From the Guidelines
The yellow fever vaccine provides lifelong protection for most people after a single dose. According to the most recent and highest quality study, evidence from multiple studies demonstrates that yellow fever vaccine immunity persists for 30–35 years and probably for life 1.
Key Points
- The International Health Regulations previously required revaccination at intervals of 10 years to boost antibody titer.
- However, the latest evidence suggests that one dose provides lifetime immunity for most individuals.
- Certain groups may still need booster doses, but this is not supported by the most recent evidence.
Vaccine Mechanism and Side Effects
The vaccine works by introducing a weakened form of the yellow fever virus, which stimulates your immune system to produce antibodies without causing the disease itself. These antibodies remain in your system and provide long-term protection against future yellow fever infections. Side effects are generally mild and may include headache, muscle pain, or low-grade fever for a few days after vaccination.
Booster Doses
While some studies suggest that revaccination can boost antibody titer, the most recent evidence indicates that this is not necessary for most individuals 1.
Special Considerations
It is essential to note that the evidence may not be directly applicable to certain groups, such as those who were immunocompromised when they received their initial vaccine or laboratory workers who routinely handle yellow fever virus. However, the most recent and highest quality study does not provide specific guidance on these groups 1.
From the Research
Duration of Yellow Fever Vaccine Immunity
- The duration of immunity after yellow fever vaccination is a topic of ongoing research and debate 2, 3, 4, 5, 6.
- Some studies suggest that a single dose of yellow fever vaccine confers sustained life-long protective immunity against yellow fever 2, 3.
- However, other studies have found that immunity may wane over time, particularly in certain populations such as children and older adults 4, 5, 6.
- A study published in 2013 found that a single dose of yellow fever vaccine is highly immunogenic and confers sustained life-long protective immunity against yellow fever, and therefore, a booster dose is not needed 2.
- Another study published in 2021 found that older travelers who received a single dose of yellow fever vaccine at 60 years or older were still seropositive 10 years after primary vaccination, suggesting that a single vaccination is sufficient to convey long-lasting immunity for at least 10 years 3.
- In contrast, a study published in 2016 found that antiviral immunity may be lost in 1-in-3 to 1-in-5 individuals within 5 to 10 years after a single vaccination, and that children may be at greater risk for primary vaccine failure 4.
- A study published in 2019 found that a single dose of 17DD yellow fever vaccine induced short-lived immunity in children, with a progressive decline in neutralizing antibodies and cellular immunity over time, suggesting that booster vaccination may be required to guarantee protective immunity in children 5.
- Another study published in 2016 found that a booster dose after 10 years is recommended following 17DD-YF primary vaccination, as YF-neutralizing antibodies and memory T and B cells tend to decrease over time 6.
Population-Specific Considerations
- Children may be at greater risk for primary vaccine failure and may require booster vaccination to guarantee protective immunity 4, 5.
- Older adults who receive a single dose of yellow fever vaccine at 60 years or older may still be seropositive 10 years after primary vaccination, but further research is needed to confirm this finding 3.
- Individuals with certain medical conditions, such as human immunodeficiency virus (HIV) infection, may require special consideration when it comes to yellow fever vaccination 2.