Yellow Fever Vaccine Un-Availability & Is Substitute Accepted

Just found out the the US’s supply of the yellow vaccine is depleted. We need this vaccine to sail with Holland America January 2019 on the South America Circumnavigation cruise. I cannot be the only person in this situation. Searched for yellow fever vaccine on CC but didn’t find anything.

What I have found out so far and what I am doing next is below. In the meantime, thought I would post here to see what others are doing about the yellow fever vaccine.

Did a little research this morning and found that the company that supplies the vaccine (Sanofi Pasteur) is building a new manufacturing facility with plans to provide vaccines to the US again by the end of 2018. Scary timing for us as we won’t be allowed onboard on Jan 4, 2019 without proof of the vaccine.

Also found that during the interim the manufacturer has worked out a deal with the CDC to provide a vaccine that is currently used in over 70 countries, but isn’t approved by the CDC. This drug is considered investigational in the US. From Sanofi Pasteur’s website “Working closely with the CDC, more than 250 geographically distributed sites throughout the US were identified for inclusion in the program so patients can have continued access to yellow fever vaccine.”

I have lots of questions and will be making phone calls over the next day or so to get answers. If I get the substitute vaccine.... will I still receive the required yellow card? Will the countries requiring proof of the vaccine accept the substitute? Will Holland America accept it? Are we required to go through a process similar to that used with an experimental drug if we get the substitute? Why hasn’t the CDC approved the substitute since so many other countries use it?

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Don't know how old you are but, yellow fever vaccine is not recommended for "senior citizens." If you're around 70, talk with your physician about getting a letter stating you cannot use it.

BTW, I think the CDC is okay with a substitute: https://wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/search

Thanks for the info. I am 52 so should be good if I can find the vaccine.

Thanks for the link too - that is one I had found earlier and gotten a lot of information from. I think I will still call them though and make sure they accept it and will still give me the yellow card. This is an expensive cruise and I don’t want to risk not being allowed on board due to this vaccine.

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I would also consider speaking with a "Travel Clinic". Their entire job is to assist you with all medical related information when traveling.

Found this with a quick Google search.

https://wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/state/florida

I’m only going to take on the OP’s last question as to why this version of the vaccine, which is widely available elsewhere has not been approved by the FDA. Drug and Vaccine approval and licensing is a complex and expensive process in the US. For an agent that has a limited market and thus not a huge upside profit there is little reason for the manufacturer, in this case Sanolfi-Pastuer, to pursue approval for a second agent when it already has 100% of the market. Basically it uses this alternate version elsewhere so it is not a new or experimental agent. As a means of covering the needs of a limited number of travelers until it could rebuild it stock of the approved agent S-P worked out an agreement to allow the alternate to be used. Had that not been done, travelers to or from yellow fever endemic regions would not have been able to travel until the production of the usual vaccine had resumed.

Don't know how old you are but, yellow fever vaccine is not recommended for "senior citizens." If you're around 70, talk with your physician about getting a letter stating you cannot use it.

BTW, I think the CDC is okay with a substitute: https://wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/search

Off shoot question - does a physician statement that you cannot get the vaccine mean you can take a cruise that normally requires the immunization?

Called a few places the CDC has in the list of places that carry the substitute vaccine. They all have the substitute vaccine and you get the yellow card. They do not anticipate a shortage of the substitute vaccine. I was surprised to find prices varied from $190 to $235. Plus some places also charge an office fee.

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I also called Holland America and they do accept the substitute vaccine.

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I would also consider speaking with a "Travel Clinic". Their entire job is to assist you with all medical related information when traveling.

 

Found this with a quick Google search.

https://wwwnc.cdc.gov/travel/yellow-fever-vaccination-clinics/state/florida

Speaking with Gravel Clinic is a good idea.

HOpe it works out fine for you and all who require the vaccine and cannot get it.

Off shoot question - does a physician statement that you cannot get the vaccine mean you can take a cruise that normally requires the immunization?

That's an excellent question. I'm calling Oceania today about any "requirement" vs "against medical advice" for Amazon cruise later this year. Our invoice says "recommended."

Don't always listen to cruise lines advice when its 'recommended' rather than a must. Cruise line simply don't know and have centre agents that are just as clueless.

The reason I say this is some countries require anyone entering to be vaccinated against yellow fever and show proof of it if they have recently been in a country that has a high risk of yellow fever. I am sure there are a few countries that waive this for passengers of ships for the day but there are some that will not.

We did not want to take the risk of this as we were in Columbia at the start of a cruise (Yellow fever country) and went to Costa Rica late on (a country that required proof of yellow fever vaccine if recent visits to certain countries had been made).

Yellow fever vaccines have always been depleted over here in the UK and are not free on our NHS. We paid about £10 more for the vaccine than the previous year but we got it done. It cost us £80 in 2014.

I was surprised to find prices varied from $190 to $235. Plus some places also charge an office fee.

Yes the yellow fever vaccine is quite expensive in the US. I don't know where your embarkation point is, but if it's in South America (rather than in the US), check to see if your arrival airport has a clinic that will administer the vaccine. That can save you quite a bit of money.

Yes the yellow fever vaccine is quite expensive in the US. I don't know where your embarkation point is, but if it's in South America (rather than in the US), check to see if your arrival airport has a clinic that will administer the vaccine. That can save you quite a bit of money.

I am not sure that I would want to take any injected medication on the day that I arrive at a foreign location. What if you have an unexpected reaction to the medicine or to the shot?

DON

I am not sure that I would want to take any injected medication on the day that I arrive at a foreign location. What if you have an unexpected reaction to the medicine or to the shot?

 

DON

Good point. In addition getting the shot at that point would be late to the game. A vaccine is not effective at the very moment it is injected but requires the body to mount an immune response to the biologic product. In general we suggest that it takes roughly 2 weeks post injection for protection to be effective.

Good point. In addition getting the shot at that point would be late to the game. A vaccine is not effective at the very moment it is injected but requires the body to mount an immune response to the biologic product. In general we suggest that it takes roughly 2 weeks post injection for protection to be effective.

If I remember correctly the yellow fever vaccine is not effective until 10 days after the Shot.

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Yes the yellow fever vaccine is quite expensive in the US. I don't know where your embarkation point is, but if it's in South America (rather than in the US), check to see if your arrival airport has a clinic that will administer the vaccine. That can save you quite a bit of money.

My surprise was more from the costs variance than the cost itself. For some reason I was thinking it would be the same cost even though nothing else is in the medical world. Crazy me.

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I had the same confusion you have now re travel around SA and the yellow fever shot. Personal doctor said I didn't need the shot, visited the county health dept for advice and they stated no, I didn't need the shot, called one of those health clinics who wanted me to make an appt to discuss if I need the shot. Cost of that visit would be $65 and the shot would be close to $300 if I decided to get it. All this because I read so much back and forth on cruisecritic. I took the 60 day Princess SA cruise in January and no one asked about any yellow fever shot. Just my experience. Some of these people on cruisecritics can really get you going.

Our Yellow fever cards are now 12 years old, we checked to see whether we needed new jabs or a booster, we were advised neither but must keep the original certificate. There is some interesting and conflicting data on the below sites.

https://www.nhs.uk/conditions/yellow-fever/vaccination/

http://www.who.int/mediacentre/news/releases/2013/yellow_fever_20130517/en/

I had the same confusion you have now re travel around SA and the yellow fever shot. Personal doctor said I didn't need the shot, visited the county health dept for advice and they stated no, I didn't need the shot, called one of those health clinics who wanted me to make an appt to discuss if I need the shot. Cost of that visit would be $65 and the shot would be close to $300 if I decided to get it. All this because I read so much back and forth on cruisecritic. I took the 60 day Princess SA cruise in January and no one asked about any yellow fever shot. Just my experience. Some of these people on cruisecritics can really get you going.

We are getting the shots for 2 reasons: Holland America says we need the yellow fever card to board and because Brazil is having an outbreak of yellow fever. We have several Brazilian ports on our cruise.

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Well, if HAL says it is required for boarding then it sounds like you better get the vaccine.

I also encountered the YF vaccine shortage for a SA trip we took earlier this year. The vaccine was "recommended" because of outbreaks in Brazil in populated areas. I was advised the temporary substitute vaccine had such potentially severe side effects for my age group, I should not use it. But, the big difference for my circumstance was that Celebrity did not require the vaccine for boarding.

FYI -- WHO's site has a list, country-by-country of where yellow fever vaccine is required.

I was advised the temporary substitute vaccine had such potentially severe side effects for my age group, I should not use it.

Do remember what the severe side affects were?

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I have been to the Panama Canal and South America. I have never been bitten by a mosquito yet. Just use a good insect repellant. I have been bitten more at home than on a cruise.

It only takes the first time.

But as mentioned, there are countries you cannot enter without proof of YF vaccination. And they DO check.

Do remember what the severe side affects were?

 

 

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I am sorry, I don't. But is was worded something like unless you know you are going to catch yellow fever, don't use this stuff. Maybe go to CDC and follow the links for more info.

BTW, I actually spoke with a CDC person about our trip and potential exposure. They were very helpful and thought we would be OK without any vaccination.

PS: I suffered several mosquito bites around my ankles during this trip. I used repellant and the bracelet, but made the mistake of wading in some water. I guess it washed enough off to make me fair game.

Well, if HAL says it is required for boarding then it sounds like you better get the vaccine.

 

I also encountered the YF vaccine shortage for a SA trip we took earlier this year. The vaccine was "recommended" because of outbreaks in Brazil in populated areas. I was advised the temporary substitute vaccine had such potentially severe side effects for my age group, I should not use it. But, the big difference for my circumstance was that Celebrity did not require the vaccine for boarding.

 

FYI -- WHO's site has a list, country-by-country of where yellow fever vaccine is required.

Here is a link to CDC.

LINK

We got the shot in 2016 not fro the cruise, but because there was a warning about the Iguazu falls area.