Yellow Fever Vaccine Cases, Mark Gershman - ISTM

Vaccine Precaution* Condition in a vaccine recipient that• Might increase the risk for a serious adverseevent (SAE)Or• Might compromise the ability of the vaccine toproduce immunity Must carefully weigh benefit of protectionfrom vaccine versus risk for SAE Consider deferring vaccine*General Recommendations on Immunization: Advisory Committee on ImmunizationPractices (ACIP), MMWR, Vol. 60, No. 2, Jan. 28, 2011Contraindications to Yellow FeverVaccine Administration (WHO)* Allergy to any vaccine component Age < 6 months Symptomatic HIV infection Thymoma or history of thymectomy Immunodeficiencies from medication or disease*International Travel and Health, 2011, WHO, Geneva, SwitzerlandPrecautions to Yellow Fever VaccineAdministration (WHO)* Age 6-8 months Pregnancy Breastfeeding*International Travel and Health, 2011, WHO, Geneva, SwitzerlandContraindications to Yellow FeverVaccine Administration (U.S.)* Allergy to any vaccine component Age < 6 months Symptomatic HIV infection or CD4 + count < 200/mm 3 Thymus disorder associated with abnormal immune cellfunction Primary immunodeficiencies Malignant neoplasms Transplantation Immunosuppressive and immunomodulatory therapiesPrecautions to Yellow Fever VaccineAdministration (U.S.)* Age 6-8 months Asymptomatic HIV infection and CD4 + count200-499/mm 3 Pregnancy BreastfeedingYellow Fever Vaccination Decision Making — CONTRAINDICATIONSNo vaccination.Patient presentsDiscourage travelYESto YF endemicfor YF vaccinationarea.YF VaccineRECOMMENDED?NOWaiverYESContraindicationYESCONTRAINDICATIONpresentYF Vaccinepresent?REQUIRED?No vaccination.YESDiscourage travelNO YF Vaccineto YF endemicarea.RECOMMENDED?NONONo vaccinationYESVaccinateNO YF vaccinePRECAUTIONREQUIRED and/orpresent?RECOMMENDED?• *Yellow Fever Vaccine: Recommendations of the Advisory Committee on ImmunizationPractices (ACIP), MMWR, Vol.59, July 30, 2010• Blue font indicates Contraindication details not listed by WHO• *Yellow Fever Vaccine: Recommendations of the Advisory Committee on ImmunizationPractices (ACIP), MMWR, Vol.59, July 30, 2010• Blue font indicates Precaution details not listed by WHOYESSeePrecautionflow chartNONo vaccinationMark Gershman MD, CDC, Atlanta, GA, USAMay 2013