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Yellow fever, a disease spread by mosquitoes, is prevalent in many countries of South America and Africa. Some countries require a yellow fever vaccination to get a visa or enter the country. Other countries recommend the vaccine, but don’t require it.

Unfortunately, manufacturing problems in 2016 created a shortage last year of the only yellow fever vaccine licensed in the United States. A year ago, 4,000 clinic sites in the U.S. offered yellow fever vaccine. Today, only 250 clinics are permitted to dispense the vaccine.

RiverStone Health is the only place in Montana that can administer the yellow fever vaccine. The closest neighboring cities offering the vaccine are in Spokane, Washington; Fargo, North Dakota; Cheyenne, Wyoming; and Idaho Falls, Idaho. This winter, some travelers drove 11 hours in one direction over icy roads to get their yellow fever vaccine, then turned around after their appointment to return home. RiverStone Health’s centralized location has drawn people from parts of Wyoming and the Dakotas, as well as across Montana. Our Immunization Clinic has taken calls requesting the vaccine from as far away as Washington State.

As supplies of the only U.S. licensed vaccine dwindled, the Food and Drug Administration (FDA) approved use of Stamaril, a yellow fever vaccine made in France. While Stamaril is not licensed in the U.S., the FDA made the vaccine available to a limited number of designated vaccination centers under an expanded access program.

Stamaril is not an experimental or investigational vaccine. It has been used in 70 countries for more than 30 years. The French manufacturer uses the same vaccine substrain, with comparable safety and efficacy to the U.S. product.

The vaccine is the best option to protect against yellow fever and the immunization’s protection lasts for 10 years. About 15 percent of those who are exposed to yellow fever will get a serious illness that causes hemorrhaging, shock and organ failure. Twenty to 60 percent of those cases are fatal.

Other ways to prevent the spread of yellow fever involve avoiding mosquito bites. Travelers to affected areas should wear long sleeves and pants to help prevent mosquito bites. Wearing clothing treated with Permethrin is another deterrent. Insect repellents should contain 50 percent DEET for adults and 10-30 percent for children over the age of 2 months. Mosquito repellant products with Picaridin or oil of lemon eucalyptus can also reduce mosquito bites. Sleeping in screened, air-conditioned rooms or under insecticide- treated bed nets is advised.

The American-made vaccine is predicted to be back in production by the end of the year, although RiverStone Health does not have a definite date when it will be widely available.

As always, planning ahead for travel immunization is critical to your health. Do not wait to make appointments. For any travel vaccines, contact RiverStone Health four to six weeks prior to traveling, so we can best serve your needs.

Karmen Hammermeister, a registered nurse and immunization specialist at RiverStone Health, can be reached at 247.3380 or karmen.ham@riverstonehealth.org

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