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There’s limited access to the Yellow fever vaccine–here’s how to get it.

Daydreaming about surfing in Brazil? Hiking Machu Picchu in Peru? Going on safari in Kenya? You need one important thing before you go: the yellow fever vaccine. It’s an essential part of your trip, not only to protect you from the disease but also because it can actually be required by some countries.

Getting vaccinated can be easier said than done. That’s because there’s currently a shortage of the only FDA-approved yellow fever vaccination, YF-Vax.

Never fear. We talked to a yellow fever expert at the CDC, Dr. Mark Gershman, who assured us you can still get vaccinated, plus where to find the vaccine and who needs it.

Which Countries Require the Yellow Fever Vaccine?

Safari-goers and Amazon trekkers, you’ll need to be vaccinated for much of South America and Africa.
Before we run down the list, take note: even if a country doesn’t require the vaccine, you should follow the recommendation of the CDC. And don’t take the word “recommend” lightly.

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When in doubt, it’s always better to receive it than have trouble at the airport later, or worse, contract the disease.

“It sounds less forceful, ‘recommend,’ but it’s the word to pay attention to because it’s much more important in protecting the traveler,” said Dr. Gershman. “Certain countries make entry requirements to protect their country, but entry requirements are not intended as guidance to protect individual travelers.”

It makes sense when you think about it: Some countries with risk of yellow fever, such as Brazil, do not have an entry requirement for yellow fever vaccination, but the CDC certainly recommends that travelers to most parts of Brazil get vaccinated. With that said, countries that require an International Certificate of Vaccination or Prophylaxis (ICVP) for entry include: Angola, Burundi, Central African Republic, Congo, Cote d’Ivoire, the Democratic Republic of the Congo, French Guiana, Gabon, Ghana, Guinea-Bissau, Liberia, Mali, Niger, Sierra Leone, Suriname, and Togo.

Countries in which the CDC recommends yellow fever vaccination for entry include much of Africa and South America. They’ve created a handy map where you can double-check your destination and see if the vaccine is recommended. Check with the CDC and WHO to determine if an official ICVP is required by the country on entry. When in doubt, it’s always better to receive it than have trouble at the airport later, or worse, contract the disease.

yellow fever congo
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Why Is There Limited Access to the Yellow Fever Vaccine?

A shortage—now a complete depletion—of the only FDA-approved yellow fever vaccine in the U.S., YF-Vax, began in 2015 when the vaccine manufacturer, Sanofi Pasteur, was in the process of moving to a new facility.

If the U.S.-Approved Yellow Fever Vaccine Is Gone, Can I Still Be Vaccinated?

Yes. Because the U.S.-approved YF-Vax is completely out of stock, the FDA has allowed a temporary, limited distribution of a comparable yellow fever vaccination, Stamaril, under a special program.

Is the Alternate Yellow Fever Vaccine, Stamaril, Safe?

Before you get all “Wait, it’s not FDA-approved?!” on us, take a deep breath. While the Stamaril vaccine is not technically FDA licensed, it has essentially the same ability to protect against yellow fever, it has the same uncommon side effects, and it has been used successfully for years in many countries. Even though it’s deemed “investigational” for purposes of this temporary supply, it’s not in a testing stage by any means, so no, you won’t unknowingly become part of a medical trial.

“There’s nothing investigational about it,” Gershman said. “It’s been licensed and used globally in more than 70 countries and has proven to be every bit as good as YF-Vax.”

“[The Stamaril vaccine] has been licensed and used globally in more than 70 countries, and has proven to be every bit as good as YF-Vax.”

Essentially, it’s like using a different designer or brand drug (ex: not Advil, but drug store-brand ibuprofen). So while there are some differences, the bottom line is that it’s made from the same virus strain, and the CDC officially calls the alternate “comparable in safety and efficacy.”

Where Can I Get the Vaccine?

Only about 260 clinics across the country are approved to carry the alternate vaccine Stamaril (previously, around 4,000 carried the FDA-approved YF-Vax)—which has made it harder to find a provider, especially in rural areas. A list of providers can be found here on the CDC’s website (we recommend Passport Health). Make sure to ask if the vaccine is available before scheduling an appointment.

How Far in Advance Do I Need to Book?

You need the vaccine at least 10 days before your trip to ensure immunity and before the ICVP becomes valid, but we recommend searching for a clinic at least one month in advance to ensure you can secure an appointment. This will also ensure you have enough time to gain immunity from other vaccines that may be recommended for your trip, including Typhoid (you must finish the 1-week pill pack 7 days before your trip).

When Will the FDA-Approved Vaccine Be Restored?

Dr. Gershman said the manufacturers of the vaccine are planning to announce an expected date of resupply in late 2019, but there’s no firm date yet. So if you’re getting vaccinated this year, expect to receive Stamaril, and prepare for the fact that you may have more trouble finding a provider and may experience higher costs. Check back with the CDC on the latest availability.

What Are the Side Effects of the Vaccine?

The most common side effects of the vaccine are sore muscles, a low-grade fever, and redness at the site of injection. Severe adverse reactions are rare and mostly only seen in infants, older adults, and people with weakened immune systems.

What Even Is Yellow Fever?

It’s a disease caused by a virus spread by mosquitos that can cause fever, chills, headache, and muscle ache. About 15% of cases turn into a serious illness with a high death rate.

How Long Does the Yellow Fever Vaccine Protect Me?

New studies show that one dose could protect you your entire life, though previously a booster was recommended every 10 years.

How Much Is It Going to Cost?

It ain’t cheap. Because of the requirements of the FDA program under which Stamaril is being imported, prices have increased. The CDC said while they’re aware that some clinics have started charging more than usual for the vaccine, price is ultimately up to the clinics. The rise in cost may be attributed to the extra paperwork and time burden it costs them to administer an investigational drug.

Of the places we called around to in New York, the yellow fever vaccine was on average $220, and there was a mandatory travel consultation fee of $65-$85. Be sure to factor in the cost of other vaccines such as Hep A ($105) and Typhoid ($119), which are both recommended if you’re going off the beaten path or planning to eat street food. It’s entirely possible you’ll leave with a bill of $500+ (ouch). There’s no savvy trick we can give for you to avoid the steep bill, but trust us, the memories of your trip will be priceless.

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