Recent amendments to yellow fever vaccination requirements for travellers to African countries at low risk for yellow fever transmission
The World Health Organization (WHO) International Health Regulations (2005) requires countries at risk of yellow fever introduction to employ the following measures:
- Obtain vaccination certificates from individuals travelling from areas determined by the WHO to be at risk of yellow fever transmission.
- Disinfect aircraft, ships, tyre-casing consignments and other modes of transportation coming from a yellow fever risk area.
At their 136th session meeting in Geneva which took place at the end of January 2015, the WHO Executive Board conducted a review of countries with risk of yellow fever transmission during. Based on area-specific data for risk of yellow fever virus transmission, the board classified Zambia, Tanzania, Eritrea, Somalia, São Tomé and Prìncipe as yellow fever low-risk countries (Figure 2). The board also recommended that all travellers from these countries should no longer be required to produce a proof of vaccination certificate against yellow fever upon arrival at countries at risk for yellow fever introduction. In line with this recommendation, the South African Ministry of Health announced on 03 February 2015 that with immediate effect yellow fever vaccination certificates will no longer be required at South African ports of entry for travellers arriving from these countries.
In line with the International Health Regulations (2005), South Africa requires a valid yellow fever certificate from all citizens and non-citizens (over one year of age) travelling from a yellow fever risk country. Vaccination certificates are routinely checked at the South African port of entry for travellers arriving from countries designated as high risk for yellow fever transmission. Persons who have been in transit exceeding 12 hours through the airport of a country with high risk of yellow fever transmission are also required to produce a proof of vaccination certificate upon arrival. If the traveller is unable to produce a valid yellow fever vaccination certificate at the point of entry, entry will be refused and the traveller will be placed under quarantine surveillance until their certificate becomes valid, or be quarantined for a period not exceeding six days. For travellers who are in possession of an exemption certificate due to medical reasons they will be allowed entry, be placed under quarantine and/or will be required to report any fever or other symptoms to health authorities.
- Yellow fever vaccine should be administered at least 10 days prior to departure (to allow for production of protective antibodies following vaccination)
- Yellow fever vaccination certificates are valid for 10 years
- Vaccine is contraindicated in pregnant women, infants <9 months, individuals with egg allergies, and certain immunosuppressed individuals (including HIV-infected persons with CD4 counts <200/mm3). These individuals still require a health certificate indicating the reason for non-receipt of vaccine.
- Vaccinated travellers should still take precautionary measures to avoid being bitten by mosquitoes. This will ensure additional protection not only against yellow fever, but also against a number of other endemic mosquito-borne infections (e.g. malaria, dengue).