Fri Apr 25 12:58:24 SGT 2014  
    Yellow Fever Vaccine, Singapore

Yellow Fever Vaccine, Singapore

Summary

Yellow Fever Vaccine, Singapore @beautysingapore_com: Live attenuated yellow fever virus vaccine jab/shot/injection schedule, to vaccinate against the Yellow fever virus, to immunise against Yellow fever

Keywords: Yellow Fever Vaccine Singapore, Singapore Yellow Fever Vaccine, Yellow Fever Vaccine.

Description

The 17D vaccine, which is based on a live, attenuated viral strain, is the only commercially available yellow fever vaccine. It is given as a single subcutaneous (or intramuscular) injection. Yellow fever vaccine is highly effective (approaching 100%). All individuals aged 9 months or older and living in countries or areas at risk should receive yellow fever vaccine.

Precautions and contraindications

With the exception of very rare cases of vaccine-associated neurotropic and viscerotropic disease (see below), the 17D vaccine is generally considered to be safe. However, some vaccine recipients develop mild systemic reactions, including myalgia and headache. Contraindications include true allergy to egg protein, immunodeficiency (congenital or acquired) and symptomatic HIV infection (Chapter 9). There is a theoretical risk of harm to the fetus if the vaccine is given during pregnancy and vaccination of nursing mothers should be avoided because of the risk for the transmission of 17D virus to and encephalitis in the breast-fed infant.These risks must be weighed against the risk to the mother of remaining unvaccinated and travelling to an area where exposure to YFV may occur. In general, unvaccinated pregnant or nursing women should be advised not to travel to such areas.

Hypersensitivity reactions are rare, particularly anaphylactic reactions. However, the vaccine is produced in embryonated chicken eggs and is contraindicated in persons with a history of oral egg intolerance or strong allergic reactions to egg-based products.

Encephalitis has been reported as a rare event following vaccination, principally in infants under 6 months of age. As a result, the vaccine is contraindicated in infants under 6 months of age and is not recommended for those aged 6–8 months, except during epidemics when the risk of YFV transmission may be very high.

Vaccine-associated viscerotropic disease is a recently described adverse event that on very rare occasions has occurred after the first immunization with the yellow fever 17D vaccine. Onset is within 10 days of vaccination and the pathological process is characterized by severe multi-organ failure and an overall case—fatality rate in excess of 60%. Known risk factors include a history of thymus disease (e.g. thymoma or thymectomy) and age ≥ 60 years. In the United Sates, the risk for people aged ≥ 70 years of contracting viscerotropic disease after receiving vaccination against yellow fever is estimated to be 2.4 cases/100 000 vaccine doses.

Increased incidence of vaccine-associated neurotropic disease (e.g. meningoencephalitis, acute disseminated encephalomyelitis and Guillain-Barré syndrome) has been reported in infants under 6 months of age and in vaccine recipients aged ≥60 years . The reported rate of vaccine-associated neurotropic disease in travellers from the United States and Europe ranges between 0.13 and 0.8 per 100 000 doses.

Yellow fever vaccination is required for travellers to certain countries and recommended for all travellers to countries or areas with risk of yellow fever transmission (see Country list and Annex 1). The risk to unvaccinated individuals who visit countries or areas where there may be yellow fever transmission is often greater than the risk of a vaccine-related adverse event. While yellow fever vaccination should be encouraged as a key prevention strategy, it is important to screen travel itineraries and carefully evaluate the potential risk of systemic illness after yellow fever vaccination. Great care should be exercised not to prescribe yellow fever vaccination to individuals who are not at risk of exposure to infection, based on an accurate assessment of the travel itinerary. Although vaccination is generally not recommended for travellers going to areas where the risk of exposure is low, any risk (e.g. as a result of prolonged travel or heavy exposure to mosquito bites) should be weighed against individual risk factors for vaccine-associated adverse events (e.g. altered immune status).

Type of vaccine: Live, attenuated

Number of doses: One dose of 0.5 ml

Booster: Currently every 10 years (if re-certification is needed)

Contraindications: Infants aged less than 6 months; history of allergy to egg or to any of the vaccine components, or hypersensitivity to a previous dose of the vaccine; thymoma or history of thymectomy, immunodeficiency from medication, disease or symptomatic HIV infection.

Adverse reactions: Rarely, neurological (encephalitis) or multi-organ failure resembling wild-type yellow fever

Before departure: International certificate of vaccination becomes valid 10 days after vaccination.

Recommended for: All travellers to countries and areas with risk of yellow fever transmission and when required by countries.

Special precautions: Not recommended for infants aged 6-8 months, except during epidemics when the risk of YF virus transmission may be very high. The risks and benefits of vaccination in this age group should be carefully considered before vaccination. The vaccine should be avoided during pregnancy or breastfeeding. However, pregnant or nursing women may be vaccinated during epidemics or if traveling to country or area a risk of transmission is unavoidable.

Advertisement: Come to sunny Singapore to have your testing and treatment. Singapore Ministry of Health registered general practice (GP) clinic:
SHIM CLINIC
168 Bedok South Avenue 3 #01-473
Singapore 460168
Tel: (+65) 6446 7446
Fax: (+65) 6449 7446
24hr Answering Tel: (+65) 6333 5550
Web: Yellow Fever Vaccine, Singapore
Opening Hours
Monday to Friday: 9 am to 3 pm, 7 pm to 11 pm
Saturday & Sunday: 7 pm to 11 pm
Public Holidays: Closed
Last registration: one hour before closing time.
Walk-in clinic. Appointments not required.
Bring NRIC, Work Pass or Passport for registration.

References


Latest News

Preferences and Decision Needs of Boston‐Area Travelers to Countries With Risk of Yellow Fever Virus Transmission: Implications for Health Care Providers
Thu, 17 Apr 2014 21:55:20 +0100 | Journal of Travel Medicine
ConclusionMost participants sought YF disease and vaccine risk information and wanted to be involved in decision‐making; however, fewer than half recalled discussing their opinions or concerns about YF vaccine. Providers need effective risk communication skills and the ability to elicit and respond to travelers' concerns to help them make informed, shared decisions. (Source: Journal of Travel Medicine)

Localized bullous fixed drug eruption following yellow fever vaccine
Thu, 17 Apr 2014 21:12:27 +0100 | Journal of the American Academy of Dermatology
To the Editor: Yellow fever is a potentially fatal, mosquito-borne disease endemic to areas of South America and Africa. The yellow fever vaccine is recommended to those traveling to high-risk areas and is considered one of the safest and most effective vaccines ever developed. The vaccine is a live attenuated version of the 17D strain grown in egg embryos and imparts durable immunity for 10 years. Reported dermatologic side effects of the vaccine include mild injection site reactions, urticaria, and anaphylaxis. (Source: Journal of the American Academy of Dermatology)

Assurance of neuroattenuation of a live vaccine against West Nile virus: A comprehensive study of neuropathogenesis after infection with chimeric WN/DEN4Δ30 vaccine in comparison to two parental viruses and a surrogate flavivirus reference vaccine.
Sat, 12 Apr 2014 00:00:00 +0100 | Vaccine
Authors: Maximova OA, Speicher JM, Skinner JR, Murphy BR, St Claire MC, Ragland DR, Herbert RL, Pare DR, Moore RM, Pletnev AG

RE: Non-specific effects of co-administration of live measles, yellow fever and pentavalent vaccines on mortality?
Tue, 25 Mar 2014 00:00:00 +0100 | Vaccine
Authors: Schmid DA, Demasi R, Ibarra de Palacios P

[YEL-AND meningoencephalitis in a 4-year-old boy consecutive to a yellow-fever vaccine.]
Tue, 11 Mar 2014 00:00:00 +0100 | Archives de Pediatrie
We describe herein the case of a 4-year-old child who presented with severe encephalitis consecutive to a yellow-fever vaccine, with favorable progression. Diagnosis is based on the chronology of clinical and paraclinical signs and the presence of yellow-fever-specific antibodies in CSF. The treatment consists of symptomatic treatment and immunoglobulin injection.

Knowledge, Attitudes, and Practices of US Practitioners Who Provide Pre‐Travel Advice
Tue, 04 Mar 2014 00:00:00 +0100 | Journal of Travel Medicine
ConclusionsMany PCP survey participants provided pre‐travel advice, but most saw few travelers. Volume of travelers and holding an ASTMH or ISTM certificate had the greatest influence on knowledge of travel medicine and provision of appropriate advice and recommendations. Creating easily accessible travel medicine education programs for US providers from a wide range of disciplines is needed to improve the management of travelers. (Source: Journal of Travel Medicine)

Meningitis vaccine withstands African heat without damage
Wed, 19 Feb 2014 11:23:23 +0100 | Guardian Unlimited Science
MenAfriVac can be used effectively at 40C and below, raising hopes for yellow fever and cholera immunisation campaignsThe first immunisation campaign in Africa using a vaccine that does not have to be stored in fridges and iceboxes has been successful and substantially cut costs, according to scientists.MenAfriVac is authorised for use at temperatures not exceeding 40C and can be kept out of the fridge for up to four days. The vaccine against meningitis A was unusual in being designed specifically for the African meningitis belt, where annual epidemics used to kill thousands, but experts say it would be feasible to allow other vaccines to be used outside of cold-chain conditions. Vaccines against yellow fever and cholera are among those that could potentially be kept and used safely at hig...

An unusual case of influenza-like illness after yellow fever vaccination
Thu, 06 Feb 2014 00:00:00 +0100 | Journal of Clinical Virology
Abstract: Yellow fever (YF) is an important public health concern in areas where the disease is endemic. For more than 60 years a highly effective live attenuated vaccine has been available, its widespread use resulting in a dramatic decrease in the number of cases. On rare occasions, YF vaccine can cause mild to severe disease and rare adverse vaccine-associated events have been reported. Additionally, an average viremia of 3–5 days after administration of the YF vaccine has been published. Here we present a case where YF vaccine was isolated in cell culture from a respiratory swab collected from a patient presenting with influenza-like illness. To the best of our knowledge, this is the first report finding replicating YF vaccine in the respiratory sample of a post inoculated individual...

Challenges and solutions for a rational vaccine design for TB-endemic regions.
Tue, 04 Feb 2014 00:00:00 +0100 | Critical Reviews in Microbiology
Authors: Gowthaman U, Mushtaq K, Tan AC, Rai PK, Jackson DC, Agrewala JN

A review of successful flavivirus vaccines and the problems with those flaviviruses for which vaccines are not yet available.
Tue, 28 Jan 2014 00:00:00 +0100 | Vaccine
Authors: Ishikawa T, Yamanaka A, Konishi E