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YF-VAX (Yellow Fever Vaccine) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Data are limited in regard to the interaction of YF-VAX® with other vaccines.

  • Measles (Schwartz strain) vaccine, diphtheria and tetanus toxoids and pertussis vaccine adsorbed (DTP), 31 Hepatitis A and Hepatitis B vaccines, 2,12,32,33 meningococcal vaccine, Menomune® - A/C/Y/W-135, and typhoid vaccine, Typhim Vi®, 2,12,32 have been administered with yellow fever vaccine at separate injection sites.
  • No data exist on possible interference between yellow fever and rabies or Japanese encephalitis vaccines. 2
  • In a prospective study, persons given 5 cc of commercially available immune globulin did not experience alterations in immunologic responses to the yellow fever vaccine.2,34
  • The anti-malarial drug chloroquine has been administered with yellow fever vaccine.2,35

CONTRAINDICATIONS

HYPERSENSITIVITY

Because the yellow fever virus used in the production of this vaccine is propagated in chicken embryos, YF-VAX® should not be administered to anyone with a history of acute hypersensitivity to eggs or egg products; anaphylaxis may occur. Less severe or localized manifestations of allergy to eggs or to feathers are not contraindications to vaccine administration and do not usually warrant vaccine skin testing (see PRECAUTIONS section, Hypersensitivity Reactions subsection). Generally, persons who are able to eat eggs or egg products may receive the vaccine.2,22

INFANTS

Vaccination of infants less than 9 months of age IS CONTRAINDICATED because of the risk of encephalitis, and travel of such persons to rural areas in yellow fever endemic zones or to countries experiencing an epidemic should be postponed or avoided, whenever possible.

IMMUNOSUPPRESSED PATIENTS

Exposure to yellow fever vaccine, which is a live virus vaccine, poses a risk of encephalitis or other serious adverse events to patients with illnesses that commonly result in immunosuppression (eg, acquired immunodeficiency syndrome or other manifestations of human immunodeficiency virus (HIV) infection, leukemia, lymphoma, thymoma, generalized malignancy), or patients whose immunologic responses are suppressed by drug therapy (eg, corticosteroids, alkylating drugs, or antimetabolites) or radiation. Therefore, immunosuppressed subjects should not be immunized, and travel to yellow fever endemic areas should be postponed or avoided. If travel to a yellow fever-infected zone is unavoidable, immunosuppressed patients should be advised of the risk, instructed in methods for avoiding vector mosquitoes, and supplied with vaccination waiver letters by their physicians (see ADVERSE REACTIONS section).

Family members of immunosuppressed persons, who themselves have no contraindications, may receive yellow fever vaccine.2,23

REFERENCES

  1. Monath TP. Vaccines. 3rd Edition, WB Saunders Company. 1999;815-879.
  2. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2002;51(RR17):1-10.
  3. Teichmann D, et al. Lancet 354:1608.
  4. ACIP. MMWR 2000;49:(14);303-305.
  5. McFarland JM, et al. Clin Infect Dis 1997;25:1143-1147.
  6. Centers for Disease Control and Prevention (CDC). MMWR 2002;51(15):324-325.
  7. World Health Organization (WHO). Weekly Epidemiological Record 2001;76:365-372.
  8. Barros MLB, et al. Lancet 1996;348:969-970.
  9. Mason RA, et al. Appl Microbiol 1973;25(4):539-544.
  10. WHO Technical Report Series 594, 1976.
  11. Wisseman CL, et al. Am J Trop Med Hyg 1962;11:550.
  12. American Society for Microbiology. JAMA: HIV/AIDS Resource Center 1996;Sept 15-18.
  13. Meyer HM, et al. Bull World Health Org 1964;30:783.
  14. Bancroft WH, et al. J Infect Dis 1984;149:1005-1010.
  15. Jackson J, et al. Third International Conference on Travel Medicine; Paris 1993;April 25-29.
  16. Monath TP, et al. Am J Trop Med Hyg 2002;533-541.
  17. Goujon C, et al. Fourth International Conference on Travel Medicine; Acapulco, Mexico 1995;April 23-27.
  18. Nasidi A, et al. Transactions of the Royal Society of Tropical Medicine and Hygiene 1993;87:337-339.
  19. Bonnevie-Nielson V, et al. Clin Diag Lab Immunol 1995;2:302-306.
  20. Smithburn KC, et al. Am J Trop Med Hyg 1945;45:217.
  21. WHO. Geneva 1983.
  22. American Academy of Pediatrics. 2000;35-175.
  23. CDC. US Department of Health and Human Services, Public Health Service 2001;3-6,12-21,154-160,207-220.
  24. Martin M, et al. Lancet 2001;358:98-104.
  25. Galler R, et al. Virology 2001;290:309-319.
  26. Chan RC, et al. Lancet 2001;358:121-122.
  27. Vasconcelos PFC, et al. Lancet 2001;358:91.
  28. CDC. MMWR 1990;39:730-733.
  29. CDC. MMWR 1988;37:197-200.
  30. Food and Drug Administration. FDA Drug Bull 1988;18(2):16-18.
  31. Ruben FL, et al. Bull WHO 1973;48:175-181.
  32. Dumas R, et al. Adv Therapy 1997;14:160-167.
  33. Coursaget P, et al. Vaccine 1995;13:109-111.
  34. Kaplan JE, et al. Bull WHO 1984;62(4):585-590.
  35. Tsai TF, et al. J Infect Dis 1986;154(4):726-727.
  36. Aventis Pasteur Inc. Data on File - 080601.
  37. Martin M, et al. Emerg Infect Dis 2001;7:945-951.
  38. Jennings AD, et al. J Infect Dis 1994;169:512-518.
  39. Stuart G. WHO 1956;143.
  40. Louis JJ, et al. Pediatr 1981;36:439.
  41. Rey M, et al. Bull Soc Med Afr Noire Lgue Fr 1966;11:617.
  42. Tsai TF, et al. J Infect Dis 1993;168:1520-1523.
  43. Nishioka SA, et al. Trop Med Int Health 1998;3(1):29-33.
  44. ACIP. MMWR 2002;51(RR02):1-36.
  45. Poland JD, et al. Bull WHO 1981;59(6):895-900.

Product information

Manufactured by: as of April 2003

Aventis Pasteur Inc.

Swiftwater PA 18370 USA

4291/4292

Aventis Pasteur Aventis

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