YELLOW FEVER VACCINE
Live 17D Virus
Action And Clinical Pharmacology: The administration of this vaccine stimulates the development of active immunity against Yellow Fever which probably lasts for many years. tag_IndicationsIndications
Indications And Clinical Uses: For all persons 6 months of age or older who are traveling to countries which require a certificate of vaccination against Yellow Fever. Under the International Health Regulations the validity period of the certificate of vaccination or revaccination is 10 years beginning 10 days after vaccination.
Contra-Indications: Pregnancy and Children: Pregnant women and children under 6 months of age should not be vaccinated, except in high risk areas.
Since the virus of yellow fever is cultured in chicken embryos, it should not be administered to an individual with a history of hypersensitivity to egg or chicken protein.
Altered Immune States: Yellow Fever Vaccine virus infection might be potentiated by severe underlying diseases such as leukemia, lymphoma or generalized malignancy, and by lowered resistance, such as from therapy with steroids, alkylating drugs, antimetabolites or radiation or from gamma globulin deficiency. Vaccination of these individuals should therefore be avoided.
Precautions: Since the virus of yellow fever is cultured in chicken embryos, it should not be administered to an individual with a history of hypersensitivity to egg or chicken protein unless an intracutaneous skin test with 0.02 mL of the vaccine has been performed. A separate but comparable skin site is injected intracutaneously with 0.02 mL of normal saline to serve as a control. A positive sensitivity test, consisting of an urticarial wheal, with or without pseudopods, surrounded by a halo of erythema, should contraindicate administration of Yellow Fever Vaccine. This is in contradistinction to a negative or minimal reaction, with no wheal or pseudopods, at the saline injection site. Epinephrine Injection (1:1 000), a tourniquet and a hypodermic syringe with needle should be at hand while performing the sensitivity test. An intracutaneous dose of 0.02 mL administered for hypersensitivity testing may be sufficient to induce immunity. However, in hypersensitive individuals, the presence of specific protective antibodies in serum obtained 3 to 4 weeks after inoculation must be confirmed or evaluated.
Generally, Yellow Fever Vaccine should be administered at least 1 month apart from other live virus vaccines. However, field observations and clinical data indicate that simultaneous administration of the most widely used live-virus vaccines has not resulted in impaired antibody response or increased adverse reactions. Thus, if time is a critical factor for required vaccinations, the clinical judgment of the responsible physician should prevail at all times. A recently completed prospective study of persons given yellow fever vaccine and 5 mL of commercially available immune globulin revealed no alteration of the immunologic response to yellow fever vaccine when compared to controls.
Vaccination with Yellow Fever Vaccine should be deferred for 3 months following blood or plasma transfusion.
A separate sterile syringe and needle should be used for each individual patient to prevent transmission of hepatitis or other infectious agents from one person to another.
Adverse Reactions: Approximately 10% of patients may develop fever or malaise 7 to 14 days following immunization. Symptoms may last from a few hours to a day or two. Treatment should be symptomatic.
In rare instances encephalitis has developed in very young infants. This has usually not been severe and recovery has ordinarily occurred without sequelae. One death has been reported.
Anaphylaxis and/or anaphylactoid shock may occur following the use of this vaccine, even in individuals with no prior history of hypersensitivity to any vaccine components. Therefore Epinephrine Injection (1:1 000) must always be immediately available to combat such serious reactions.
Dosage And Administration: A single immunizing dose of 0.5 mL should be administered s.c. Children receive the same dose as adults.
Administration: Reconstitute the vaccine immediately after removing it from the freezer and use only the diluent supplied for this purpose. Draw the volume of the diluent shown on the diluent label into a suitable size syringe and inject into the vial containing the vaccine. Slowly add diluent to vaccine, let set for 1 to 2 minutes and then carefully swirl mixture until a uniform suspension is achieved. Avoid vigorous shaking as this tends to cause foaming of the suspension. Use the vaccine within 60 minutes following reconstitution and swirl the vaccine well immediately before withdrawing each dose.
All rehydrated vaccine and containers which remain unused after 1 hour must be sterilized and discarded.
Note: It is most desirable that extraordinary reactions which may occur concomitantly or following various vaccinations be reported to the manufacturer and to the epidemiologist of the province using a special form placed at your disposal by the Department of National Health and Welfare.
Availability And Storage: Yellow Fever Vaccine is a living dried culture of the attenuated 17D strain of Yellow Fever virus. It is cultured in living leukosis-free chicken embryos and is free of avian leukosis viruses. The vaccine containing sorbitol and gelatin as a stabilizer, is lyophilized and hermetically sealed under nitrogen in glass vials. The vaccine must be reconstituted immediately before use with the proper diluent. Sodium Chloride Injection which is provided. Yellow Fever Vaccine complies with the standards of the World Health Organization. Each 0.5 mL dose contains not less than 5.04 log10 PFU. The product appears slightly opalescent and light orange in color after reconstitution. Neither the vaccine nor the diluent contain a preservative. Vials of 5 doses with vials of diluent.
Yellow Fever Vaccine is shipped in a container with solid carbon dioxide; do not use vaccine unless shipping case contains some dry ice on arrival. Vaccine must be maintained continuously at temperatures between 5 and -30Â°C; whenever possible, it should be kept frozen at a temperature below 0Â° until reconstituted for use. The vial of diluent should not be allowed to freeze.
The reconstituted vaccine must be kept cool and used within 60 minutes following reconstitution.
YELLOW FEVER VACCINE Connaught Live 17D Virus Vaccine
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