Yellow fever vaccination guidance update

The Green Book Chapter on yellow fever has been updated as of 6 February 2024. Public Health Scotland are in the process of updating pages and related training documents.

Health professionals advising travellers should ensure they are aware of the recommendations in the Green Book. PHS will issue further updates as resources are revised, where necessary.

The updated yellow fever Green Book chapter includes the following significant changes which are of particular importance.

Egg allergy

Updated guidance on contradindications for yellow fever vaccine is included in the updated chapter. This includes that  yellow fever vaccine should not be given to people with documented immediate-type food allergy to egg or chicken proteins.

In relation to egg allergy the updated chapter gives advice

• on determining if an individual has outgrown any immediate-type previously detected allergy to egg.
• on the role of desensitisation protocols for adults and children with persistent egg allergy, as well as the importance of guidance from allergy specialists where history of confirmed ongoing allergy to eggs is confirmed in any patient.

Thymectomy and cardiac surgery

The updated Green Book chapter on yellow fever also incorporates guidance from the Society of Cardiothoracic Surgery in Great Britain and Ireland for health professionals. This guidance includes important contraindications including those

• with cardiac surgery in childhood where there is no formal documentation about the present of residual thymic tissue
• having had cardiac surgery before the year 2000
• who have had a thymectomy

Advice to health professionals

Health professionals advising travellers should ensure they are aware of the updated guidance in order to inform assessments. It is important that a detailed medical history is obtained in order to inform any assessment and guidance sought as appropriate.

Those at risk of yellow fever include

• laboratory workers handling infected material
• persons aged nine months or older who are travelling to or living in areas or countries with a risk of yellow fever transmission (see yellow fever vaccination maps information on TRAVAX country pages ), even if these countries do not require evidence of immunisation on entry
• persons aged nine months or older who are travelling to or living in countries that require an International Certificate of Vaccination or Prophylaxis (ICVP) for entry.