vaccine, strain of 17D.
• Single dose of 0.5 ml vaccine given subcutaneously confers immunity only after 10 days of yellow fever vaccination and persists till life of person vaccinated.
• Passengers travelling to and from YF endemic countries (countries where Yellow Fever disease is persisting) are required to be in possession of a VALID YELLOW FEVER VACCINATION CERTIFICATE issued by authorized vaccination center. In India, Yellow Fever Vaccination Centres are authorized by Directorate General of Health Services (Dte.GHS), MoHFW.
• Those found not in possession of such Valid certificate or defective certificate, upon reporting by the Immigration Officers have to be quarantined for a period, till the YF certificate becomes valid or until a period of six days, reckoned from the date of last possible exposure to infection, has elapsed, whichever occurs first.

The Necessary Information For Yellow Fever Vaccine Beneficiaries

• Mandatory Documents Required : Original Passport
• Alternate Documents Required: Note: If original passport is not available
  CDC for Seafarers, Defence IDs for Defence personnel, Official Passport for Govt. Servants.
• Additional Documents: Treatment Report, Children (Vaccination/Immunization Record)
• The latest list of Dte.GHS authorized centres is available here
• CHARGES - RS.300/- FOR ONE DOSE of vaccine, fixed by Govt. of India from time to time.
• Two live vaccines can either be given together or minimum of four weeks apart. For example, if a person is previously vaccinated with a live vaccine such as MMR, then the Yellow Fever vaccine can either be given same day or after a minimum gap of four (04) weeks.
• All vaccine beneficiaries have to wait for 30 minutes for observation after receiving the vaccination.
• Inform immediately to the doctor on duty in case of any uneasiness, side effects, rashes, reaction or any other adverse event.

Who should not get yellow fever vaccine? (Contraindications)

• Anyone with allergy to Eggs, Chicken, or Gelatin. Since the Vaccine is developed and prepared in Chick Embryo, anyone having Allergy to Egg protein must not take the vaccination, as it is likely to lead to severe anaphylactic reaction, which could be fatal.
• Pregnant Women, or could be pregnant now or in the next two weeks
• Infant younger than 9 months of age
• HIV/AIDS patient, including persons with CD4 counts < 200 per mm3 or <15% of total lymphocytes
• Immune system is weakened as a result of cancer or other medical conditions, a transplant, or radiation or drug treatment (such as steroids or cortisone, cancer chemotherapy, or other drugs that affect immune cell function).
• Persons with acute/moderate illness (with or without a fever) should postpone receiving this vaccine until they are well.
• Patients with thymus disorder, such as myasthenia gravis, DiGeorge syndrome, or Thymoma or Thymus removed.
• Patients with major liver or kidney disease.
To Note:
• Nursing mothers should avoid or postpone travel to an area where there is risk of yellow fever.
• Adults 60 years of age and older or with any comorbidity (Diabetes, Hypertension etc.) might be at increased risk for adverse effects following vaccination.
• However, final decision to vaccinate a person will lie on the Nodal Officer of YFVC based on the risk assessment and risk versus benefit.

Mild Side Effects of Vaccination

• Fever, body aches, gastrointestinal symptoms and soreness, redness or swelling at the injection site. Approximately 15 to 40 percent of vaccine recipients may experience one or more mild side effects.1 These typically appear soon or within the first few days post-vaccination and resolve spontaneously.

2 Side Effects of Vaccination

• The risk of a vaccine causing serious harm, or death, is extremely low.
• Severe allergic reaction to a vaccine component, occur in 0.029 per 1,00,000 doses.
• Altered mental status, seizures occur in 0.8 to 2.2 per 1, 00,000 doses.
• Life-threatening severe illness with multi organ failure (about 0.25 to 7.9 per 1,00,000 doses).

What if there is a severe reaction? What should we look for?

• Look for any unusual condition, such as a high fever, behaviour changes, or flu-like symptoms.
• Signs of an allergic reaction can include difficulty in breathing, hoarseness or wheezing, paleness, weakness, a fast heart -beat, or dizziness within a few minutes to a few hours after the vaccine.

What should we do?

• Call a doctor, or get the person to a doctor right away.
• Tell the doctor what happened, the date and time it happened, and when the vaccination was given.
• Keep informed the nodal officer of Yellow Fever Vaccination Centre about any adverse reaction and treatment/hospital details.

The vaccination is valid after 10 days from the date of vaccination and duration of its validity is the life of the person vaccinated.

• This certificate is valid only if the vaccine has been approved by the World Health Organization.
• Any amendment of this certificate, or erasure, or failure to complete any part of it, may render it invalid.
• The validity of this certificate is life of person vaccinated i.e. for whole life.
• The certificate shall be fully completed in English or in French. The certificate may also be completed in another language on the same document, in addition to either English or French.
• A parent or guardian shall sign the certificate when the child is unable to write. A person who is unable to sign shall be indicated in the usual manner by the person's mark and the indication by another that this is the mark of the person concerned, which shall be considered their signature. With respect to persons with a guardian, the guardian shall sign the certificate on their behalf. (Refer IHR 2005 - Annex 6)3
• Passengers travelling to and from Yellow Fever Endemic Countries must have VALID YELLOW FEVER VACCINATION CERTIFICATE obtained from Authorized and Dte.GHS, MoHFW Designated Vaccination Centres in India or their respective Countries. Passengers who are in transit, visiting outside the transit area of the Airport in Yellow Fever Endemic Countries must have Valid Yellow Fever Vaccination Certificate.

• Vaccine given at a non-designated center
• Certificate issued less than 10 days of arrival
• Missing clinician stamp, signature of officials, or batch number
• Incorrect personal details
• Photocopy or scanned/digital version
• Alterations or overwriting on the card
• People carrying exemption certificate for YF Vaccination

Those found not in possession of a Valid Certificate are quarantined for a period till the YF certificate becomes valid or until a period of six days, reckoned from the date of last possible exposure to infection, has elapsed whichever occurs first
Note: Medical Letter of Exemption does not grant immunity from quarantine. No diplomatic immunity from quarantine procedures.

Procedure varies from centre to centre. However, in general, following procedure is adopted to ensure uniformity and discipline.
The vaccine beneficiary moves in following direction Registration counter --> waiting area --> Injection Room --> Observation Room
Note: People are requested to confirm from the vaccination centre about the appointment and procedure they follow. (Details are provided against each centre with location map in this portal).

• The vaccination services are to be provided as first come first served basis.
• The registration / token distribution system is followed to maintain the first come first serve system.
• At time of registration, the Travel Document (passport) will be checked and all the vaccinees are instructed to read the necessary information regarding Yellow Fever Vaccination displayed in the registration / waiting area.
• The vaccinees are informed to bring/keep the Travel Document (passport) and the vaccination fee Rs.300/- with them at the vaccination time.
• All the vaccinees are instructed to wait in the waiting area and the vaccinees are called for vaccination in batches of 10 persons in vaccination room.
• All the vaccinees are informed and allowed to read about the side effects / adverse reactions and other related information about Yellow Fever Vaccination.
• The informed consent will be taken from all the vaccinees and high risk consent from vaccinees in higher age group or with existing comorbidities.
• The entries are filled up in the vaccination register from Travel Document (passport) & subsequently the fee for the vaccination is collected and the receipt for the same is given to vaccinee.

PEOPLE ARE ADVISED NOT TO COME EMPTY STOMACH FOR THE VACCINE AND SHOULD HAVE EATEN SOME MEAL BEFORE VACCINATION.

Yellow Fever Endemic Countries – the list is updated on 03 January 2023 by WHO

1. Yellow fever vaccine recommendations by CDC
2. Ministry of Health and Family Welfare, Govt. of India, National Adverse Events Following Immunization Surveillance and Response, Operational Guidelines, Page no 22, 2024.
3. World Health Organization. International health regulations (2005). World Health Organization 2016; Third Edition