Yellow fever shot.

[brenner]

My job requires me to get a yellow fever shot every 5 years beacuse i get to travel to tropical countries from time to time.  I have read that this shot is not recommended for us pozzies.  Im a bit confused on whether i should take this shot or not. 
I know that this particular innoculation uses live strains of the yellow fever virus, and thats why its not recommended.
Thanks for your input.

[bocker3]

I talked with my ID doctor about this recently, as we are planning a safari to Tanzania and it is a "recommended" vaccine for entry (though not required). 
He had no concerns with me getting the shot, although he was convinced I needed it.  I have some time to decide, as the trip is still 14 months away.
Bottomline -- talk with your doctor about it, as he/she can give you the best advice for your personal situation.

Mike

[J.R.E.]

I talked with my ID doctor about this recently, as we are planning a safari to Tanzania and it is a "recommended" vaccine for entry (though not required). 

Mike

Mike,

You were in the military weren't you ?  Didn't you get the yellow fever shot, as part of the vaccinations ?

Ray

[bocker3]

Mike,

You were in the military weren't you ?  Didn't you get the yellow fever shot, as part of the vaccinations ?

Ray

I was -- I got a ton of shots prior to deploying to Saudi Arabia, Kuwait and Iraq for Desert Storm, but don't recall the yellow fever shot being one of them.  Of course, I walked down an aisle with needles being jabbed into each arm, so who the hell really knows what I got! 

M

[Valmont]

I live in an endemic country and my doc told me NOT to be vaccunated because of the kind of vaccune it is.

You should get a letter from your doc that says it is not indicated in your case (it does not have to say you have HIV).

Another thing, this vaccune offers 10 years off protection, not 5.

[J.R.E.]

  Of course, I walked down an aisle with needles being jabbed into each arm, so who the hell really knows what I got! 

M

   I remember it exactly the same way too. Walking along, and being jabbed in both arms. I was talking to Ed this morning about all the shots in Basic.     I wonder if I could get a copy of all the shots I received, from my 201 file.  HHmmmm. I thought I had a record somewhere....


http://usarmybasic.com/about-the-army/army-shots

   http://www.youtube.com/watch?v=m8DX8go6GnM


Brenner, My apologies for distracting from your thread. 




Ray

[J.R.E.]

http://www.aidsmap.com/Yellow-fever-vaccine-in-HIV-positive-people-safe-but-not-always-effective/page/1433615/


Ray

[tednlou2]

I have read several posts to the docs at the body about this.  Many poz folks report getting the vaccine there.  I also thought we weren't suppose to get the shingles vaccine, but a doc there said we should get it and it is safe. 

[wolfter]

I have read several posts to the docs at the body about this.  Many poz folks report getting the vaccine there.  I also thought we weren't suppose to get the shingles vaccine, but a doc there said we should get it and it is safe.

I believe the standard is that it's ok as long as your CD4 is over 200.  I couldn't get the vaccine when my Bill came down with them as I was battling AIDS.  He was in absolute misery and it gets to me to thinking I'll discuss this with my doctor next month.

Wolfie

[Valmont]

I link an useful info in regard to that vaccune.  It is not exactly what I´ve told before or what my docs have told me, but being an info from CDC website I think it is a good guideline...  I hope it can help you...



http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/yellow-fever.htm

Vaccine Administration
 
For all eligible people, a single injection of 0.5 mL of reconstituted vaccine should be administered subcutaneously. The International Health Regulations (IHR) published by the World Health Organization (WHO) require revaccination at 10-year intervals.

[...]


HIV infection
 
Yellow fever vaccine is contraindicated for people with AIDS or other clinical manifestations of HIV, including people with CD4 T-lymphocyte values <200/mm3 or <15% of total lymphocytes for children less than <6 years. This recommendation is based on a theoretical increased risk of encephalitis in this population (see HIV infection under the following section, Precautions).
 
If travel to a yellow fever–endemic area cannot be avoided in a person with severe immune suppression based on CD4 counts (<200/mm3 or <15% total for children less than <6 years) or symptomatic HIV, a medical waiver should be provided, and counseling on protective measures against mosquito bites should be emphasized. See the following section, Precautions, for other HIV-infected people not meeting the above criteria.

[...]

HIV infection
 
Asymptomatic HIV infection with CD4 T-lymphocyte values 200–499/mm3 or 15%–24% of total lymphocytes for children aged <6 years is a precaution for yellow fever vaccination (see also the HIV infection in the Contraindications section above). Large prospective, randomized trials have not been performed to adequately address the safety and efficacy of yellow fever vaccine among this group. Several retrospective and prospective studies including approximately 450 people infected with HIV have reported no serious adverse events among patients considered moderately immunosuppressed based on their CD4 counts. However, HIV infection has been associated with a reduced immunologic response to a number of inactivated and live attenuated vaccines, including yellow fever vaccine. The mechanisms for the diminished immune response in HIV-infected people are uncertain but appear to be correlated with HIV RNA levels and CD4 T-cell counts.
 
Because vaccinating asymptomatic HIV-infected people might be less effective than vaccinating people not infected with HIV, their neutralizing antibody response to vaccination should be measured before travel. Contact the appropriate state health department or the CDC Arboviral Diseases Branch (970-221-6400) to further discuss serologic testing.
 
If an asymptomatic HIV-infected person with moderate immune suppression (CD4 T-lymphocyte values 200–499/mm3 or 15%–24% of total lymphocytes for children aged <6 years) is traveling to a yellow fever–endemic area, vaccination may be considered. Vaccinated people should be monitored closely after vaccination for evidence of adverse events, and the state health department or CDC should be notified if an adverse event occurs.
 
If international travel requirements—not risk of yellow fever—are the only reason to vaccinate an HIV-infected person, the person should be excused from immunization and issued a medical waiver to fulfill health regulations. If an asymptomatic HIV-infected person has no evidence of immune suppression based on CD4 counts (CD4 T-lymphocyte values ≥500/mm3 or ≥25% of total lymphocytes for children aged <6 years), yellow fever vaccine can be administered if recommended.

And this...

Medical Waivers (Exemptions)
 
Some countries do not require an ICVP for infants younger than a certain age (<6 months, <9 months, or <1 year of age, depending on the country). Age requirements for vaccination for individual countries can be found in the Yellow Fever and Malaria Information, by Country section in this chapter. For medical contraindications, a physician who has decided to issue a waiver should fill out and sign the Medical Contraindications to Vaccination section of the ICVP (Figure 3-02). The clinician should also do the following:
 •Give the traveler a signed and dated exemption letter on the physician’s letterhead stationery, clearly stating the contraindications to vaccination and bearing the stamp used by the yellow fever vaccination centers to validate the ICVP.
•Inform the traveler of any increased risk for yellow fever infection associated with nonvaccination and how to minimize this risk by avoiding mosquito bites.
 
Reasons other than medical contraindications are not acceptable for exemption from vaccination. The traveler should be advised that issuance of a waiver does not guarantee its acceptance by the destination country. On arrival at the destination, the traveler may be faced with quarantine, refusal of entry, or vaccination on site. To improve the likelihood that the waiver will be accepted at the destination country, clinicians can suggest that the traveler take the following additional measures before beginning travel:
 •Obtain specific and authoritative advice from the embassy or consulate of the destination country or countries.
•Request documentation of requirements for waivers from embassies or consulates and retain these along with the completed Medical Contraindication to Vaccination section of the ICVP.