Yellow fever vaccine support

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Mass yellow fever vaccine campaigns in 14 African countries have lowered risk of outbreaks by up to 82%

Yellow fever vaccine introduced in routine immunisation systems in 17 countries in Africa

Over 30 million doses from the emergency stockpile have reached Gavi-supported countries experiencing yellow fever outbreaks 

Yellow fever Nigeria

Nigeria, where yellow fever is highly endemic, has introduced yellow fever vaccine into the routine system and conducted vaccination campaigns with support from Gavi. Credit: Gavi/2013/Adrian Brooks.

Yellow fever vaccine is highly effective: a single dose leads to long-term, probably even lifelong, immunity in 99% of people vaccinated. 

Gavi has invested more than US$ 300 million in yellow fever control since 2001, focusing on African countries where the vast majority of yellow fever deaths occur. The Vaccine Alliance funds routine vaccine introductions, an emergency stockpile and preventive vaccination campaigns.

Gavi’s support is closely aligned with the Yellow Fever Initiative, a partnership led by WHO and UNICEF to coordinate yellow fever control at the global level.


Since 2011, Gavi-supported prevention campaigns have been organised in 14 “high-risk” countries in Africa, protecting 88 million people in Benin, Burkina Faso, Cameroon, the Central African Republic, Côte d’Ivoire, Ghana, Guinea, Liberia, Mali, Nigeria, Senegal, Sierra Leone, the Sudan and Togo.

Yellow fever vaccine supply: a tale of two continents

The Vaccine Alliance’s efforts to increase immunisation against yellow fever have been so successful that more vaccine is urgently needed to meet global demand.

Learn how Gavi is working to scale up production of yellow fever vaccine in Africa and Europe.

In 2014 alone, over 7.8 million people were vaccinated in Africa, including a preventative mass campaign in the Democratic Republic of Congo which used over half a million doses from the emergency stockpile to avert a suspected yellow fever outbreak.

According to The Yellow Fever Initiative, these campaigns have significantly reduced the risk of yellow fever outbreaks across the region, lowering the burden of yellow fever by as much as 82% in some countries.


Despite the success of mass campaigns, challenges remain. Although the Vaccine Alliance has helped 17 countries introduce yellow fever vaccine through routine immunisation since 2000, more than 6 of these countries reported coverage rates of less than 80% in 2014. Vaccine Alliance partners are working together to investigate the reasons for this and how best to address it.

For example, in Nigeria, where yellow fever is highly endemic, routine immunisation coverage stood at just 49% in 2014.


The emergency stockpile, set up in 2003, has been successful in ensuring that adequate vaccine supply is available to respond rapidly to outbreaks. Funds for the emergency stockpile are channelled and coordinated by the Global International Coordinating Group on Vaccine Provision for Yellow Fever Control. Between 2003 and 2013, approximately 30 million doses were sent to 13 Gavi-supported countries for emergency control.

Countries can receive financial support to cover emergency vaccination campaigns that draw on the stockpile. For more details, visit: 

Outbreaks of yellow fever virus continue to erupt despite availability of an effective vaccine since the 1930s

Geographic focus of the disease shifting from West to Central and East Africa


Before the development of a life-saving vaccine in the 1930s, the yellow fever virus was responsible for devastating epidemics in large cities in Africa, the Americas and Europe.

In the last 20 years, the number of yellow fever cases has increased again due to declining population immunity, climate change and deforestation. A few cases also occur in countries free of yellow fever due to population movement. There are an estimated 200,000 cases of yellow fever worldwide each year, causing 30,000 deaths.

Rapid urbanisation has exacerbated the issue by concentrating people who have not been immunised in settings where the yellow fever virus thrives. City areas provide fertile breeding grounds for mosquito larvae, as stagnant water collects in water containers, cans and tyres. Overcrowded housing further accelerates the spread of the virus.


An acute viral haemorrhagic disease transmitted by mosquitoes, yellow fever causes devastating epidemics in areas where infected mosquitoes can come in contact with people who are not vaccinated. Death rates can be as high as 50% among those severely affected.

Yellow fever can be prevented by a safe, affordable and highly effective vaccine. One injection protects an individual for at least 35 years, and possibly for life.

Yellow fever cannot be eliminated. However, the risk of outbreaks can be substantially reduced by immunising at least 70% of the at-risk population. In order to achieve this high coverage and maintain immunity for life in the 33 endemic countries in Africa, Gavi supports routine immunisation and preventive campaigns in eligible countries.


The recent resurgence of yellow fever is especially pronounced in West and Central Africa, where mass vaccination campaigns in the period 1933–61 effectively meant the virus had disappeared.

This alarming trend started in equatorial Africa with a 1990 epidemic in Cameroon, and then spread across the region. By 2005, failure to immunise successive birth cohorts through routine immunisation had led to approximately 200,000 yellow fever cases and more than 50,000 deaths in West Africa's 12 highest-risk countries.

Today, the virus poses the greatest threat to 900 million people in more than 45 endemic countries – 33 in Africa and 13 in Central and South America. Shifts in migration patterns and environmental changes are affecting the geography of yellow fever, with outbreaks now occurring in areas historically considered non-endemic.

Gavi provides yellow fever support for routine immunisation, campaigns in high-risk countries and emergency stockpiles in case of outbreaks

Yellow fever vaccine is one of the priority vaccines that Gavi has supported since its foundation in 2000, both to protect populations at risk and to reduce the need for emergency response.


Preventive campaigns

Eligible countries can receive support for preventive campaigns on a one-dose vaccination schedule, as well as associated supplies. Countries receiving support for preventative campaigns do not get a vaccine introduction grant. However, Gavi provides US$ 0.65 per individual in the target population of the campaign to help cover operational costs (expected to cover approximately 80% of the total estimated cost). Countries must meet the remaining operational expenses.

Countries approved for Gavi yellow fever vaccine support


Introduction into the routine immunisation system

WHO recommends that all countries at risk incorporate the vaccine into their national routine immunisation programme.

Gavi provides support for a one-dose vaccination schedule, as well as associated injection supplies. Countries that are using the vaccine for the first time can also apply for a one-time cash vaccine introduction grant. It is expected that the government or partners cover the remaining costs associated with the vaccine introduction.

Global stockpile for emergencies

Countries eligible for Gavi support can rely on the global stockpile of yellow fever vaccine for use in emergency outbreaks. The stockpile is managed by the International Coordinating Group on Vaccine Provision for Yellow Fever Control. Countries can receive funding to cover emergency vaccination campaigns that draw on the stockpile.

In 2011, following a shortage of yellow fever vaccine during an outbreak in Guinea, a global reserve of two million doses was created to ensure a rapid response to future epidemics.


In September 2014, Nepal became the first country to introduce inactivated polio vaccine (IPV) with Gavi support. By the end of the year, 64 countries had applied for Vaccine Alliance support.


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