Yellow fever

Yellow fever is a serious infection spread by mosquitoes. It's found in certain areas of Africa and South and Central America. You should have a yellow fever vaccination if you're travelling to an area where there's a risk of getting it.

Check if you're at risk of yellow fever

You can get yellow fever if you're bitten by an infected mosquito. The mosquitoes that carry the yellow fever virus bite during the day.

Yellow fever is very common in certain parts of the world, including:

• parts of sub-Saharan Africa (the area below the Sahara desert)
• parts of South America, including Trinidad and Tobago
• parts of Central America

Yellow fever is not found in the UK, Europe, Asia, Australia, New Zealand or the Pacific Islands.

How to lower your risk of yellow fever

If you're travelling to an area where yellow fever is found, there are some things you can do to avoid being bitten by mosquitoes.

 Do 

• wear long-sleeved clothing and trousers to cover your arms and legs, particularly during early morning and early evening
• use insect repellent on your skin (ideally one that contains the ingredient DEET)
• close windows and doors whenever possible, or use blinds or screens
• sleep under a mosquito net treated with insecticide, including during the day

Yellow fever vaccination

The yellow fever vaccine is recommended if:

• you're travelling to an area where yellow fever is found
• you need a yellow fever certificate to prove you've been vaccinated

Some people at risk of yellow fever through their work should also get vaccinated.

The yellow fever vaccine is safe for most people who are 9 months old or over.

You have to pay for the yellow fever vaccine for travel, and you can only get it from registered yellow fever vaccination centres.

Symptoms of yellow fever

Yellow fever symptoms usually start 3 to 6 days after being bitten by an infected mosquito, but sometimes they can take longer to appear.

Some yellow fever symptoms are similar to flu, such as:

• high temperature
• headache
• feeling or being sick
• aches and pains
• loss of appetite
• feeling generally unwell

These symptoms often last 3 or 4 days. But a small number of people get more serious symptoms within 24 hours of feeling better.

More serious symptoms include:

• yellowing of your skin and eyes (jaundice)
• dark pee
• stomach pain
• bleeding from your eyes, nose, mouth or stomach – you may have blood in your vomit or poo

These more serious symptoms can be fatal.

Treatment for yellow fever

There's no specific treatment for yellow fever.

Most people make a full recovery after 3 or 4 days.

Things you can do to help ease your symptoms include:

• taking painkillers, such as paracetamol or ibuprofen, which can help lower your temperature and relieve muscle pain or backache
• drinking plenty of fluids to avoid dehydration

If you have more serious symptoms of yellow fever, you'll need to go into hospital immediately to be treated.

Yellow fever vaccination

There's a very effective vaccine that can stop you getting yellow fever if you're travelling to an area where the infection is found.

It's given as an injection into your upper arm.

But even if you have been vaccinated, it's important to prevent insect bites as mosquitoes can also spread other serious illnesses.

Who should have the yellow fever vaccine

The yellow fever vaccine is recommended for people from 9 months of age who are travelling to:

• a country that requires you to have a certificate proving you have been vaccinated against yellow fever

You should be vaccinated at least 10 days before you travel to allow enough time for the vaccine to work.

If you or your child has had the MMR vaccine, you or they need to wait at least 4 weeks before having the yellow fever vaccine.

If it is not possible to leave a 4-week gap, the yellow fever vaccine should be given but an additional dose of MMR should be considered at a later date. Re-vaccination with the yellow fever vaccine can also be considered on an individual basis for those at on-going risk.

Yellow fever vaccination certificate

Some countries require a certificate showing you have been vaccinated before you’re allowed entry. This document is known as an International Certificate of Vaccination or Prophylaxis (ICVP).

All yellow fever vaccination certificates are now valid for life, including older ones that show an expiry date. You’ll be given a certificate when you’re vaccinated at a registered yellow fever vaccination centre.

A certificate is not needed for entry into Spain, but it may be required for travel to certain countries where yellow fever is endemic.

Keep your certificate safe and make a copy for your records. If you lose your certificate, you may be able to get it reissued if you have a copy showing full details of the vaccination batch number and the date you had the vaccination.

Where to get the yellow fever vaccine in Spain

The yellow fever vaccine and vaccination certificates are only available from registered international vaccination centres authorised by health authorities in Spain. These are the only places where you can both receive the vaccine and obtain your ICVP.

How much the yellow fever vaccine costs in Spain

In Spain the cost of the yellow fever vaccine typically ranges from about €19 to €25 at public international vaccination centres. Prices may vary slightly by region and provider, so it’s best to confirm the exact fee with the centre when you book your appointment.

How long the yellow fever vaccine lasts

The yellow fever vaccine provides lifelong protection for most people.

A further dose of vaccine is recommended for a small number of travellers who are visiting yellow fever risk areas, including those who were previously vaccinated when they were:

• pregnant
• under 2 years old
• living with HIV
• had a weakened immune system
• before having a bone marrow transplant

Rarely, a further dose of vaccine may also be advised if there's a concern about the traveller's risk of yellow fever, for example, if they're working or living for some time in a high-risk area.

Contact a yellow fever vaccination centre for advice if you're not sure if you need another dose before travelling.

Who cannot have the yellow fever vaccine

There are some people who cannot have the yellow fever vaccine when it's recommended.

People who cannot have the vaccine include:

• babies under 6 months old
• people with a weakened immune system, such as those with leukaemia or lymphoma
• people whose immune system is weakened by treatment, such as steroids and chemotherapy
• people who are allergic to any of the ingredients in the vaccine, including people with an egg allergy
• people who've had a severe reaction to a previous dose of yellow fever vaccine
• people with a thymus gland disorder or who've had their thymus gland removed
• people over the age of 60 who are travelling to areas where yellow fever vaccine is not generally recommended
• people who have a close relative who has had a severe reaction to the vaccine causing damage to the brain or other organs

If you need a vaccination certificate for the country you're visiting but you're not able to have the vaccine, contact a yellow fever vaccination centre.

They may provide you with an exemption letter, which may be accepted by officials in countries that usually require a vaccination certificate.

Who may be able to have the vaccine in some circumstances

If you're not sure whether you can have the yellow fever vaccine, ask a travel health specialist at the vaccination centre. They'll do a full risk assessment based on your or your child's medical history and where you're travelling to.

People who may be able to have the vaccine include:

• those aged 60 and over – only when travel to a high-risk area is unavoidable
• those who are pregnant – if travel to a high-risk area is unavoidable
• those who are breastfeeding – expert advice is needed for women who are breastfeeding babies under 9 months
• those with long-term (chronic) inflammatory conditions, such as rheumatoid arthritis – if on low-dose steroid therapy
• babies from 6 months to under 9 months of age – if travel is unavoidable and risk is high, expert advice is needed
• those living with HIV – only after specialist advice

Take extra care to prevent insect bites while travelling if you have not been vaccinated.

Side effects of the yellow fever vaccine

The yellow fever vaccine can cause some side effects, but the risk of not being vaccinated usually outweighs the risk of having side effects.

After having the vaccine, up to 1 in every 3 people gets:

• a headache
• muscle pain
• a raised temperature
• soreness at the injection site

These side effects usually pass within 2 weeks.

Rarely, a person can get more serious side effects, including an allergic reaction to one of the ingredients in the vaccine.

A very rare side effect of the vaccine can cause problems with the brain or other organs, which can be fatal. This is more likely to affect:

• people aged 60 or older
• people with weakened immune systems
• anyone who's had their thymus gland removed or has a thymus gland disorder

Get medical advice if you feel very unwell within a few days or weeks of having the yellow fever vaccine.