The Yellow Fever Conundrum

Victoria Falls

VICTORIA FALLS, ZIMBABWE: My doctor told me before I left that since I’m over 65 it would not be a good idea for me to get a yellow fever vaccination. The yellow fever virus is spread by the bite of the female mosquito. According to Wikipedia, the disease, for which there is no known cure, causes over 30,000 deaths annually. “I’ll write you an immunization exception letter and you’ll be okay,” my doctor said. But arriving in Africa it hasn’t been all that clear. “Why would a country that is plagued with yellow fever want to admit someone who hasn’t been vaccinated?” the clerk at the lodge at Victoria Falls asked me when I told her I wanted to cross over into Zambia to see the falls from that side. I decided to try crossing anyway. “They can only turn me back,” I thought, “And besides I was also going to Rwanda, another yellow fever country so maybe I’d better find out now rather than later when turning back will be almost impossible.” When I showed the Zambian immigration officer my immunization exception letter he chuckled, “No, there’s no problem here. We have no such rules.” “But maybe other countries will have a problem that I have visited Zambia?” “No, no one will have a problem.” “What about Botswana, Kenya, or Zanzibar?” “No, no problems there.” “How about Ethiopia?”  He shook his head and mused: “I don’t think so. Only South Africa will have a problem. You cannot go back to South Africa.” I proceeded to the Zambian side, but was left thinking, “Have I just put at risk the rest of my itinerary.” I’ve since asked others without receiving a definitive answer. The website for the International Association for Medical Assistance to Travelers states: “If your medical practitioner has advised you against the Yellow Fever vaccine for medical reasons, a vaccination waiver should be issued. Be aware that problems may arise when crossing borders and your vaccination waiver may not be honored.” Okay, now that’s helpful, huh?