Yellow fever vaccination: centres, certificate and entry rules

In Germany, only state-approved yellow fever vaccination centres may vaccinate against yellow fever. The vaccination is recorded on the international certificate of vaccination and counts for entry from the 10th day after the jab. Since 11 July 2016, that certificate has been valid for life under the International Health Regulations. Whether you need the vaccine depends on whether your destination is a yellow fever area and on the entry rules that apply there.

What yellow fever is and where it occurs

Yellow fever is a viral disease transmitted by mosquitoes. According to the STIKO (Germany’s Standing Committee on Vaccination), it usually causes no or only mild symptoms, but severe and fatal cases with organ failure do occur. The disease is found only in tropical Africa, tropical South America and southern parts of Central America. The mosquitoes that carry it bite mainly during the day but also at night, and the risk is highest in the rainy season. Alongside vaccination, consistent mosquito protection is therefore essential on every trip to a yellow fever area.

Two reasons to get vaccinated

The STIKO recommends yellow fever vaccination for people aged nine months and over who travel to endemic areas. Separately, vaccination may be a formal requirement because a country asks for proof on entry. The two reasons often overlap, but not always.

Entry rules: the typical cases

The International Health Regulations allow countries to require proof of yellow fever vaccination on entry. The rules vary widely:

Case	Example	What applies
Proof required from all travellers	Ghana	According to the German Federal Foreign Office, everyone aged nine months and over needs the vaccine, whichever country they arrive from.
Proof only when arriving from a yellow fever area	Thailand, South Africa	No proof is needed when flying in directly from Germany, but it is after a stay in a yellow fever area or more than 12 hours in transit there.
No proof required, but medically recommended	Brazil, Kenya	No proof is required on direct entry from Germany, but the Federal Foreign Office recommends vaccination for large parts of the country.
Not a yellow fever issue	Japan	Neither a risk area nor a proof requirement.

Combined itineraries need particular care. If you pair a safari in East Africa with a beach holiday elsewhere, or change planes in a yellow fever country, your next destination may ask for proof. Give your full route, including every stopover, at your consultation. Current rules for your destination are on our country pages and in the Federal Foreign Office’s travel and safety advice.

Yellow fever centres: who may vaccinate

Under Section 7 of the IGV-DG, the German act implementing the International Health Regulations, yellow fever vaccinations may only be given at centres approved for this purpose by the competent authority. Doctors in private practice, public health authorities and medical facilities can apply for approval if they have the necessary qualifications and suitable premises for storing and giving the vaccine. The centre uses a WHO-approved vaccine and issues the international certificate in the format set out in the International Health Regulations.

You can find approved yellow fever centres near you in our directory of travel clinics. Many of them also offer other travel vaccines and a full travel health consultation.

The international certificate

The yellow fever vaccination is recorded in the international certificate of vaccination, usually a yellow booklet. At the border, the following applies:

• Valid from day 10: proof is only recognised ten days after vaccination, so make sure this period has passed before you arrive.
• Valid for life: since 11 July 2016, entry may no longer be refused on the grounds that the vaccination was given more than ten years ago. This also applies to certificates issued earlier.
• Keep it safe: the booklet is a travel document. Our guide to the vaccination certificate explains how to keep it up to date and what to do if you lose it.

Formally valid does not always mean protected

Lifelong validity concerns entry rules. Medically, after reviewing the evidence, the STIKO concluded that lifelong protection after a single dose cannot be assumed in general. It therefore recommends a single booster before another trip to, or a continued stay in, a yellow fever area if the first vaccination was ten or more years ago. Different rules apply to children, pregnant women and people with weakened immunity, and your vaccination centre will go through these with you.

Exemption certificate

If there is a medical reason against vaccination, a yellow fever centre can issue an exemption certificate. According to the STIKO, countries with a proof requirement are not obliged to accept it. In that case, check whether the trip is sensible and possible before you book.

Who should weigh things up carefully

The yellow fever vaccine is a live vaccine. Serious side effects are very rare according to the STIKO, but for some people the decision needs particular care or the vaccine is not suitable. This includes:

• people with weakened immunity or on immunosuppressive treatment
• pregnant and breastfeeding women
• babies under nine months
• people aged 60 and over, especially for a first vaccination
• people with a clinically relevant egg allergy
• people whose first-degree relatives had serious side effects after a yellow fever vaccination

Whether the vaccine is right for you is decided by the doctor at the vaccination centre after a thorough discussion. Mention all existing conditions and medication.

Timing and costs

Because the certificate only counts from day 10 and live vaccines have to be coordinated with other vaccinations, plan the yellow fever jab early. Our guide on when to get travel vaccinations shows how to spread your appointments. For private trips, yellow fever vaccination is not a standard benefit of German statutory health insurance, but many insurers reimburse it voluntarily, see travel vaccination costs.