People aged ≥9 months travelling to an area with a risk of yellow fever virus transmission are recommended to receive yellow fever vaccine

Avoiding mosquitoes

The mosquitoes that carry yellow fever usually bite during the day. All people travelling to countries with a risk of yellow fever virus transmission should be told this.

Even vaccinated people should be told about the importance of avoiding mosquitoes. Ways to avoid mosquitoes include:

• using insect repellents containing at least 30% DEET
• using mosquito nets (preferably insecticide-treated nets)
• minimising outdoor exposure at dusk and dawn
• wearing clothing that leaves a minimum of exposed skin

International travel requirements

Under the International Health Regulations (2005), many countries require travellers arriving from countries with a risk of yellow fever virus transmission to provide either:

• a valid International Certificate of Vaccination or Prophylaxis (ICVP) against yellow fever, or 
• a valid letter of exemption 

Travellers must provide this before entering those countries.

A country may require this documentation even for travellers who are only in transit through that country (in general this will only be requested for over 12 hours of airport transit time). This is because, if an infected traveller brought the virus into the country, the virus could be introduced and established in local Aedes aegypti mosquitoes.

In 2016, the World Health Organization extended the validity of the ICVP from 10 years to the life of the vaccinated person. This decision was based on evidence that a single dose of yellow fever vaccine protects most people for many decades.^3-5 (See Duration of immunity).

Travellers should check the yellow fever vaccination entry requirements for the countries they intend to enter or transit through before they leave Australia. Travellers can contact the country’s foreign embassy or consulate in Australia.

Australia’s travel requirements

Australia strongly recommends that travellers >1 year of age have a valid ICVP with proof of valid yellow fever vaccination if they:

• are entering Australia within 6 days of leaving a country that is on Australia’s list of yellow fever–declared places
• stayed in the at-risk area overnight or longer  

Only accredited Yellow Fever Vaccination Centres can give yellow fever vaccinations and ICVPs. Relevant state or territory health authorities approve these centres. The ICVP must include the:

• name of the vaccinated person
• date of the vaccination (day–month–year sequence, with the month written in letters)
• vaccine the person received
• manufacturer and batch number of vaccine or prophylaxis
• signature and professional status of the authorised health professional
• official stamp of the administering centre (provided by the state or territory health authority)
• signature of the vaccinated person (or guardian)

As of 16 June 2016, Australia considers an ICVP to be valid for the life of the vaccinated person. The certificate becomes valid 10 days after vaccination.

Travellers arriving in Australia who do not have a valid ICVP receive information about yellow fever. They are advised to promptly seek medical assessment if they develop relevant symptoms within 6 days of leaving a yellow fever–declared place.

A list of yellow fever–declared places is available from the Australian Government Department of Health’s yellow fever fact sheet.⁶

Exemptions to vaccination

People with a true contraindication to yellow fever vaccine (see Contraindications and precautions) can still travel to countries with a risk of yellow fever virus transmission. They should have a dated and signed letter on letterhead stationery from an accredited Yellow Fever Vaccination Centre. The letter should:

• state that the yellow fever vaccine is contraindicated on medical grounds
• display the centre’s official stamp provided by the state or territory health authority

Medical exemption letters should be written for the current trip only. If the person needs exemption for yellow fever vaccination for another trip, they need a new medical exemption letter. The immunisation provider must also complete, stamp and sign the Medical Contraindications to Vaccination section of the ICVP.

Travellers arriving in Australia who have a medical exemption letter for yellow fever vaccination receive information about yellow fever. They are advised to promptly seek medical assessment if they develop relevant symptoms within 6 days of leaving a yellow fever–declared place.

Contraindicated travellers to other countries that need an exemption for yellow fever vaccination should contact the country’s foreign embassy or consulate in Australia. The mission can advise which language(s) the letter needs to be written in.