Mark D. Gershman, Emily S. Jentes, Rhett J. Stoney (YELLOW FEVER) Kathrine R. Tan, Paul M. Arguin, Stefanie F. Steele (MALARIA)
The following pages present country-specific information on yellow fever vaccine requirements and recommendations (see Table 3–26) and malaria transmission information and prophylaxis recommendations. Fifteen country-specific maps of malaria transmission areas, 10 country-specific maps depicting yellow fever vaccine recommendations, and reference maps of 2 countries are included to aid in interpreting the recommendations. The information was accurate at the time of publication; however, this information is subject to change at any time as a result of changes in disease transmission or, in the case of yellow fever, changing country entry requirements. Updated information, reflecting changes since publication, can be found in the online version of this book ( and on the CDC Travelers’ Health website ( General recommendations for other vaccines to consider during the pre-travel consultation can be found on the CDC Travelers’ Health website (www.cdc.gov/travel).
Since publication of the 2014 edition of CDC Health Information for International Travel, additional country-specific data on the geographic risk of yellow fever virus (YFV) transmission was provided by certain countries and the Pan American Health Organization (PAHO). Based on a review of these data by CDC, the World Health Organization (WHO), PAHO, and other yellow fever and travel medicine experts, updated yellow fever vaccination recommendations were made for Argentina, Colombia, Peru, and Venezuela. Furthermore, an updated recommendation for the Democratic Republic of the Congo was made after an outbreak of yellow fever was confirmed in Katanga Province in early 2014.
Revaccination for yellow fever has been required by certain countries at 10-year intervals to comply with International Health Regulations (IHR). In 2014, the World Health Assembly (of WHO) adopted the recommendation to remove the 10-year booster dose requirement from the IHR as of June 2016. Once this change is instituted, a completed International Certificate of Vaccination or Prophylaxis will be valid for the lifetime of the vaccinee. It is uncertain when and if all countries with current yellow fever vaccination entry requirements will adopt this change.
In the United States, the Advisory Committee on Immunization Practices (ACIP) is considering the issue of the continued need for yellow fever vaccine boosters. In February 2015, ACIP approved a new recommendation that one dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. The recommendations also identify specific groups of travelers who should receive additional doses and others for whom additional doses may be considered. The official recommendations were published after this edition went to press. For the most up-to-date information about yellow fever vaccine boosters, consult the CDC Travelers’ Health website or the ACIP website (www.cdc.gov/vaccines/hcp/acip-recs/).
Ultimately, the clinician’s decision whether or not to vaccinate any traveler must take into account the traveler’s risk of being infected with YFV, country entry requirements, and individual risk factors for serious adverse events after yellow fever vaccination (such as age and immune status). For a thorough discussion of yellow fever and guidance for vaccination, see the Yellow Fever section earlier in this chapter.