DoD Policies Ensure Sufficient Yellow Fever Vaccine Despite Global Shortage

By Annette M. Boyle

In this historic photo from around the turn of the 20th century, Dr. Walter Reed studies the transmission of yellow fever. The infectious disease, which is endemic to 47 countries in sub-Saharan Africa and tropical areas of Central and South America, remains an issue for the military, which now is grappling with vaccine shortages.

FALLS CHURCH, VA—In mid-2016, Sanofi Pasteur announced that manufacturing issues could produce a YF-VAX shortage that might last for several months. Continued problems are expected to result in complete depletion of supplies this summer, and a new stock will not be available until mid-2018.

Though YF-VAX is the only yellow fever vaccine approved by the U.S. Food and Drug Administration and Sanofi is its only manufacturer, DoD has no concerns.

“DoD maintains a supply of yellow fever vaccine adequate to meet current and projected operational needs,” said Kevin Dwyer, spokesman for the Defense Health Agency. “We do not anticipate a complete depletion of supply prior to resumption of manufacturing.”

Yellow fever is endemic to 47 countries in sub-Saharan Africa and tropical areas of Central and South America. In the past two years, Angola, the Democratic Republic of the Congo and Brazil have experienced major outbreaks of the disease, which is caused by a flavivirus transmitted by the Aedes aegypti mosquito. Chad, Colombia, Ghana, Peru and Uganda also have reported recent outbreaks.

Nearly 85% of individuals infected with yellow fever exhibit no symptoms. Symptoms, including fever, headache, jaundice, muscle pain, nausea, vomiting and fatigue, occur among the other 15%, starting three to six days after infection. Among those who develop symptoms, fatality rates range from 20%-50%.

According to the DHA, 18 African countries require proof of yellow fever immunization. So do several countries within the DoD’s SOUTHCOM area of responsibility of Central and South America. Service members who cannot show immunization within the last decade may be denied entry, which could affect their mission or lead to quarantine or other detainment.

In a typical year, the DoD receives about 170,000 doses of the vaccine, according to the U.S. Centers for Disease Control and Prevention. In 2016, however, DoD facilities had to request additional doses through a tightly-controlled requisition process.

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