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Yellow Fever Exemption

August 22nd, 2013

Many people have recently been ringing our clinic and asking … Is it acceptable to have a medical exemption for yellow fever vaccine instead of the vaccination certificate? Some of our patients have been told by their travel agent that the exemption certificate is not good enough and they must get vaccinated. This is ill informed and dangerous and here is some information to help dispel this misunderstanding.

 

Yellow fever is a dangerous disease present in parts of Africa and South America. The World Health Organisation estimates there are 200,000 cases of yellow fever, and 30,000 deaths, worldwide each year.

The yellow fever vaccine is a very safe vaccine – with over 400million doses of vaccine being given over 60 years. However, everyone is different and some persons cannot be vaccinated safely.

Persons with some types of medical history cannot be safely vaccinated as they can develop serious side effects, even death from the vaccine.

These are persons where the risk from the vaccine is greater than the risk from the disease. These people may chose to change their travel plans, or carry a medical exemption and take other precautions to avoid yellow fever. (Since the yellow fever disease is spread by mosquitoes, mosquito avoidance and accepting a small risk of catching the disease, may be strategy that some travellers opt to take, especially for short trips eg a day in Iguassu falls.)

It does not make sense to vaccinate persons with yellow fever if they could get really sick from the vaccine. The International Health regulations have a system for those people. Yellow fever vaccine providers are entitled to issue a medical yellow fever exemption certificate or a medical waiver.

“If there are medical grounds for not getting vaccinated, International Health Regulations state that this must be certified by the appropriate authorities.” World Health Organisation

A medical yellow fever exemption or waiver is perfectly legal and can be used in place of a vaccination certificate, provided it has the following:

  • On letterhead from the designated yellow fever provider
  • The travellers correct name and date of birth as it appears on their passport
  • The dates that the exemptions relate to
  • The signature of the travel doctor
  • The yellow fever clinic stamp with special authorisation number

 

You cannot get a medical exemption because you would rather not have the vaccine, you don’t like vaccines, you are worried about side effects etc. You cannot get a medical exemption from any doctor.

Only a yellow fever approved centre can issue yellow fever exemptions. Properly trained travel medicine doctors are trained to know how much risk there is of yellow fever in different parts of the world, and know how much risk there is from different medical conditions and make a judgment about the safest course of action for any individual person and trip. Note: not all yellow fever providers in Australia undergo extra training, so it pays to ask about training and experience with the vaccine.

American CDC information on medical yellow fever exemption certificates

UK information on medical yellow fever exemption

More information about Yellow Fever

4 Responses to “Yellow Fever Exemption”

  1. Lynette Ann Harrower says:

    I have been advised by my Doctor that there are greater risks to having the vaccination as I am 75 years of age therefore she has given me a letter (duly signed and stamped) stating this. I previously had the vaccination in 1976 before travelling through South America. This time I shall be travelling through Cuba, Colombia, Ecuador and Galapagos with stopovers in Lima and Santiago.

  2. Oliver says:

    Dear Dr. Deb

    Thank you for your article. However after a lot of research on the topic, it states clearly on “The Department of Health ” website ( the Australian governments website ). You are not required to have a yellow fever vaccination coming back into Australia. It is only recommended! On the Uganda Immigration website it states you are required to have a yellow fever vaccination if ….! Here is the big IF! You are coming from a yellow fever contaminated country! Australia is not one of those countries. Most of them are in Africa. Kind regards Oliver

    • Dr Deb says:

      HI Oliver – I agree that you will not be denied entry to Australia
      From http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-communic-factsheets-yellow.htm#09
      Will I be allowed to enter Australia, if I do not have a yellow fever vaccination certificate?
      If you are arriving in Australia from a yellow fever risk country but do not hold a vaccination certificate you will still be permitted to enter Australia without one. On arrival in Australia, Department of Agriculture, Biosecurity officers will reinforce the seriousness of the disease to you and provide you with a Yellow Fever Action Card. The card provides instructions on what you should do if you develop any symptoms of yellow fever in the six-day period following your departure from a yellow fever risk country.

      However, the same fact sheet says

      The yellow fever vaccine is recommended for:

      persons who are nine months of age or older travelling or living in any country in West Africa, regardless of where they will be in that country; and
      persons who are nine months of age or older travelling or living outside the urban areas of all other yellow fever endemic countries.

      The disease Yellow Fever is very unpleasant, even if no-one looks at your yellow book.
      regards Dr Deb

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