Are you a seafarer or a relief worker? Do you have any plans of heading to Africa or South America soon? Most likely you will need a Yellow Fever vaccine to visit. There are only a few select places where you can get this vaccine. So, if you are from the Philippines, this is a comprehensive guide for you made by someone who just recently been vaccinated!
What is Yellow Fever?
Yellow fever is an acute viral hemorrhagic fever caused by the yellow fever virus. It is found in certain parts of Africa and South America.
It is called Yellow Fever because it causes jaundice or yellowing of the skin and sclera(white part of the eyes) in patients.
What are the signs and symptoms of this illness?
Symptoms usually show up 3 to 6 days after the mosquito bite.
- fever and flu-like symptoms like chills, headache, backache, and muscle aches
- jaundice (yellow skin or eyes)
- bleeding from multiple body sites (15%)
- shock
- liver, kidney, respiratory and other organ failures
- death (20% – 50% of serious cases)
What will I do if I suspect that I have it?
Go a hospital!
Take acetaminophen. o not take pain relievers that contain aspirin and ibuprofen because it has a tendency to make you bleed.
Get lots of rest, and drink plenty of liquids.Avoid spreading the disease by preventing more mosquito bites.
How can it be transmitted?
It is spread through the bite of an infected mosquito from the Aedes and Haemogogus species just like in Dengue and Malaria.How will I prevent getting it?
- Get a Yellow Fever Vaccine
- staying in well-screened or air-conditioned areas
- wear light-colored clothes that cover your hands and legs like long trousers and long-sleeved shirts
- use an effective insect repellent with 25% DEET and reapply (apply sunscreen first before your insect repellent)
- take meticulous anti-mosquito bite measures during the daytime in Yellow Fever risk areas
- permethrin-embedded clothing or bed netting
- Use products with the following active ingredients:
- DEET
- Picaridin
- Oil of lemon eucalyptus (OLE) or PMD
- IR3535
What is the Yellow Fever Vaccine?
Yellow fever vaccine is a live, weakened virus. It is given as a single shot on the deltoid or upper arm. According to the revised Third Edition of the IHR, from 11 July 2016 the certificate of vaccination against yellow fever is valid for the life of the person vaccinated.
Since yellow fever is a live attenuated vaccine, the potential harms and benefits of vaccination in relation to underlying immune status must be carefully considered.
You should receive this vaccine at least 10 days before your trip.
Where can I get the vaccine?
Yellow fever vaccine is given only at designated vaccination centers. In the Philippines, this is at the Bureau of Quarantine office in Manila, Iloilo, Cebu, and Davao. The address in Manila is 25th St, Port Area. The vaccine is available from 8am to 2pm with no lunch break.
In my case, I needed to get vaccines which were difficult to find in Tacloban City like Cholera and Typhoid Fever, so I chose to go to Manila to get the vaccination.
Who usually gets a Yellow Fever Vaccine?
- Travelers heading to Africa and South America
- Seafarers
What proof will I get after being vaccinated?
After getting the shot, you will be given a signed and stamped yellow card. This is called the "International Certificate of Vaccination or Prophylaxis." This certificate is valid 10 days after vaccination and can be used for up to 10 years.
What is the use of this Yellow Card?
The yellow "International Certificate of Vaccination or Prophylaxis" card serves as your proof of vaccination. If you fail to show this card in certain countries that have this listed as an entry requirement, you might face the following scenarios:
- refused entry
- vaccinated upon entry
- quarantined up to six days to make sure that you are not infected
You will need this card as proof of vaccination to enter certain countries. Other countries require proof of vaccination only if travelers have been in a risk area, so if you are visiting multiple countries, the order of travel may be important. Travelers without proof of vaccination could be given the vaccine upon entry or detained for up to 6 days to make sure they are not infected.
What countries require Yellow Vaccine Card for embarkation?
Africa: Angola, Benin, Burundi, Cameroon, Central African Republic, Chad, Republic of the Congo, Côte d’Ivoire, Democratic Republic of Congo, Congo, Equitorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, Sudan, Togo, Uganda
South America: Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago, Venezuela
Who can get vaccinated?
- 9 months to 59 years old
- traveling to an area where Yellow Fever is endemic
- traveling to a country where the vaccination is an entry requirement
How much does the vaccination cost?
- A multi-dose vial good for 5-6 people costs 1500PHP. This is offered from 8am to 2pm.
- A single dose vial is worth 2000PHP and available from 3pm to 5pm. Call (02)-320-9108 first to get this arranged.
What shall I do before I get my vaccination?
Eat a full breakfast.
What shall I bring with me?
The DOH site recommends bringing in a valid ID and passport, although, they did not check mine when I was there.
Bring your vaccination record though, especially if you've had vaccinations in the last 30 days and if you are planning to get more. Make sure you mention these points as well as the places you are traveling to when you get assessed by the in-house doctor.
They didn't have cotton and micropore to cover my injection site so it just free bled. It would be wise to bring a band-aid if your clotting factor is a bit slow.
What to wear?
Dress decently since this is a government office. If you come in with a sleeveless shirt, shorts, and slippers you might be turned away. However, since you will get vaccinated in the deltoid or upper arm, it would be convenient to wear a short sleeved shirt.
What will I do if I lose the card?
You can always request a new one for 300PHP
Who cannot get vaccinated?
- People who have severe allergic reaction to eggs, gelatin, and chicken which contains the protein component found in the vaccine.
- Infants younger than 6 months old.
Don't forget to inform your doctor before you get the shot if :
- You are immunocompromised especially those who are undergoing chemotherapy, had a transplant or undergoing certain drug treatment. Live attenuated vaccines may be contraindicated in certain immunocompromised patients
- You have HIV/AIDS
- You have a thymus disorder like Grave's disease or if the thymus has been removed
- You are above 60 years old
- You have a baby who is 6 to 8 months old
- You are pregnant or nursing
What to expect during the vaccination process?
First, the security guard at the gate will hand you two forms to fill out. One is the Yellow Fever Vaccine Questionaire which is more specific. These were the salient questions:
- Allergic reaction to eggs, chicken, or gelatin because if you have it, you might also be allergic to the protein content of the vaccine.
- Allergies to drugs
- Adverse reactions to yellow vaccine
- Medical problems
- Medications or current treatment
- vaccination for the last 30 days
- if breastfeeding
- last menstrual period
Once you are done, bring this to the Department of Quarantine office and hand it to the nurse-in-charge. She will then refer you to the doctor for assessment.
Talk over with the doctor any concerns you have.
On my part, I asked him for malarial prophylaxis advice as well as a note saying that I have adverse reactions to Doxycycline. Read about my experience here. I also asked him to review my vaccination schedule as I've just had a couple of shots a few days back and I still need to get Meningitis ACWY, typhoid by injection, typhoid oral, and cholera vaccinations.
Once the doctor gives his go signal, you will need to seat on a bench to wait for your turn to get vaccinated. While waiting, you will be asked to read the instructions below:
Once done, just place it back on the bench and approach the nurse. The shot is gentle and it does not hurt much but then again, this is relative. Just relax your muscles and inhale and exhale deeply. Focus on your breathing and you won't notice the pain. The guy who went before me winced for a minute or so after the vaccination.
After this procedure, sit back and wait for 5 minutes. Be mindful and if you feel lightheadedness, itchiness, or anything other than your normal, report it to the nurse. On the other hand, if you feel fine, just move forward to the cashier to pay for the procedure. Finally, you will then be handed with your yellow card.
How much do this and other services cost?
What if you need to get vaccinated but you cannot get one because of some medical reason?
You can contact the embassy of the country you want to go to for alternatives. This would probably be a waiver for the vaccine from a doctor. However, be aware that this waiver may not be honored when crossing certain borders.
In the Philippines, a waiver certificate is issued to travelers who are allergic to Yellow Fever vaccine by the Bureau of Quarantine. The Exemption Certificate is equivalently accepted as International Certificate of Vaccination (ICV) and will set you back 300Php.
Vaccination waiver: A vaccination waiver can be issued by your medical practitioner if the Yellow Fever vaccine is contraindicated for medical reasons. This can also be given especially if you will not be visiting an area where there is little epidemiological risk. Be aware that problems may arise when crossing borders and the vaccination waiver may not be honored. Take meticulous anti-mosquito bite measures during the daytime in Yellow Fever risk areas. More details on insect bite prevention.
Things to remember after vaccination:
- Watch out for the side effects.
- Wait until two weeks after vaccination before donating blood. The vaccine virus might be transmitted.
What is my body's possible reaction to the vaccine?
The mild reaction includes a low-grade fever as well as heat, soreness, redness, and swelling in the area where you got vaccinated. This usually lasts for 7 days.
If you exhibit very high fever or signs of a severe allergic reaction like dizziness, weakness, fast heart rate, difficulty breathing, hives, and swelling of the face and throat, you better go to the nearest hospital.
What are the other services available at the Bureau of Quarantine?
Other vaccinations available are for Polio, Cholera, and Typhoid. Check for availability first as these run out fast.
You can also go to Supercare Medical Services (573 Patria Bldg., Maria Orosa Cor. Engracia Reyes Sts. Ermita, Manila) which is located right across the Court of Appeals, for your other vaccination concerns. They mostly serve seafarers but you can just walk-in.
These are the vaccines they offer and the price:
- Varicella 2500PHPH
- Hepa A 3000PHP
- Hepa B 850PHP
- MMR 1000PHP
- Polio 1500PHP
- Tetanus
- Tdap 850PHP
- Td
- Cholera Shancol (liquid)
- Cholera Oravacs (capsule) 2550PHP
- Typhoid Vlvotif (capsule)
- Tyhpoid Typhiim (injectable) 1200PHP
I got most of my vaccinations in Tacloban with Dr. Ralph Aniceto, who specializes in infectious diseases at the Divine Word Hospital. It was far cheaper than the clinics in Manila. Contact his secretary at +639275557852.
Since there is a measles outbreak right now, measles vaccine is given out free in public hospitals and local health care centers.
Sources:
https://www.cdc.gov/vaccines/hcp/vis/vis-statements/yf.html
http://quarantine.doh.gov.ph/yellow-fever-vaccination-first-time-re-vaccination/https://www.cancernetwork.com/oncology-journal/immunocompromised-traveler
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