Yellow Fever
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Flavivirus
photograph of yellow fever

Yellow fever is a serious disease caused by the yellow fever virus. It is mainly found in central areas of Africa and tropical areas of South America. It is spread through the bite of an infected mosquito and cannot be spread directly from person to person. However, infected people can transmit the virus back to mosquitoes if bitten shortly before the onset of symptoms and for the first 3 to 5 days of illness.

Most people infected with yellow fever virus will not have symptoms. If symptoms are present, they will begin about 3 to 6 days after exposure. Symptoms begin with a sudden onset of fever, chills, headache, backache, myalgia (muscle pain), fatigue, nausea, and vomiting. Most people improve after this initial presentation. However, about 15% of people with symptoms will have a brief remission followed by jaundice (yellowing of the skin), hemorrhagic symptoms, and eventually shock and multisystem organ failure. The overall death rate for cases with jaundice is up to 50%.

There is no specific treatment for yellow fever. Care focuses on symptomatic relief and includes rest, fluids, analgesics and fever-reducing medications usually within a hospital environment.

About the Vaccine

There is one yellow fever vaccine licensed for use in the United States.

Yellow Fever Vaccines Licensed for Use in the U.S.

Product: YF-Vax® (Yellow Fever Vaccine)
Manufacturer: Sanofi Pasteur
Year licensed: 1978
Product Insert

Indications Contraindications and precautions
  • People living in or traveling to endemic areas or areas that require yellow fever vaccine.
  • Laboratory workers who might be exposed to the virus.
  • Alert military forces during deployment or travel to yellow fever-endemic areas.
  • People who have had a severe allergic reaction to a previous dose of yellow fever vaccine or a yellow fever vaccine component.*
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • Infants younger than 9 months of age. However, infants 6 to 8 months may receive the vaccine after healthcare provider evaluation if the vaccine is clearly indicated.
  • People 60 years and older need healthcare provider evaluation to determine whether the vaccine should be given.
  • 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.
  • People who are immune compromised due to disease, treatment, or medication. People with asymptomatic HIV may receive the vaccine after healthcare provider evaluation if the vaccine is clearly indicated.
  • People with thymus disorders.
  • Pregnancy is a precaution for yellow fever vaccine administration. The vaccine should only be given in situations where exposure to yellow fever virus cannot be avoided or postponed.

* Yellow fever vaccine contains egg protein and gelatin. Stopper contains dry, natural latex rubber. See package insert for other content information.

Vaccine Dose/Route Routine Administration Schedule Booster Dose
YF-Vax Dose: 0.5 mL

Route: Subcutaneously (SC)
Single dose. Every 10 years if still at risk of exposure     
Yellow Fever Vaccine Side Effects
  • Soreness, redness, or swelling at the injection site (up to 25% of people).
  • Fever (up to 25% of people).
  • Aches (up to 25% of people).
  • Severe nervous system reaction (rare, more common in infants younger than 9 months of age).
  • Life-threatening major organ system failure (rare, more common in people 60 years of age and older).
  • Severe allergic reaction (very rare).       
Product Name Supplied Storage and Handling
YF-Vax
Sanofi Pasteur
0.5 mL single dose vials with diluent (5 sets per package) and a 5-dose vial with diluent (1 set per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. The diluent may be stored in the refrigerator with the lyophilized vaccine or separately at room temperature.

YF-Vax is a slight pink-brown suspension after reconstitution. Reconstituted vaccine must be used within 1 hour of reconstitution.     
ALCOAST PDF 04 Apr 13
IMMUNIZATIONS UPDATE (Smallpox, Yellow Fever, Tdap)
BUMED PDF 05 Sep 12
YELLOW FEVER (YF) AND TYPHOID FEVER (TF) VACCINATION GUIDANCE
BUMED PDF 30 Oct 08
ADDITIONAL CLARIFICATION ON TYPHOID (TF) AND YELLOW FEVER (YF) VACCINATION FOR PERSONNEL ASSIGNED TO OPERATIONAL UNITS UNCLASSIFIED
Recommendations of the Immunization Practices Advisory Committee
Package Insert - Vaccine
MMQC-11-1564 19 Aug 11
SANOFI PASTEUR / YELLOW FEVER VACCINE / UPDATE
Vaccine Information Statement
Author(s): Gerasimon G, Lowry K
Publication: Southern Medical Journal, vol. 98, no. 6
Subject: Vaccine-Safety
Disease: 
Yellow Fever