Vaccination is necessary despite recent adverse reports

Three recently published articles, from Brazil, the United States, and Australia, and three follow up letters from Europe, have challenged the reputation of the yellow fever vaccine, 17D, that for more than 50 years was almost beyond reproach.1^–6 These reports describe an illness resembling yellow fever occurring within a week of vaccination for yellow fever and leading to death within two weeks in six of 10 individuals. These adverse effects of the vaccine probably represent the delayed recognition of a very unusual outcome. The present recommendations must stand until an even safer vaccine is available. Primary 17D vaccination remains the least of several risks that any traveller to the tropics has to take.

Medical history was made in 1927 when Stokes, Bauer, and Hudson infected rhesus monkeys with blood from Asibi, a native of the Gold Coast (now Ghana) with a mild attack of yellow fever.7 The Asibi strain proved not to be benign …