Eugene has recently been designated a STAMARIL Yellow Fever Vaccine
Center. To understand what this means, please read on.
Yellow fever is a serious, potentially fatal disease caused by a
mosquito transmitted virus which may be contracted by travelers to some
destinations in central Africa or central South America. For decades,
the US has had an effective, readily available vaccine for yellow fever,
YF-VAX, supplied by Sanofi Pasteur. Manufacturing problems arose in the
US plant; this vaccine will likely not be available again until July
2018. It will be replaced temporarily by a similar French yellow fever
vaccine, STAMARIL. Meanwhile, we are in the middle of a world-wide
yellow fever vaccine shortage due to epidemics in Brazil, Angola and the
Democratic Republic of the Congo.
Sanofi has set up 250 "STAMARIL clinics" in the US, far fewer than the
4000 YF-VAX clinics we have had until recently. Three STAMARIL clinics
have been established in Portland and. area; Eugene has been chosen as
Oregon' only STAMARIL clinic in Oregon outside the Portland area, thus
ensuring that people will not have to travel as far to obtain this
All yellow fever vaccines contain live virus and they are the only
vaccines for which I have a safety concern. In YF vaccine recipients,
there is a tiny incidence (perhaps 1 per 100,000 or 0.001%) of a yellow
fever-like illness, with a 50% death rate in those who develop this side
effect of the vaccine. For this reason, yellow fever vaccine is given
only by those who possess a special license to do so, and is given only
to traveling patients who really need it. Some patients should not
receive yellow fever vaccine. Some countries do not allow some travelers
to enter unless they possess a Yellow Fever Certificate signifying that
they have received the vaccine.
To put some of this in perspective: We are living in a truly remarkable
time. Public health measures have decreased the burden of many
infectious diseases in the United States and worldwide. The most
efficient of these measures are vaccines. Those of us born since 1960
will not have memories or understanding of the ill effects of measles,
polio, pertussis (whooping cough), diphtheria, meningitis, mumps,
chicken pox or rubella, and may not understand vaccines' importance.
Vaccines which caused significant side effects in the past (prior
formulations of typhoid, pertussis, rotavirus and oral polio vaccines,
as well as vaccines for smallpox and Lyme disease) have now been
replaced by safer versions or have been taken off the market.
Everyone living in the United States (including travelers) can choose
from effective, safe vaccines for 18 different diseases: tetanus,
diphtheria, pertussis, polio, measles, mumps, rubella, hepatitis A,
hepatitis B, meningococcal meningitis, HPV, rotavirus, HIB, varicella,
shingles, pneumococcal pneumonia, influenza and rabies.
For travelers to destinations outside the US, disease risk depends on
geography. Vaccine- preventable diseases of concern for travelers
include hepatitis A, influenza, typhoid fever, yellow fever and Japanese
encephalitis. Some travelers may wish to review other concerns, for
which there are no vaccines, including malaria (preventable with
medication), prevention and treatment of diarrhea, mosquito and sun
protection, dengue-like illnesses, jet lag and altitude sickness.
Several diseases are mentioned on both lists, signifying their
importance for both travelers and those staying home. Discuss whether
you are at risk for these diseases with your doctor.
It would be best for traveling patients who may need YF vaccine to plan far
in advance, have an
evaluation by a travel medicine practitioner, and call a STAMARIL clinic to
appointment if YF vaccine is indicated. To inquire of
about either YF-VAX or
www.TravelClinicOregon.com and send an email through our website
describing your situation.
Those wishing more information on these issues may consult
and especially the Yellow Fever chapter
John D. Wilson, M.D.
A STAMARIL Center