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travel to brasil -- yellow fever
Feb 4, 2004

I am travelling to Brasil -- Amazonas -- in the Spring. I will be on a cruise ship, but I would like to take a couple of jungle excursions. Should I take the yellow fever vaccine? Do I have a choice not to? If I do not take it, can I still travel there, and do I need to show a waver of some sort. What is the risk if I do take the vaccine, and if I take it, is there a window of time after the vaccine in which I know the vaccine has done its job and is not going to cause complications. (T-cells 350, viral load 50,000).

Response from Dr. Henry

The jury of often split on the issue of yellow fever vaccination. If a person is aymptomatic with a decent immune system (CD4 > 250-350) AND exposure is likely unavoidable then many clinicians would recomment vaccination. THe concern is that the vaccine is a live attenuated vaccine that could cause some problems if the immune system was significantly impaired. I have vaccinated a modest number (? 10) patients in your situation without incident. It is a judgement call that is ultimately up to the patient in many instances. KH

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