YELLOW FEVER VACCINATION IN PREGNANCY

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(Date of issue: August 2019, Version: 3)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on yellow fever vaccination in pregnancy is available at www.medicinesinpregnancy.org.

Summary

Yellow fever is a 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, weighing up the possible fetal risks of vaccination against the risk to both 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 690 unique cases of intrauterine exposure. These data do not currently demonstrate an increase in risk of adverse pregnancy outcomes or congenital infection following gestational exposure to yellow fever vaccine. However, the data are currently too limited to exclude the possibility.

Following vaccination against yellow fever, positive 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 document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to ensure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org

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 health care professionals at www.toxbase.org.

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 TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.