Logan Reed
Yellow fever is a viral infection that occurs in Africa and South America. The yellow fever vaccine is a live, weakened form of the virus that has been in use since the 1930s. The vaccine is named 17D and is considered safe, with over 500 million doses given and very few documented cases of illness or severe reactions. The World Health Organization (WHO) recommends routine immunization for people aged 9 months and older who are living in or travelling to areas where yellow fever is common.
| Characteristics | Values |
|---|---|
| Name | Yellow Fever 17D Vaccine |
| Virus Type | Arbovirus |
| Transmission | Bites of infected Aedes and Haemagogus mosquitoes |
| Vaccine Type | Live, weakened form of the virus |
| Dosage | Single dose |
| Longevity | Life-long protection |
| Immunity Development | Within 10 days for 80-100% of people, within 30 days for more than 99% of people |
| Side Effects | Mild: headache, muscle pains, fever, rash, itching, swelling of the tongue and throat |
| Severe Side Effects | Anaphylaxis, swelling of the brain, spinal cord or surrounding tissues, Guillain-Barré syndrome |
| Severe Side Effects Incidence | 1.3 cases of anaphylaxis per 100,000 doses, 0.8 cases of YEL-AND per 100,000 doses |
| Booster Dose | Not necessary, but may be considered after 10 years for those at continuous risk of exposure |
| Age Limit | Recommended for people older than 9 months, limited use for elderly patients older than 65 |
| Pregnancy | Vaccination recommended only if travel to epidemic areas is essential and mosquito bites cannot be avoided |
| Breastfeeding | Weigh potential benefits against potential risks |
| Allergies | Discuss egg allergy with physician before vaccination |
| HIV Positive | Booster dose may be beneficial after 10 years |
| Availability | Only at authorized Yellow Fever Vaccination Centers |
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What You'll Learn
The 17D strain
The yellow fever vaccine is considered safe and affordable, with a single dose providing life-long protection against the disease. The vaccine is made from a weakened yellow fever virus and is given either by injection into a muscle or just under the skin. The World Health Organization (WHO) recommends routine immunization in all countries where the disease is common, typically between the ages of 9 and 12 months. Those travelling to areas where the disease occurs should also be immunized at least ten days before arriving in an endemic area.
The 17D vaccine is considered safe, with over 500 million doses given and very few documented cases of vaccine-associated illness (62 confirmed cases and 35 deaths as of January 2019). The majority of adverse reactions to the 17D vaccine are due to allergic reactions to the eggs in which the vaccine is grown. Persons with known egg allergies should consult their physician before vaccination. There is also a small risk of neurologic disease and encephalitis, particularly in individuals with compromised immune systems and very young children. The 17D vaccine is contraindicated in infants between zero and six months, people with thymus disorders associated with abnormal immune cell function, people with primary immunodeficiencies, and anyone with a diminished immune capacity, including those taking immunosuppressant drugs.
The 17D-204 strain has given rise to the two substrains of the 17D virus that are currently used to produce the world's yellow fever vaccine: 17D-204 and 17DD. These two strains have accumulated genotypic and phenotypic differences due to independent serial passages, but both are equally immunogenic and safe for humans. The attenuated Yellow Fever 17D (YF17D) vaccine has been widely adopted for the immunization of humans for over 70 years. A single primary dose of YF17D can promote effective and safe seroconversion in more than 90% of vaccinees and can provide immunity for over 40 years.
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Development history
The yellow fever vaccine, also known as the 17D vaccine, came into use in 1938. It is made from a weakened yellow fever virus and is administered through injection into a muscle or just under the skin. The vaccine is considered safe and provides effective immunity within 10 days for 80-100% of people vaccinated, and within 30 days for more than 99% of people vaccinated.
The development of the yellow fever vaccine began in the late 19th century when several investigators claimed to have found bacteria responsible for the disease and created the first "vaccines" from these candidates. However, a thorough study by Dr. George Sternberg found these vaccines to be poorly conceived or ineffective, leaving no progress in yellow fever prevention at the turn of the century.
In the early 20th century, there were further attempts to develop a vaccine, particularly after the opening of the Panama Canal in 1912. Efforts focused on anti-mosquito measures, and by mid-1919, the city of Guayaquil was declared free of yellow fever for the first time in a century.
In the 1930s, a French team developed the French Neurotropic Vaccine (FNV), which was extracted from mouse brain tissue. This vaccine was associated with a higher incidence of encephalitis and was not recommended after 1961. During this decade, Max Theiler and his team at the Rockefeller Foundation discovered a highly effective strain of the vaccine, named 17D, by using chicken eggs to culture the virus. Theiler's vaccine was widely used, but it was later found to be responsible for the largest outbreak of hepatitis B in history due to contamination from human serum.
In 1941, researchers at Rocky Mountain Laboratories developed a safer alternative, an "aqueous-base" version of the 17D vaccine, using distilled water combined with the virus grown in chicken eggs. Since then, screening technology for hepatitis B virus contamination has been routinely used in vaccine preparation.
Today, the 17D vaccine remains the only vaccine in use, with over 500 million doses given and very few documented cases of vaccine-associated illness. The World Health Organization (WHO) recommends routine immunization in all countries where yellow fever is common, typically between the ages of 9 and 12 months.
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Effectiveness and side effects
The yellow fever vaccine, also known as the 17D vaccine, is considered safe and effective. It is a live, weakened form of the virus, grown in chicken eggs, and has been in use since the 1930s. Since then, only 12 known cases of yellow fever post-vaccination have been identified after 600 million doses, and immunity does not decrease with time. The World Health Organization (WHO) recommends routine immunization in all countries where the disease is common, for those aged 9 to 12 months. The vaccine is also recommended for anyone over 9 months who has not been previously immunized and either lives in or travels to an area where the disease occurs.
The vaccine is typically given by injection into a muscle or just under the skin, and a single dose is sufficient to provide life-long protection for most people. It is considered safe, with over 500 million doses given and very few documented cases of vaccine-associated illness (62 confirmed cases and 35 deaths as of January 2019). Mild side effects may include headache, muscle pains, pain at the injection site, fever, and rash. These reactions are generally mild and are not long-lasting.
However, there is a small risk of more severe adverse reactions to the vaccine, particularly in individuals with compromised immune systems and very young children. These can include allergic reactions, with difficulty breathing or swallowing (anaphylaxis), swelling of the brain, spinal cord, or surrounding tissues (encephalitis or meningitis), and Guillain-Barré syndrome, a nervous system disorder that can cause muscle weakness and paralysis. Those with a known egg allergy should discuss this with their physician before vaccination, as the majority of adverse reactions result from allergic reactions to the eggs in which the vaccine is grown.
In addition, there is a small risk of neurologic disease and a slightly higher risk of a yellow fever-like disease associated with the vaccine, known as yellow fever vaccine-associated acute viscerotropic disease (YEL-AVD). This reaction causes a fairly severe disease closely resembling yellow fever caused by virulent strains of the virus. Overall, the benefits of the yellow fever vaccine greatly outweigh the risks, and it is an important tool in preventing this potentially serious and life-threatening disease.
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Availability and administration
The yellow fever vaccine, also known as the yellow fever 17D vaccine, is available only at authorised Yellow Fever Vaccination Centres. The location of these centres can be obtained from local health departments. The vaccine is recommended for all persons aged 9 months or older who are travelling to or living in areas where yellow fever is present, such as parts of Africa and South America. It is also recommended for those travelling to countries that require a yellow fever vaccination certificate for entry.
The vaccine is a live, weakened form of the virus, grown in chicken eggs. It works by causing the body to produce antibodies against the virus, providing effective immunity within 10 days for 80-100% of people vaccinated, and within 30 days for more than 99% of people vaccinated. A single dose of the vaccine is typically sufficient to grant lifelong protection, and additional doses are generally not needed. However, a booster dose may be recommended every 10 years for individuals who are at continuous risk of exposure to the virus, such as residents of endemic areas, and is required by certain countries for entry.
The yellow fever vaccine is generally safe, with mild side effects such as headache, muscle pains, fever, and rash. However, in rare cases, people may develop severe, life-threatening reactions to the vaccine, including anaphylaxis, encephalitis, and Guillain-Barré syndrome. Those with egg allergies or compromised immune systems, including those with symptomatic HIV/AIDS, should consult with their physician before vaccination, as they may be at a higher risk of developing severe reactions.
The vaccine should be administered by a healthcare professional, who can provide advice on the risks and benefits of the vaccine for each individual. It is given by injection into a muscle or just under the skin.
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Risks and contraindications
The yellow fever 17D vaccine is considered safe, with over 500 million doses administered and very few documented cases of vaccine-associated illness. However, there are some risks and contraindications to be aware of.
Firstly, the majority of adverse reactions to the 17D vaccine are due to allergic reactions to the eggs in which the vaccine is grown. Therefore, persons with known egg allergies should consult their physician before vaccination. Secondly, there is a small risk of neurologic disease and encephalitis, particularly in individuals with compromised immune systems and very young children. The 17D vaccine is contraindicated in infants between zero and six months, people with thymus disorders associated with abnormal immune cell function, people with primary immunodeficiencies, and anyone with a diminished immune capacity, including those taking immunosuppressant drugs.
Pregnant women should also exercise caution and consult their healthcare provider before receiving the yellow fever vaccine, as there may be risks associated with vaccination during pregnancy. Additionally, individuals with severe immunodeficiency due to symptomatic HIV/AIDS or other causes are typically excluded from vaccination.
While the yellow fever vaccine is generally safe and effective, some mild side effects may occur, including headaches, muscle aches, and low-grade fevers. These side effects are typically not severe and resolve within a few days. However, in rare cases, more serious adverse reactions can occur, and individuals should carefully consider the contraindications and precautions before receiving the vaccine.
It is important to note that the risks associated with not being vaccinated against yellow fever can be significant, especially in areas where the disease is endemic. Yellow fever is a potentially life-threatening disease with a high risk of international spread, and vaccination is the most important means of prevention. Therefore, individuals should carefully weigh the risks and benefits of vaccination based on their specific circumstances and consult with a healthcare provider to determine if they should receive the yellow fever vaccine or a booster shot before travelling to an area at risk.
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Frequently asked questions
The name of the yellow fever vaccine is the yellow fever 17D vaccine.
The yellow fever 17D vaccine is a live, weakened form of the yellow fever virus. It is considered safe, with over 500 million doses given and very few documented cases of vaccine-associated illness.
The yellow fever 17D vaccine is recommended for people aged 9 months or older who are living in or travelling to areas with a risk of yellow fever transmission, such as Africa and South America.
A single dose of the yellow fever 17D vaccine is usually sufficient to provide lifelong protection. However, a booster dose may be recommended every 10 years for patients who are at continuous risk of exposure to the yellow fever virus.
