All travelers to South America or Africa should keep their yellow fever vaccinations up to date and that little yellow booklet which serves as proof of having received the vaccine with them wherever they go. This is not a health warning — as unless you are going into the heart of Africa or deep into the Amazon during a yellow fever outbreak the chances of catching this disease are so slight as to be negligible – but an administrative one: some countries may deny you entry without documentation that you have been vaccinated. The worst part of this is the fact that because many countries have this clause written into their entry requirements some airlines will not let you board a flight to such a place without first seeing proof that your yellow fever vaccine is up to date.
The spiderwebs of modern world travel.
“I’ve never been asked for yellow fever documents,” some travelers have told me as though they are immune to such regulations.
Well good for you, neither have I.
It matters little if you are not asked for proof of yellow fever vaccine five times if the sixth time you are busted and denied entry to a country or prevented from boarding a flight. Honestly, I’m not prepared to forfeit a thousand dollars worth of air tickets or be forced to pay for an expensive exit flight on the chance that I may not be asked for proof of my yellow fever vaccine. The fact of the matter is that I could be asked, many travelers are asked, and the stakes are high if you are among the un-auspiciousness handful who have their travel plans disrupted because they failed to get a simple vaccine. This seems like an unwarranted chance to take, especially since yellow fever vaccines and the little yellow certification booklets that accompany them can often be had in countries where the diesease is present for a nominal fee or even for free.
Examples of travelers being denied entry to countries or refused boarding on aircraft because of the inability to produce a yellow fever vaccine certificate
Has anyone had experience with a Brazilian needing the yellow fever vaccine before being allowed to enter Costa Rica?
My wife was denied entry onto the plane because she didn’t have the vaccine. She went and got it but is told she has to wait 10 days before she can enter Costa Rica.
from Gringoes forum
A relative of mine who travels on a Venezuelan passport (with valid B-2 US Visa) was just denied boarding at CCS when she was planning to transit the USA on the way to BGI.
The AA ticket agent was sympathetic but said that Barbados immigration authorities require Yellow Fever vaccination certificates for passport holders of certain countries, including Venezuela.
I got tripped up by a similar issue last week– flying Colombia to the U.S. with an overnight in El Salvador on a U.S. passport. According to TIMATIC, El Salvador requires the yellow fever certificate for passengers leaving the airport who have been in Colombia, Ecuador, Brazil and several other countries within the prior 10 days.
-Discussion from Flyer talk forum yellow fever requirement
Yellow fever vaccine immigration rules
The IHRs allow countries to require proof of yellow fever vaccination as a condition of entry for travelers arriving from certain countries, even if only in transit, to prevent importation and indigenous transmission of YFV. Some countries require evidence of vaccination from all entering travelers, which includes direct travel from the United States. Travelers who arrive in a country with a yellow fever vaccination entry requirement without proof of yellow fever vaccination may be quarantined for up to 6 days, refused entry, or vaccinated on site. A traveler who has a specific contraindication to yellow fever vaccine and who cannot avoid travel to a country requiring vaccination should request a waiver from a physician before embarking on travel. – CDC Yellow Fever
Countries that “officially” have yellow fever
If you are traveling to, away from, or are even transferring flights in any of these countries, check their Yellow Fever immigration requirements as well as that of your destination country. In many parts of these countries yellow fever is no more of a risk than in New York City, but this is a matter of officiousness, not logic.
Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Republic of the Congo, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia, Gabon, The Gambia, Ghana, Guinea, Guinea-Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, Sudan, Togo, Uganda
In South America
Argentina, Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Panama, Paraguay, Peru, Suriname, Trinidad and Tobago, Venezuela
List A: Countries that officially require proof of yellow fever vaccination from all travelers regardless of where they are traveling from
Angola, Benin, Bolivia, Burkina Faso, Burundi, Cameroon, Central African Republic, Congo, Côte d’Ivoire, Democratic Republic of Congo, French Guiana, Gabon, Ghana, Guinea- Bissau, Liberia, Mali, Niger, Rwanda, Sierra Leone, Togo
List B: Countries that officially require proof of yellow fever vaccination from travelers coming from an infected country
- Antigua and Barbuda
- Cape Verde
- Costa Rica (Argentina, Panama, and Trinidad and Tobago are exceptions)
- El Salvador
- Equatorial Guinea
- French Guiana
- India (6 days of quarantine before entry)
- North Korea
- Papua New Guinea
- Saint Lucia
- Saint Vincent and Grenadines
- Sao Tome and Principe
- Saudi Arabia
- Solomon Islands
- South Africa (vaccination necessary even if transiting through a yellow fever country)
- Sri Lanka
- Trinidad and Tobago
Be aware that many of these countries may also demand proof of yellow fever vaccination even if you were in a country where the disease exists 6 to 10 days prior to arrival. Also, some of these countries may require proof of the vaccine even if you just transfer flights or transit through a “yellow fever” country.
What is yellow fever and how is it transmitted
Yellow fever is a potentially deadly disease that is transmitted between humans via bites from a mosquito. The reason why many countries are anal about this disease in particular is that it can easily be transferred to a local population where yellow fever is not present by a traveler coming from an infected region. The disease takes around 10 days to gestate before symptoms are evident, so a traveler could potentially arrive in a new country completely healthy, show symptoms later on, and spread the infection to other people — and, if this country does not routinely vaccinate for this disease, perhaps cause an epidemic (or at least this is the fear). In this way, borders act as palisades against yellow fever, and some countries can be very rigid about admitting travelers who were previously in countries where the disease arises from time to time without proof that they were vaccinated.
Therefore, apart from the countries in list A above which “officially” require proof of a yellow fever vaccine for all visitors to enter (in practice this is seldom enforced and is often only a crowbar to extract a bribe), travelers often do not need to be vaccinated against yellow fever to enter a yellow fever country IF they are coming from a country where the disease is not officially prevalent. For example, if you are traveling from the USA to Colombia, there is no threat that you will need to show proof of vaccination before boarding an aircraft or when going through immigration.
The problem comes when you want to leave a country with yellow fever and go elsewhere. As you can see, the list of countries that regulate against this is massive — some, such as India, are removed from yellow fever regions by continents and oceans but they still technically can require proof of vaccination if traveling there from large parts of South America or Africa. Getting vaccinated against yellow fever — which is good for 10 years — removes one more obstacle for onward travel and usurps a potentially major annoyance.
The cheapest way to receive a yellow fever vaccine
Yellow fever vaccine can be received cheap or even for free if you get it in a country that systematically vaccinates their population for the disease. As many countries that have yellow fever do not require you to have the vaccine prior to entry, it is more than possible to visit one of their public health departments after arrival and get the jab and the yellow book certification for nothing — or, in some countries, next to nothing. My family just received this vaccination in Colombia for free, if we tried to do this in the USA we would have paid $80 to $200 each.
The risk of catching yellow fever when traveling
According to the CDC, the risks associated with of an unvaccinated traveler contracting yellow fever and the chances of subsequent death resulting from a two week visit to an endemic area are as follows:
Chance of contracting yellow fever: 50 per 100,000
Chance of it proving fatal: 10 per 100,000
Chance of contracting yellow fever: 5 per 100,000
Chance of death: 1 per 100,000
There is very little risk of actually contracting yellow fever when traveling, and even less that you will die from it. In fact, even within the “endemic” areas that are outlined in the above maps, the actually prevalence of the disease is relatively scarce. Occasionally, there will be outbreaks in regions of countries that have yellow fever, but, more often than not, the disease is virtually non-existent. Only around 30,000 people currently die from yellow fever each year, and this is mostly in extremely remote areas outside the reach of modern medicine and vaccines.
Yellow fever is a “public” rather than an “individual” health concern, and many countries that are affected by the disease vaccinate their populations routinely. There is very little risk of a person outside of backwoods Africa or deep in the Amazon contracting this disease, but the philosophy behind public vaccination is that every member of a society needs to be protected for the entire society to be protected, so the administrative walls are up against travelers moving across borders as unvaccinated free radicals. I did not vaccinate my family against this disease for health reasons, but for political ones: I do not want to get stuck in the spiderwebs of bureaucracy, I want to travel from point A to point B as smoothly as possible.
The biggest risk of traveling without proof of a yellow fever vaccination is with the airlines, not immigration
Whether or not the immigration officials of countries who technically require proof of yellow fever vaccination for entry will really demand you to show this proof is anyone’s guess — and in my experience this is pretty rare. I have never been asked for my yellow fever vaccine card when crossing through South and Central America overland — even when traveling from an “infected” country — and it is my impression that, even though some travelers have been denied entry to countries or placed in quarantine for not having that little yellow book, the biggest risk of traveling without this vaccine lies with the airlines.
Immigration officials can often be worked, their policies can often be bent, but if that airline rep behind the check-in counter reads up on the entry requirements of the country you’re flying to and deems that you do not meet them in full, there is nothing you can do: you will miss your flight and lose the lion’s share of what you paid for your ticket. All too often, airlines are now preemptively administering the immigration policies of the countries they fly passengers to with iron fists. That over-glorified clerk behind the airline check-in counter is often far stricter in terms of administering the immigration policies of various countries than the actual immigration officials themselves. This is becoming one of the biggest problems of modern travel.
The reasons for this are two fold:
1. Many countries now administer large fines to airlines who fly passengers in who do not meet the official entry requirements.
2. The airlines know they can make more money off you if they refuse you boarding and either pocket your cash, sell you another ticket, or charge you a ticket change fee. This is an ever growing graft being pulled by airlines all over the world which includes the pre-enforcement of many immigration policies — from onward ticket requirements to proof of vaccination. And if you think that you can get a refund on your economy class flight because you did not get your yellow fever vaccine 10 days before flying, think again — the airline will pocket this money, as it is YOUR responsibility to know the entry requirements of the country you’re flying into.
I now fear the airlines’ administration of immigration policy far more than the immigration officials of whatever country I’m traveling to. Once I get on that plane, I consider myself home free. Ten years ago I use to grow nervous about going through entry immigration, now I am nervous checking into my flight. Getting your yellow fever vaccine is more a precaution against airline policy than that of any country. I’m not going to risk losing the price of a flight for a vaccine that I could get for free.