Brazil’s National Yellow Fever Vaccination Effort Starts Slowly

Brazil continues to report an expansion of the Yellow Fever virus outbreak, confirming 1,127 yellow fever cases and 331 deaths from July 1, 2017, through April 10, 2018.

The incidence of disease in this monitoring period, until April 10, 2018, is 3.0 cases for 100 thousand inhabitants.

Additionally, the Brazilian Ministry of Health (MOH) announced the vaccination rates for 3 states.

And these results are not the best.

The Yellow fever vaccination rates in the 3 hardest-hit states are approximately 50 percent, which would normally be great, in a normal situation.

But, MOH’s vaccination goal is 95% or a total of 23.8 million people.

Which means 10 million more people need to be immunized in these states, said the MOH in an update.

"The measure is preventive and aims to anticipate protection against disease for the entire population in case of an increase in the area of circulation of the yellow fever virus," according to a Google Translate version of the update.

The state-based vaccination coverage is:

• 40.9 percent in Rio de Janeiro state,
• 52.4 percent in Sao Paulo state, and
• 55 percent in Bahia state.

“These municipalities should continue to vaccinate the population with the fractionated dose, which guarantees the same protection of the standard dose, and expand vaccine coverage to prevent new cases of yellow fever in the country,” said the MOH.

The Stamaril vaccine is the best protection against this disease.

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According to the MOH, all the cases of yellow fever registered in Brazil since 1942 are wild, including the current ones.

This means that the current transmissions originate from the genera Haemagogus and Sabethes mosquitoes, which are located in forest environments. The anthropophilic mosquitoes Aedes aegypti and Aedes albopictus are potential vectors.

These mosquitoes infect themselves from infected monkeys.  Then they pass the virus on to humans when they are bitten.

Yellow fever virus is an acute viral hemorrhagic disease that is endemic in tropical areas. Cases can be difficult to distinguish from other viral hemorrhagic fevers such as arenavirus, hantavirus or dengue.

Symptoms of yellow fever usually appear 3 to 6 days after the bite of an infected mosquito. For most patients, these symptoms disappear after 3 to 4 days.

However, 15 percent of patients enter a second, more toxic phase, and several body systems may be affected, including the kidneys.

In light of the ongoing yellow fever outbreaks in Brazil, Borno, Nigeria, Peru, China, Kenya, and The Congo, the US Centers for Disease Control and Prevention (CDC) are reiterating the importance of international travelers getting vaccinated prior to visiting affected countries.

In the USA, the Stamaril vaccine is available during the YF-VAX vaccine shortage.

For most travelers, a single dose of yellow fever vaccine provides long-lasting protection. However, some travelers may require a booster dose, says the CDC.

"It is critical to protect yourself ten days or more before traveling to yellow fever endemic areas," said Chris Felton, PharmD, at Brookshires Grocery pharmacy.

"Even though Stamaril is in the FDA’s “investigational new drug program”, it is not a new vaccine.  Stamaril has been used in many countries for decades.”

“Like YF-Vax, Stamaril is a live vaccine, and both vaccines have similar efficacy and safety profiles."

"If the YF-Vax vaccine is not available at your local pharmacy or clinic, a pharmacist can help you find one of the locations authorized to administer Stamaril, " said Felton.

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Providers and patients may also visit CDC Travelers' Health for information about which countries require yellow fever vaccination for entry and for which countries the CDC recommends yellow fever vaccination.

The requirements for the International Certificate of Vaccination against yellow fever, are available on the World Health Organization (WHO) International Travel and Health website.

The CDC Vaccine Price List provides private sector vaccine prices for general information. Vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.