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Yellow fever pre-vaccination checklist

A checklist for travellers to be used during the travel health consultation to assist yellow fever vaccine risk assessment

In accordance with the recommendations in the Commission on Human Medicine's Expert Working Group report, the National Travel Health Network and Centre (NaTHNaC) and Public Health Scotland (PHS) have produced a yellow fever pre-vaccination checklist (screening tool).

The NaTHNaC/PHS yellow fever pre-vaccination checklist is a tool designed to:

• help the healthcare professional risk assess a person's suitability for yellow fever vaccination.
• it does not replace the broader individual risk assessment in the travel health consultation.
• be completed by the person travelling in advance of, or during, the travel health consultation.
• but must be carefully reviewed by the advising healthcare professional as part of a shared decision-making process for yellow fever vaccination.

Instructions: Downloading the yellow fever pre-vaccination checklist

The NaTHNaC/PHS yellow fever pre-vaccination checklist has been produced in interactive PDF format to give users the option of completing and saving the document electronically.

To ensure full functionality please download and open the PDF in Adobe Reader rather than your web browser.

Yellow fever pre-vaccination checklist PDF 168 KB 5 pages

The yellow fever pre-vaccination checklist can be signed electronically by using Adobe 'Fill and Sign'*.

To use this feature on the desktop version of Adobe Reader:

1. select the Adobe Reader 'signature' icon from the horizontal menu bar
2. choose how you want to add your signature
• to use keyboard to add your signature select 'type' and follow the on screen instructions
• to use mouse or similar device to draw your signature select 'sign' and follow the on screen instructions
• to upload an image of your signature select 'image' and follow the on screen instructions
3. select 'Apply' and then drag and drop your signature into required signature field
4. select 'Close' in the horizontal 'Fill and Sign' menu bar

Once completed, the yellow fever pre-vaccination checklist can be saved by clicking 'file' from the horizontal menu bar and then selecting 'Save As' to save the document in the required location.

To use the 'Fill and Sign' feature on the mobile or tablet version of Adobe Reader:

1. select the 'edit' icon, situated bottom right
2. select 'Fill and Sign' from the menu
3. select the 'signature' icon
4. select 'Create Signature'
5. choose how you want to create the signature
• to draw your signature on screen, select 'draw' and follow the on screen instructions
• to use an image already on your device, select 'image' and follow the on screen instructions
• to take a picture using the device camera, select 'camera' and follow the on screen instructions
6. select 'done' and tap on/select the required signature field to place your signature
7. select the 'tick' icon , situated top left to save your signature

Once completed, close the file to save the yellow fever pre-vaccination checklist.

*Please note, signing the yellow fever pre-vaccination checklist is not mandatory and is not essential for consent purposes. All Yellow Fever Vaccination Centres (YFVC) in the UK are responsible for following their own local policies and procedures regarding best practice around consent.

Travel risk assessment form

We also have an example risk assessment / risk management form for travel health consultations. This form is used separately to the yellow fever check list and can be downloaded and printed. Clinics may wish to use this as an example to create their own form which is adapted to their own practice.

• Risk assessment / Risk management checklist