Main Menu ► International Regulations and Certificate Requirements ► Medical Waivers (Exemptions)
IHR (2005) states: If the supervising clinician is of the opinion that the vaccination (or prophylaxis) is contraindicated on medical grounds, the supervising clinician shall provide the person with reasons, written in English or French, which the competent authorities on arrival should take into account.
If a traveler has a medical contraindication to yellow fever vaccination, a medical waiver can be issued in lieu of administering the vaccine. In this case, the provider should fill out and sign the Medical Contraindications to Vaccination section of the ICVP. Also, it is the provider's responsibility to counsel the patient about the risks of traveling without vaccination to a country with risk of yellow fever virus transmission and about personal protective methods against mosquito bites. Patients in this situation should be advised that the safest alternative is to avoid or postpone travel.
Additionally, CDC suggests that a clinician who decides to grant a medical waiver provide the patient with a signed and dated exemption letter on letterhead stationery, clearly stating that the vaccine is contraindicated on medical grounds. This letter should also display the center's official yellow fever vaccination stamp. Medical exemption letters should be written for the current trip only. Subsequent exemption letters can be issued prior to future trips, if required.