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Yellow fever vaccine: see when you should take it

Yellow fever vaccine: see when you should take it

The yellow fever vaccine consists of live attenuated virus (strain 17D) presented in a lyophilised form in a multi-dose vial with diluent (saline solution).

A vaccination is considered by the World Health Organization to be the most important way to prevent yellow fever. So much so is the frequent vaccination that prevents the disease from spreading even in endemic areas. It is necessary that at least 80% of the population is immunized against a virus to prevent the disease in these regions.

What is the fractional dose of the yellow fever vaccine?

With the monkey deaths in São Paulo at the end of 2017 and early 2018, the State Department of Health has decided to adopt the fractional version of the yellow fever vaccine. The forecast is that it is also adopted by Rio de Janeiro and Bahia. *

According to the World Health Organization (WHO), the full-dose vaccine lasts a lifetime, while the fractionated vaccine will last for nine years. The new rule, already used in countries such as Angola, was highlighted after analysis by the National Immunization Commission, which determined the duration of the vaccine.

Initially, it was estimated that protection of the fractioned dose would be only one year, but there was a follow-up with the people who received it and the result was satisfactory.

Diseases the vaccine prevents

The vaccine prevents yellow fever, a disease caused by a virus of the Flavivirus family, a type of virus that causes disease in humans and other vertebrates. It is considered acute and hemorrhagic and is called jaundice, a symptom that leaves the eyes, skin and mucous membranes looking yellowish.

The disease is transmitted through a mosquito bite. And it is important to warn that there are three species of mosquitoes capable of transmitting the virus. Mosquito species Haemagogus and Sabethe transmit wild yellow fever because they are concentrated in forest and inland regions. The Aedes aegypti is responsible for the transmission of urban yellow fever, which affects large cities and metropolitan areas. However, the transmitted virus is the same, it only changes the transmitting agent.

In 2017, Brazil again experienced an outbreak of this condition that began in January of this year. To date, 101 cases have been registered, 97 in Minas Gerais, three in São Paulo and one in Espírito Santo.

The World Health Organization (WHO) has reported that this outbreak may reach other states in Brazil. According to the organization, so far there is no evidence that Aedes aegypti is transmitting the virus, causing urban sprawl.

How the yellow fever vaccine works

The yellow fever vaccine is administered subcutaneously, in the arm region. The protective effect occurs from the tenth day after it has been taken and warrants immunity for at least 10 years. It acts by stimulating the body to produce its own protection against the virus.

The main localities where the yellow fever vaccine is indicated are the forest and river regions of the following locations: all States in the North and Mid- West; state of Maranhão, southwest of Piauí, west and extreme-south of Bahia, state of Minas Gerais and west of São Paulo and north of Espírito Santo, and states of Paraná, Rio Grande do Sul and Santa Catarina, in the South. It is important to remember that whoever travels to regions affected by the outbreak needs to take the vaccine 10 days before embarking to be immunized.

Necessary doses

Currently, in Brazil, two doses with a 10-year interval are recommended. plus the reinforcement every 10 years. Outside of Brazil, WHO recommends only one dose.

Contraindications

The vaccine against yellow fever is contraindicated for pregnant women, women who are breast-feeding, children under six months and people over 60 years of age. . Immunocompromised people such as cancer patients and those with chronic diseases should also not take it.

Indications for the yellow fever vaccine

The yellow fever vaccine is indicated for people between 9 months and 60 years living in regions In the impossibility of postponing vaccination, such as in situations of epidemiological emergencies, the occurrence of outbreaks, epidemics or travel to areas at risk of contracting the disease, and for people living in urban areas and going to regions affected by the outbreak.

In the case of persons over 60 years of age who have never been vaccinated, the physician should take into account the risks of vaccination, which include the risk of adverse events in that range age or comorbidities.

Pregnant women should only be vaccinated against yellow fever if the risk of acquiring the disease is extremely high. In addition, it is also contraindicated for women who are breastfeeding. However, if the infant needs to take the immunization, it is necessary to suspend breastfeeding preferably for 28 days after vaccination.

See table below and better understand each indication:

Indication

Outline

Children of 6 months to 9 months of age incomplete

The vaccine is indicated only in cases of epidemiological emergency, outbreak period, epidemics or urgent trip to an area at risk of contracting the disease.Children aged 9 months up to 5 years incomplete
One dose should be given from 9 months of age, boosted at 4 years of age, with a minimum interval of 30 days between doses.People over 5 years of age who have already received a dose of the vaccine
A single booster dose with a minimum interval of 30 days between doses should be givenPersons aged 5 years who have not been vaccinated
Give two doses of the vaccine at a 10-year intervalPeople from 5 years of age who have already received 2 doses
Are considered as vaccinatedPersons aged 60 years and older who have been vaccinated
The physician should evaluate the benefit and risk of vaccination, taking into account the risk of the disease and the risk of adverse events in that range age or comorbidities.Pregnant women
Regardless of the vaccination status, vaccination against yellow fever is contraindicated.Infants
A In the absence of postponement of vaccination, such as in emergency epidemiological situations, outbreaks, epidemics or travel to an area at risk of contracting the disease, the physician should evaluate the benefit and risk of vaccination. vaccination is not indicated and should be postponed until the child reaches 6 months of age. If it is impossible to postpone vaccination, such as in emergency epidemiological situations, outbreaks, epidemics or travel to an area at risk of contracting the disease, the physician should evaluate the benefit and risk of vaccination.Travelers in Brazil
Travel to areas with vaccine recommendation in Brazil: vaccinate yourself before the trip. In the case of the first dose, take it at least 10 days before the trip.Possible side effects
Generally, the vaccine produces few side effects. But episodes of local pain, headache, and fever may occur five to ten days after the application.What are the implications of people taking the vaccine unnecessarily?

In the last few days we have seen that many people are interested in taking the vaccine against yellow fever. It is important for people to care about their health. However, if the individual is not at risk or will not travel to a location where the outbreak is occurring there is no need to take this immunization. The virus is located in rural areas and has not yet reached large metropolises. If people take it unnecessarily, it can happen that the vaccines in the posts are over and who really needs the protection may run out.

Those living in the big city need to protect themselves against the Aedes aegypti mosquito, which can transmit yellow fever and other diseases as well, such as Zika virus, dengue fever and chikungunya fever

Where to find yellow fever vaccine

The vaccine is available in public networks - for at-risk groups - and private. Some medical covenants cover her in the private healthcare system.

Frequently Asked Questions

If I do not remember taking the vaccine, can I go to the clinic and repeat the dose?

Yes. The best measure to do in these cases is to check the vaccination card. But if you missed it for some reason, or thought it was vaccinated, but it is not on the record, the best thing to do is to get vaccinated, albeit repeatedly.

People allergic to egg protein can take the vaccine against yellow fever Persons with a history of mild to moderate allergic reactions after ingesting eggs (eg urticaria only) may receive immunization under medical supervision and should be observed for 30 minutes after vaccination.

Individuals with history of severe allergic reactions after egg ingestion, such as anaphylaxis, for example, have contraindications. However, if the risk of exposure to yellow fever is very high, the patient should be referred to the specialist for skin testing with the vaccine. If the test result is negative, it can be administered under medical supervision and with a 30-minute observation period. If the test is positive, dose fractionation or desensitization should be discussed with the allergist in an environment that offers the possibility of appropriate management in the event of possible post-vaccinal anaphylaxis.

In an outbreak scenario, who should take the yellow fever vaccine?

At the present time it is important that people residing in risk areas take the vaccine. Those who are not in these locations but will travel to some risk area need to vaccinate 10 days before traveling. It is not safe for the person to take the vaccine on the day before the trip because the immunological window of the vaccine is 10 days.

Is the yellow fever vaccine part of the Immunization Schedule for people living in the endemic area? From 6 months to 9 months of age incomplete: the vaccine is indicated only in cases of epidemiological emergency, outbreak period, epidemics or urgent trip to the area at risk of contracting the disease

From 9 months to 4 years 11 months and 29 days of age: one dose is indicated at 9 months of age and a booster dose at 4 years of age

From the age of 5: if the person has already received a vaccine, one more dose may be given. If it has never been vaccinated, a starting dose and a booster dose should be given 10 years later.

For people over 60 who have never been vaccinated, the doctor should take into account the risks of vaccination, which include the risk of adverse events in this age group or due to comorbidities. Pregnant women and infants are contraindicated to take this vaccine as well as immunosuppressed people.

What are the implications of people taking the vaccine unnecessarily?

In recent days we have seen that many people are interested in taking the vaccine the yellow fever. It is important for people to care about their health. However, if the individual is not at risk or will not travel to a place where the outbreak is happening there is no need to take the vaccine against yellow fever. The virus is located in rural areas and has not yet reached large metropolises. If people take the vaccine unnecessarily, it can happen that the vaccines in the outposts stop and those who really need the protection may run out. Those living in the big city need to protect themselves against the Aedes aegypti mosquito, which can transmit yellow fever and other diseases as well, such as Zika virus, dengue fever and chikungunya fever


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