Skip Navigation
Michigan Department of Community HealthMichigan.gov, Official Website for the State of Michigan
Michigan.gov Home
  • MDCH Home
  • Sitemap
  • Contact MDCH
  • close print view

    Travel Vaccines including Yellow Fever Vaccine

    Frequently Used Websites


    Yellow Fever Vaccine Requirements for Michigan Health Care Providers

    Many countries require specific travel immunizations for visitors. International Health Regulations require that yellow fever vaccine be administered only at designated Yellow Fever Vaccination Centers. In the United States the responsibility for designating Yellow Fever Vaccination Centers has been delegated to State Health Departments. 

    In Michigan, health care providers who wish to purchase and administer yellow fever vaccine must complete the Yellow Fever Provider Application (DCH-1292)  and be approved by the Michigan Department of Community Health (MDCH). Sanofi pasteur will not allow the purchase of yellow fever vaccine by health care providers unless they are approved Uniform Stamp holders. 

    Yellow Fever Provider Application (DCH-1292) 

    A physician, physician's assistant or nurse practitioner (with prescription-writing privileges) can legally administer the Yellow Fever vaccine after a physician completes the Yellow Fever Provider Application. Yellow Fever Center designation can be requested at the same time the Uniform Stamp is requested or at a later date if the physician already is a Uniform Stamp holder. The Yellow Fever Center Registration Form will be processed once the applicant has been approved for a Michigan Uniform Stamp. 

    Mail the completed form to:

    Michigan Department of Community Health
    Division of Immunization
    201 Townsend St.
    PO Box 30195
    Lansing  MI  48909

    The application must be completed in full, and then mailed to the above address. Any applications with missing or
     

    incomplete information will be returned to the applicant. Applicants are also required to attach a narrative description of the supervising physician's experience in providing travel immunizations and their reason(s) for applying to be a travel immunization/yellow fever vaccine provider (see  Yellow Fever Provider Application ).

    Once you have received your Uniform Stamp and your completed Yellow Fever Provider Application is on file at the Michigan Department of Community Health (MDCH), you will automatically become a designated Yellow Fever Vaccination Center in Michigan and you will be eligible to purchase and administer yellow fever vaccine. You will be required to report your annual number of yellow fever doses administered to MDCH by January 15 of each year.
     


    Adverse Event Reporting
     

    Adverse events reported to providers after vaccination should be submitted to the  Vaccine Adverse Events Reporting System (VAERS)  according to state guidelines. Private providers should report all adverse events directly to VAERS, and also notify MDCH.

    For more information and reporting forms, please contact VAERS at (800) 822-7967 or visit the
     VAERS website.


    How to Order Yellow Fever Vaccine

    Yellow fever vaccine produced by sanofi pasteur is obtained directly from sanofi pasteur, the sole distributor in the United States. For information, prices, and ordering procedures, contact sanofi pasteur. Please note that providers are not able to order yellow fever vaccine unless they have been authorized by the Michigan Department of Community Health. 

    Sanofi Pasteur
    Route 611, P.O. Box 187
    Swiftwater, PA 18370
    1-800-VACCINE
    www.sanofipasteur.com 


    Additional Resources


    Revised International Certificate of Vaccination or Prophylaxis

    To comply with the International Health Regulations (2005), the Centers for Disease Control and Prevention (CDC) revised the International Certificate of Vaccination or Prophylaxis (ICV) in 2007. 

    Currently, yellow fever is the only disease under the International Health Regulations (2005) for which proof of vaccination may be required for travelers. Previously issued certificates remain acceptable proof of vaccination against yellow fever as long as the certificate is valid. Travelers should keep the ICV with their passports at all times. 

    The new certificates are available for purchase from the Government Printing Office bookstore.

    To order 100 cards: http://bookstore.gpo.gov/products/sku/017-001-00566-5
    The cost for 100 cards is $53.50.

    To order 25 cards: http://bookstore.gpo.gov/products/sku/017-001-00567-3
    The cost for 25 cards is $24.


    More Travel Websites



     

     

    QR code

    Michigan.gov Home
  • MDCH Home
  • Office of Regulatory Reinvention
  • Contact MDCH
  • State Web Sites
  • Spending & Accountability

  • Privacy Policy
  • Link Policy
  • Accessibility Policy
  • Security Policy
  • Michigan NewsMichigan.gov Survey

    Copyright © 2001-2013 State of Michigan