Thinking About Yellow Fever Vaccine Age Limit

Background: A traveler's risk for acquiring YF is determined by multiple factors, including immunization status, use of personal protection measures against mosquito bites and local rate of virus transmission. An epidemic started in 2017 in Brazil beaches challenging physicians, because Argentinian people use to spend their holidays there and require vaccination regardless of their age. The aim of the study is to describe the outcome of vaccinating elderly people after a thorough assessment by an infectious disease specialist. Methods & Materials: We examined the clinical reports of all individuals aged ≥60 years vaccinated 2006–2018. We assessed pre-existing conditions and looked 45 days forward for symptoms ascribable to the vaccine. Results: Out of 3978 vaccines 439 were ≥60 years old (60–87, median 64). 205 were female. Most frequent comorbidities were high blood pressure (36%), diabetes (10%) and endocrine disorders other than diabetes (7%). Fifteen patients (3.4%) had ≥3 comorbidities. There were no reports of severe adverse effects among 347 patients, 92 had no data after vaccination date, we assume they did well because, due to our national proceedings, we would have been informed. As most guidelines advice precaution in vaccinating people aged ≥60 years, it was understood, even by non-specialist physicians, as a contraindication and people travelled without vaccination; 7 travelers returned ill. It is known that up to 60% of infections can be subclinical, thus the potential importation and spread of the disease is worrisome. Nowadays a 60–70 year old person is still fit to travel, the decision to vaccinate them needs to weigh the risks and benefits of the vaccination in the context of their destination-specific risk for exposure; the risk of yellow fever to any country where the infection is enzootic or has recently been epidemic continues to exceed the known risk from the vaccine. A travel medicine trained physician is the appropriate person to advise an elderly patient to get the vaccine or to avoid travelling. Conclusion: Although the number of people we vaccinated is not very high we can conclude that with a specialized thorough assessment of the individual patient the risk of vaccinate people aged ≥60 years is very low.