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YELLOW FEVER VACCINATION IN PREGNANCY

Date of issue: December 2023, Version: 4

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A corresponding patient information leaflet on YELLOW FEVER VACCINATION IN PREGNANCY is available.

Yellow fever is a potentially life-threatening mosquito-borne viral infection endemic to rural areas of sub-Saharan Africa and tropical regions of South America. The yellow fever vaccine is a live attenuated vaccine indicated for providing active immunisation for people travelling to, or residing within, yellow fever endemic areas, or countries which require an International Certificate of Vaccination and those handling potentially infectious material (e.g. laboratory personnel).

Live vaccines including the yellow fever vaccine are generally contraindicated in pregnancy due to the theoretical risk of strain reversion and congenital infection following gestational exposure. Unvaccinated pregnant women are therefore advised to avoid travelling to yellow fever-endemic areas and handling potentially infected material. Where travel or contact is unavoidable, vaccination in pregnancy should be considered on a case-by case basis. The possible fetal risks of vaccination should be weighed against the risk to mother and fetus from yellow fever infection which is associated with significant morbidity and mortality, particularly in immune-naïve individuals.

The available published data are limited to approximately 2,000 unique cases of intrauterine exposure. These data do not demonstrate an increase in risk of adverse pregnancy outcomes following gestational exposure to yellow fever vaccine.

Following vaccination against yellow fever, immunity is usually acquired within ten days. However, evidence from a small sample of pregnant women has suggested that gestational stage at vaccination can affect seroconversion. Women vaccinated in the third trimester should therefore be vigilant in identifying symptoms of infection following potential exposure.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to NHS health care professionals who are logged in.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from UKTIS.org to ensure you are using the most up-to-date version.