Yellow fever vaccine

[sanddunes]

You are correct - that particular article is old, but the risks have not changed.  

Statistically, 4 out of every 1 million who receive the yellow fever live vaccination become infected with yellow fever and die.  Live virus vaccines are inherently more dangerous than inactivated vaccines.

It’s a small percentage, but definitely something to consider, especially when you are going to a lower-risk area of Brazil like Rio. 

I’m not against the vaccine.  Certainly if I was planning to go to a high-risk area of Brazil like the Amazon I would get it..

[Riobard]

Here is my two cents based on the recent data as well as what is known about YF vaccine morbidity/mortality.

I  got the nonfractionated vaccine as I spend a few months per year in various Brasilian locations. I have been sick with mosquito-sourced viremia twice and I double-down on precautions. 

Assuming zero antecedent inoculation, the chances of infection in Brasil over the past year comes to about six-fold the probability of a serious adverse vaccination-related event.

Given that a sizeable proportion of BRZ residents had been previously vaccinated (many states do it routinely) and that a large proportion of those infected succumb to YF, I am confident that the protective advantages of vaccination outweigh the risks of vaccination illness/death by at least 10:1 ...

this is simplistic, mind you, in that geographical regions and duration of stay by visitors is not taken into account. 

A short visit in a non-endemic zone might nullify the advantages based exclusively on the virus-vacc dialectic. According to my crude math, two weeks in Rio in low season, for example, does not seem too risky and there is no major reason to freak out if you just became YF-savvy.

Social media goes viral related to isolated vaccination incidents and information gets distorted. In my estimation, more infection residuals for the unvaccinated will continue to overtake the risks of a vacc dose. But that applies more to full-time residents. 

Some folks find anything short of absolute zero risk intolerable. But they overlook other layers of unacceptability:

Risk of infection with YF is greater than zero. Risk of being a vector of infection passed to others, if infected oneself, is greater than zero. 

Of course there is the complication of possibly being less accepting of bad results due to a decision already made, however reasonable the choice, compared to more apparently random misfortune.

It would be great if the answer to the vacc were more illumuninated yellow rather than being in a gray zone. 

[CaliPexx]

@sanddunes and @Riobard: You are both right. In healthcare, there are potential risks in everything we do. So the answer to that, as you are doing, is to evaluate the benefit:risk ratio for any proposed procedure or treatment.

My own primary care physician told me a story about his son, who was not immunocompromised or anything, and was planning a prolonged stint in the Amazon with the Peace Corps or a similar organization. My doctor's kid actually developed a case of vaccine-induced yellow fever that landed him in the ICU before he left the U.S. for Brazil. Fortunately, the guy recovered from that and continued on his mission in the Amazon.

I mulled over that story quite a lot but, in the end, after reviewing the risks vs the benefits, decided to get the vaccine. Fortunately, I didn't suffer any adverse outcomes from the YF immunization. With the recent upsurge in cases of yellow fever in Brazil, my three traveling companions also decided not to take any risks of the disease and obtained the YF vaccine prior to our 2018 trip. Once again, they did not report any problems, even the mild flu-like symptoms you sometimes get with a flu shot.

So, in the end, it's really all about being an informed consumer, doing your homework, and deciding on what level of risk you are willing to accept vs the benefits the vaccine might provide.

[caeron]

I wasn't sure if I needed it, but turns out I forgot I got it several years ago for another trip.I'd like to pretend that advancing years has weakened my memory, but the truth is I always had a shitty memory! 

 

I am a strong believer in vaccines. Whatever the risks a vaccine may have, and most have very little, the risk of NOT getting it when you need it is far, far worse.

[Pinkeey22]

I'm Canadian, and from what I read on government websites there is no requirement for Canadians to get a yellow fever vaccination when travelling to and from Colombia.

My questions to you guys are:  Should I get one anyway?  Will I be at risk in Bogota and Medellin?  Is there any other vaccination or health consideration that I should be concerned about?

Thanks.

[CaliPexx]

On 2/23/2019 at 7:54 PM, Pinkeey22 said:

I'm Canadian, and from what I read on government websites there is no requirement for Canadians to get a yellow fever vaccination when travelling to and from Colombia.

According to the U.S. Embassy in Bogotá, there is also no yellow vaccine recommendation for Americans traveling to either Bogotá or Medellin.
 

Quote

Yellow Fever Vaccination. ... The embassy recommends that all travelers between the ages of 1 – 60 years receive the yellow fever vaccine at least 10 days before traveling to areas in Colombia (see map) determined to be at high risk of yellow fever transmission. Bogota, Cartagena, and Medellin are not high risk areas.

 

[Riobard]

I am also Canuck. You should be OK clinically. However, previous contributions here have highlighted the necessity of YF vaccine if you are not returning directly to Canada or USA. Same for Brazil outbounds. For example, if you are connecting in Panama you will be denied entry if you want to leave airside zone. Not a problem for a quick transfer, but an extended delay leaving Panama would put you uncomfortably on a standard Tocumen gate chair, though access to amenities, with no option to clear customs and visit the city or book an airport area hotel. You are likely Air Canada direct from or thru TO. If Copa, word to the wise is herein delivered. I will be flying Copa to Bogotá, but I have the lifetime nonfractionated inoculation. Personally, I recommend vaccination to allow for spontaneity or pitfalls in planning or execution. 

Edited February 26, 2019 by Riobard

[Riobard]

The spike in Yellow Fever seen in the most high-risk season (Dec-May) in 2016-17 and 2017-18 has not been repeated to the same degree so far ... Dec2018-Mar2019 is latest tally period.

However, it remains much higher, and mostly in São Paulo, than any year from 1980 up to 2016, notwithstanding that now more than 13 million state Paulistas have been vaccinated. 

This suggests that YF is still circulating at a higher rate among the host mosquitoes and nonhuman primates. A São Paulo zoo monkey died from it earlier this year.