People aged ≥9 months travelling to an area with a risk of yellow fever virus transmission are recommended to receive yellow fever vaccine
1 dose of yellow fever vaccine is recommended for people ≥9 months of age who are travelling to an area with a risk of yellow fever virus transmission. This includes expatriates and people who are visiting friends and relatives.
Travellers should seek up-to-date information about yellow fever virus activity and risk of yellow fever in their travel destinations from reputable sources, such as:
- the World Health Organization web page on international travel and health1
- the Centers for Disease Control and Prevention web page on on travellers’ health2
Some travellers may need yellow fever vaccination to meet a country’s vaccination requirements for travel. This might happen even if they are not travelling to an area with a risk of yellow fever virus transmission. See International travel requirements.
People who do not respond optimally to yellow fever vaccination are recommended to receive a booster dose if their last vaccine dose was 10 years ago or more. This includes:
- women who were pregnant (in any trimester) when they received their 1st dose of yellow fever vaccine
- people who had HIV when they received their 1st dose of yellow fever vaccine, regardless of their level of immunocompromise at the time
Travellers whose last vaccine dose was 10 years ago or more are recommended to receive a booster dose under certain circumstances. This might be:
- because they have a higher risk of yellow fever virus infection, such as people who will be staying in a high-risk location for an extended period of time
- because they are travelling to an area with ongoing outbreaks
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
- 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.
Printed content may be out of date. For up to date information, always refer to the digital version: https://immunisationhandbook.health.gov.au/recommendations/people-aged-9-months-travelling-to-an-area-with-a-risk-of-yellow-fever-virus.