Eugene has recently been designated a Stamaril Yellow Fever Vaccine Center. To understand what this means, read on.
Yellow fever is a serious, potentially fatal disease caused by a mosquito-transmitted virus that may be contracted by travelers to some destinations in central Africa or central South America.
For decades, the United States has had an effective, readily available vaccine for yellow fever, YF-VAX, supplied by Sanofi Pasteur. Manufacturing problems arose in the U.S. plant, and this vaccine will not be available again until next July. It will be replaced temporarily by a similar French yellow fever vaccine, Stamaril. Meanwhile, we are in the middle of a worldwide 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 United States, far fewer than the 4,000 YF-VAX clinics we had until recently. Three Stamaril clinics have been established in the Portland and Vancouver, Wash., area; Eugene has been chosen as Oregon’s only Stamaril clinic site outside the Portland area, thus ensuring that few people will have to travel far to obtain this vaccine.
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 percent) of a yellow fever-like illness, with a 50 percent death rate.
For this reason, yellow fever vaccine is given only by those who possess a special license to do so, and it 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 live 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 have no memories or understanding of the ill effects of measles, polio, pertussis (whooping cough), diphtheria, meningitis, pneumonia, mumps, hepatitis, chicken pox or rubella, and may not understand vaccines’ importance. Vaccines that 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of typhoid, pertussis, rotavirus and oral polio vaccines, as well as vaccines for smallpox and Lyme disease) have now been replaced by safer versions or have been taken off the market.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 who lives 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, human papillomavirus, rotavirus, HIB, varicella, shingles, pneumococcal pneumonia, influenza and rabies.
For travelers to destinations outside the United States, 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 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 schedule an appointment if YF vaccine is indicated. To inquire of the Travel Clinic about either YF-VAX or Stamaril, go to www.TravelClinicOregon .com and send an email through our website describing your situation. More information is available from the Centers for Disease Control and Prevention’s travel health guide at, and especially the Yellow Fever chapter,
John Wilson, M.D., is a travel medicine practitioner at the Travel Clinic in Eugene.