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It is vital for patient safety and public health that all healthcare professionals working in yellow fever vaccination centres (YFVC) always undertake a full travel risk assessment - including a detailed medical history - to determine as accurately as possible an individual’s suitability for receiving yellow fever (YF) vaccine. Unfortunately, the risk of serious adverse events following YF vaccination – including death - is greater for some individuals, and accordingly administration of YF vaccine is contraindicated in those individuals who are identified as having underlying medical conditions causing compromise of the immune system. This includes those patients with a proven or possible history of thymectomy* for any reason, such as those who have ever undergone cardiac surgery.
*Thymectomy is removal of the thymus gland (not to be confused with thyroid gland) which is found in the upper chest behind the sternum. It forms part of the immune system, processing lymphocytes.
For more information on YF vaccine, serious adverse events and information on contraindications to YF vaccination, please see the following pages on TRAVAX.
Healthcare professionals are reminded that they must refer to Yellow fever: the green book, chapter 35 for up-to-date guidance on the administration of YF vaccine. Advice in the green book may differ from that in the vaccine manufacturers’ Summary of Product Characteristics (SmPC); if and when this occurs, it is the recommendations in the green book (which are based on current expert advice received from the Joint Committee on Vaccination and Immunisation (JCVI) that should be followed. In addition, the NaTHNaC/PHS YF pre-vaccination checklist (screening tool) should always be completed to help the healthcare professional risk assess a person’s suitability for YF vaccination. The YF pre-vaccination checklist should be completed by the person that is travelling in advance of, or during, the consultation and the responses must be carefully reviewed by the advising healthcare professional as part of a shared decision-making process for YF vaccination.
If a healthcare professional has any concerns about a traveller’s suitability for receiving YF vaccine, they can contact one of the health professionals advice lines listed here.
Scotland: Public Health Scotland Travel Health Advice Line Telephone: 0141 300 1130
England, Wales and Northern Ireland: Travel Health NaTHNaC Advice Line Telephone: 0845 602 6712
Yellow Fever Vaccination Centres Information Pack
Report of the Commission on Human Medicine’s Expert Working Group on benefit-risk and risk minimisation measures of the yellow fever vaccine (2019)
Yellow Fever Vaccine eLearning Resource
