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Yellow fever vaccine contraindication — DTM&H MCQ

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HardTravel medicine and vaccination for travellersYellow fever vaccine contraindicationDTM&H

A 62-year-old receiving infliximab plans optional travel to a yellow-fever-risk district and has never been vaccinated. Which advice is safest?

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Correct answer: C — Change the itinerary or seek specialist waiver and bite-avoidance advice

The best answer is “Change the itinerary or seek specialist waiver and bite-avoidance advice”. Infliximab causes clinically important immunosuppression and live yellow fever vaccine can cause severe vaccine-associated disease. An optional itinerary should be changed. If exposure cannot be avoided, a designated specialist service should assess a waiver and reinforce meticulous mosquito precautions rather than improvising a vaccine interval.

Reference: MHRA: Yellow fever vaccine and immunosuppression: https://www.gov.uk/drug-safety-update/yellow-fever-vaccine-stamaril-and-fatal-adverse-reactions-extreme-caution-needed-in-people-who-may-be-immunosuppressed-and-those-60-years-and-older