Yellow Fever Vaccine Administration and use of the Pre-vaccination Checklist

Fatal adverse reactions to yellow fever (YF) vaccine in the UK prompted the UK’s Commission on Human Medicines to convene an Expert Working Group (EWG) in 2019. The EWG reviewed the balance of benefits and risks of YF vaccine, the risk factors for serious adverse reactions, and the measures in place in the UK to minimise risks. This review resulted in strengthened measures to minimise the risk of serious adverse reactions to YF vaccine, which included the use of a standardised pre-vaccination checklist prior to YF vaccine administration.

In the UK, YF vaccine should only be administered in designated yellow fever vaccination centres (YFVCs) by registered healthcare professionals specifically trained in YF vaccine provision. It has come to our attention that not all healthcare professionals involved in YF vaccine provision are utilising a YF pre-vaccination checklist prior to vaccine administration. It is vital for patient safety that all healthcare professionals working in YFVCs use a YF pre-vaccination checklist.

The NaTHNaC/PHS YF pre-vaccination checklist is a tool designed to:

• help the healthcare professional risk assess a person’s suitability for YF vaccination
  • it does not replace the broader individual risk assessment in the travel health consultation
• be completed by the person travelling in advance of, or during, the consultation
  • but must be carefully reviewed by the advising healthcare professional as part of a shared decision-making process for YF vaccination

Health care professionals should always discuss the risk of YF disease and the potential risk of vaccination fully with patients to enable them to make an informed decision regarding proceeding with YF vaccination.

Instructions on how to download and use the YF pre-vaccination checklist can be found here:

• Yellow Fever Pre-vaccination Checklist

For more information on YF vaccine, serious adverse events and information on contraindications to YF vaccination, please see the following pages on TRAVAX.

• Yellow Fever Disease
• Yellow Fever FAQ

Health professionals must refer to Yellow fever: the green book, chapter 35 for current guidance on the administration of YF vaccine in the United Kingdom. This includes the use of a YF pre-vaccination checklist. Advice in the green book may differ from that in vaccine manufacturers’ Summary of Product Characteristics (SmPC); when this occurs, the recommendations in the green book (which are based on current expert advice received from the Joint Committee on Vaccination and Immunisation (JCVI)) should be followed.

If a healthcare professional has any concerns about a traveller’s suitability for receiving YF vaccine, they can contact one of the health professionals advice lines listed here.

Contacts for Healthcare Professionals

Scotland: Public Health Scotland Travel Health Advice Line Telephone: 0141 300 1130

England, Wales and Northern Ireland: Travel Health NaTHNaC Advice Line Telephone: 020 7383 7474

Resources

TRAVAX Yellow Fever Disease Page

TRAVAX Yellow Fever FAQ Page

fitfortravel Yellow Fever Vaccine page

Yellow fever: the green book, chapter 35 

Yellow Fever Vaccination Centres Information Pack

Report of the Commission on Human Medicine’s Expert Working Group on benefit-risk and risk minimisation measures of the yellow fever vaccine (2019)

Yellow Fever Vaccine eLearning Resource