Is the yellow fever vaccine still required for travel to Zambia?

Yellow Fever Vaccination Requirements for Travel to Zambia

Yellow fever vaccination is no longer required for travelers to Zambia unless arriving from a country with risk of yellow fever transmission. 1

Current Status of Yellow Fever in Zambia

• North-Western and Western provinces of Zambia have been reclassified as low-risk areas for yellow fever, with evidence of both past and recent infections, but at very low prevalence rates (0.3% for long-term infection and 0.2% for recent infection) 1
• Despite the low risk, yellow fever remains a disease with potentially severe consequences, including a 20-50% case-fatality ratio for severe cases with hepatorenal dysfunction 2

Risk Assessment for Travelers

• The risk of acquiring yellow fever varies based on multiple factors including:

  • Immunization status
  • Use of personal protective measures against mosquito bites
  • Location of travel within the country
  • Duration of exposure
  • Occupational and recreational activities
  • Local rate of virus transmission at the time of travel 2

• For unvaccinated travelers, the estimated risk of illness and death from yellow fever during a 2-week stay in endemic areas of West Africa is 50 and 10 cases per 100,000 population, respectively; for South America, the risks are 5 cases and 1 case per 100,000 population 2

Vaccination Recommendations

• While Zambia itself has a low risk of yellow fever transmission, vaccination may still be required if:

  • You are arriving from a country with risk of yellow fever transmission
  • You have transited through a country with yellow fever risk for more than 12 hours 2

• Yellow fever vaccination should be administered at least 10 days before travel to be valid for entry requirements 2

• The vaccine provides long-lasting immunity with a single dose, which is now considered to provide lifetime protection 3

Important Considerations and Precautions

• Yellow fever vaccine is a live-virus vaccine and should not be given to:

  • Immunocompromised individuals (including symptomatic HIV infection)
  • Patients with leukemia, lymphoma, or generalized malignancy
  • Those immunosuppressed by corticosteroids, alkylating drugs, antimetabolites, or radiation 2

• Pregnant women should only receive the vaccine if travel to a high-risk area cannot be avoided 2

• Adults aged 60 years and older have an increased risk of serious adverse events following vaccination and should discuss risks and benefits with their healthcare provider 2

Practical Advice for Travelers

• Even if yellow fever vaccination is not required for entry to Zambia, all travelers should take precautions to avoid mosquito bites by:

  • Using insect repellent
  • Wearing permethrin-impregnated clothing
  • Staying in accommodations with screened or air-conditioned rooms 2

• If vaccination is needed, it must be administered at an approved Yellow Fever Vaccination Center, and travelers should receive an International Certificate of Vaccination or Prophylaxis (ICVP) as proof 2

• If you cannot receive the yellow fever vaccine due to medical contraindications but must travel to an area where it might be required, your physician can provide a medical waiver letter 2

Conclusion

While Zambia has been classified as a low-risk area for yellow fever, the decision to vaccinate should be based on your specific travel itinerary, including any countries you may visit before arriving in Zambia. Given the potentially fatal nature of yellow fever infection (with 8 of 9 reported cases in unvaccinated travelers resulting in death) 2, vaccination remains an important consideration for travelers to regions where any risk of transmission exists.