Updated: Jul 24
Many retirees enjoy cruises to South America and Africa. One requirement for some of these cruise lines is to have a yellow fever vaccine certificate or waiver. These documents must be shown when exiting the cruise ship in a country with yellow fever outbreaks.
The yellow fever vaccine has some potential adverse effects that are more likely to occur in patients over 60 years of age. YEL-AVD is a serious complication from the yellow fever vaccine causing death in about half of all cases.
The risk of YEL-AVD in people under 60 years of age is 0.8 cases per 100,000. For people over 60, the risk is 2.2 cases per 100,000. For people over 70, the risk is even higher.
A travel clinic is staffed by travel health specialists that take your medical history and determine your risk of adverse reactions. If you are taking steroids, allergic to eggs or chicken, or are over 60 years of age, they may recommend a medical exemption form instead of the yellow fever vaccination.
Medical exemption forms are valid for a single trip. Your destination country could potentially decline your exemption, but having the proper documentation makes it less likely to occur. The yellow fever card and accompanying physician’s note should be kept together when traveling. Copies of these documents are not accepted by most countries.
Each subsequent trip, you will need a new physician’s note because it details the countries you are traveling to and the dates you will be there. If you only have the yellow card without any physician’s note, you may be fined or denied entrance into your destination country.
If you are unable to receive the yellow fever vaccine, you want to use mosquito repellent and protect yourself from mosquito bites. Repellents with DEET, picaridin, or oil of lemon eucalyptus are best. If you are also wearing sunscreen, apply sunscreen first before applying insect repellent. The efficacy of the sunscreen is decreased by insect repellent, so wearing a hat and long-sleeve clothing is best.
You can also treat your clothing with permethrin spray prior to your trip. This spray does not damage or stain clothing, but it repels insects for 6 weeks or 6 washes, whichever is reached first. Permethrin is a safe, effective way to prevent mosquito bites. Mosquito repellent must be applied every couple of hours, but permethrin is a solid alternative or addition.
In addition to yellow fever, mosquitoes can also transmit malaria, zika, dengue fever, and other diseases. Wearing insect repellent can protect you from a plethora of illnesses abroad and prevent long-term health effects.
Talk with a travel health specialist at Away Clinic in Scottsdale or Mesa, Arizona to learn more about which vaccinations are recommended for your upcoming trip. Yellow fever, typhoid, Japanese encephalitis, and more are readily available at both locations.