Tropical Medicine and Infectious Disease (Jul 2020)

Ensuring the Safety of Yellow Fever Vaccination in Travelers—The Experience at a Large U.S. Academic Medical Center in Colorado

  • Mehdi Bandali,
  • Jonathan Schultz,
  • Kimlien Than,
  • Donna McGregor,
  • Solana Archuleta,
  • Sindhu Chadalawada,
  • William Mundo,
  • Daniel Chastain,
  • Carlos Franco-Paredes,
  • Elaine Reno,
  • Andrés F. Henao-Martínez

DOI
https://doi.org/10.3390/tropicalmed5030125
Journal volume & issue
Vol. 5, no. 3
p. 125

Abstract

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Background: Yellow fever (YF) virus has the potential to cause fatal outcomes among at-risk individuals visiting endemic areas. Vaccinating travelers who are at risk is necessary to prevent virus-related life-threatening complications. We lack data on the clinical features of persons seeking YF vaccination. We aim to describe the characteristics of a cohort of persons receiving the YF vaccine before travel. Methods: A retrospective analysis of 964 travelers receiving the YF vaccine (Stamaril®) from Oct 2016 to Jul 2019 was performed at the University of Colorado Hospital, U.S. Percentages, means, and standard deviations were calculated. A multivariate logistic regression model was built to evaluate the association between receiving YF vaccination less than 10 days before departure and visiting friends and relatives (VFR). Results: The average age of the subjects was 39 ± 18 years with a range of nine months to 83 years. Persons who were 60 years of age and older represented 17%. Women consisted of 52%, and most of the travelers were Caucasians (64%). Travelers reported traveling to Africa (57%) or South America (40%). The primary destinations for travelers overall were Kenya (19%), Uganda (11%), and Tanzania (11%) in Africa; and Peru (14%) and Brazil (13%) in South America. The most common reasons for travel included leisure (44%), VFR (18%), and mission trips (10%). Comorbidities included a history of hematologic disorders (4%), HIV infection (2%), and diabetes mellitus (3%). The average duration between vaccine administration and travel was 43 days. Those VFR were two times more likely to receive the YF vaccination Conclusions: Identifying the type of travel, itinerary, and underlying medical conditions allows providers to administer the YF vaccine to travelers safely. There is a need to identify strategies to improve the timing of YF vaccination among VFR travelers.

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