Yellow Fever Vaccination
Certificates- procedures and
challenges in the region
THE 8TH MEETING OF THE CAPSCA ASIA PACIFIC &
THE 6TH MEETING OF THE CAPSCA GLOBAL PROGRAMME COORDINATION
15-18 NOVEMBER 2016, BANGKOK, THAILAND
Dr Bardan Jung Rana, Regional Adviser
International Health & Regulations (IH&R)
WHO South-East Asia Regional Office (SEARO)
Recent Outbreak
• Yellow Fever (YF) case detected in Luanda, Angola in
December 2015; spread to 14/18 provinces by May 2016
• Exported cases to Democratic Republic of Congo, China &
Kenya
• 7 countries (Peru, Uganda, Brazil, Chad, Colombia, Ghana &
Guinea) reported YF outbreaks/sporadic cases not linked to
Angola outbreak
• No new YF case reported
– in Angola since 23 June 2016
– in DRC since 12 July 2016
• Uganda declared end of YF outbreak on 6 September 2016
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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Emergency Committee
Recommendation
Emphasis on serious national & international
risk of the outbreak
‾ Affected countries: accelerate control
interventions
‾ All countries: ensure YF vaccination of
all travelers to/from affected countries
‾ At risk countries: intensify surveillance &
preparedness, verification of YF
vaccination in travelers, risk
communication
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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YF Strategic Response Framework
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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Yellow Fever Prevention
• YF prevented by an extremely
effective vaccine, which is
safe & affordable
• The vaccine provides effective
immunity within 30 days for
99% of persons vaccinated
• Currently no specific anti-viral
drug for yellow fever
• Good supportive treatment in
hospitals improves survival
rates of those infected with YF
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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International Health Regulations (IHR)
(2005)
Yellow fever – only disease
specified in IHR (2005) for which
countries may require proof of
vaccination from travelers as a
condition of entry under certain
circumstances & may take
certain measures if an arriving
traveler is not in possession of
such a certificate
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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Yellow Fever Vaccination Requirement
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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Fractional dose of YF vaccine
• Due to limited supply of YF vaccine, dose sparing
strategy used to achieve greater coverage
• Fractional dosing using 1/5th of the regular dose
provides effective immunity against YF for at least
12 months & possibly much longer
• Infants/children <2Y require full dose of YF vaccine
as they may have a weaker immune response to the
vaccine than older people
• People receiving fractional dose of YF vaccine are
not entitled to a yellow fever certificate that is
valid for international travel
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
8
Amendment to Annex 7, IHR (2005)
• A single full dose of yellow fever
vaccine is sufficient to confer
sustained immunity and life-long
protection against YF disease
• Policy of lifetime dose of yellow
fever vaccine came into force
under International Health
Regulations on 11 July 2016
• All countries must accept a YF
yellow fever vaccination
certificate as valid for the life of
the person holding it
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
9
Yellow Fever in South East Asia (SEA)
• No case of YF reported in the region
• The vector Aedes aegypti endemic in SEA
• YF vaccination recommended to travelers going
to areas at risk of YF
• Travelers arriving from regions with risk of YF
required to present proof of vaccination
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
10
Yellow Fever threat to SEA
• Risk of introduction of YF
into Asia is now greater
than at any time in history
• Countries need to develop
& keep contingency plans
ready for possible YF
outbreaks
International Health & Regulations
WHO South-East Asia Regional Office (SEARO)
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