YF-Vax Shortage: What Providers and Prescribers Need to Know in 2026

For travel medicine clinicians, infectious disease specialists, and primary care providers who administer travel vaccines, YF-Vax has been a consistent logistical challenge. The six-year national shortage (2015–2021), combined with the structural limitation of single-supplier status and restricted distribution, continues to shape how clinicians must approach yellow fever vaccination in 2026. This article provides a current clinical and operational overview for healthcare providers.

Current Supply Status (2026)

As of early 2026, YF-Vax (Sanofi Pasteur) is commercially available in the United States. The new production facility was FDA-licensed on December 26, 2020, and doses became available for clinical ordering beginning April 5, 2021. There is no active FDA drug shortage designation for YF-Vax.

Providers with a current Yellow Fever Vaccination Stamp from their state or territorial health department may order YF-Vax directly from Sanofi Pasteur. YF-Vax is available in single-dose and multi-dose (5-dose) vials (NDC 49281-0915-01).

Clinicians should be aware that while national supply is stable, individual clinic-level stockouts can still occur, particularly during periods of elevated travel health advisories. The CDC issued a Level 2 Travel Health Advisory for a yellow fever outbreak in South America in April 2025, which may have increased demand at some sites.

Shortage History: 2015–2021 and the Stamaril eIND Program

The shortage began in November 2015 when Sanofi Pasteur began transitioning YF-Vax production from their existing facility to a new site in Swiftwater, PA. A manufacturing complication during this transition caused significant dose losses. By spring 2016, CDC was notified that complete supply depletion was probable.

In response, CDC and FDA implemented an Expanded Access IND (eIND) protocol to import Stamaril (Sanofi Pasteur, France) — a 17D-strain yellow fever vaccine licensed in over 70 countries. A tiered clinic selection process was developed, prioritizing high-volume sites (>250 doses/month) to maintain geographic access while training participating sites in eIND protocol requirements. Approximately 250 U.S. clinical sites participated.

Enhanced safety surveillance was implemented during the Stamaril eIND period. Data showed YEL-AND incidence of 1.0 per 100,000 doses overall (6.2 per 100,000 in patients ≥60 years) and YEL-AVD incidence of 0.5 per 100,000 doses (2.1 per 100,000 in patients ≥60 years) — consistent with the YF-VAX safety profile. ICVP certificates issued under the eIND program are valid, and those patients are considered protected.

Clinical Considerations: Ordering and Administering YF-Vax

Key operational points for providers:

Authorization requirement: Only sites holding a valid Yellow Fever Vaccination Stamp from their state or territorial health department may order and administer YF-Vax.

Storage: Store at 2°–8°C. Do not freeze. The diluent vial should also not be frozen.

Reconstitution: Reconstitute immediately before use with the provided sterile diluent (Sodium Chloride Injection USP). Do not substitute diluent. Use within 60 minutes of reconstitution.

Dosing: Administer a single 0.5 mL subcutaneous injection. Subcutaneous route only — not IV, IM, or intradermal.

Multi-dose vials: The 5-dose vial is designed for use when multiple patients are vaccinated simultaneously. Schedule batches when possible to avoid wasting reconstituted vaccine.

ICVP documentation: Complete, sign, and stamp the International Certificate of Vaccination or Prophylaxis (ICVP) with the date, lot number, and manufacturer. The ICVP becomes valid 10 days after vaccination.

Key Contraindications and Precautions to Review Before Vaccination

Because YF-Vax carries a small but real risk of serious adverse events (YEL-AND and YEL-AVD), thorough pre-vaccination screening is essential. Absolute contraindications include:

Age <6 months

Immunodeficiency: primary or secondary (including HIV with CD4 <200 cells/mm³ or <15% of total lymphocytes in children <6 years)

Thymus disorder with abnormal immune cell function (e.g., myasthenia gravis, thymoma)

Hypersensitivity to vaccine components (chicken/egg protein, gelatin)

Precautions (individualized risk-benefit assessment required): age 6–8 months, age ≥60 years, asymptomatic HIV with moderate immunosuppression, pregnancy, and breastfeeding. The incidence of YEL-AVD is 1.2 per 100,000 doses in patients ≥60 years vs. 0.3 per 100,000 overall.

Helping Your Patients Find YF-Vax

If your clinic doesn't currently stock YF-Vax or a patient can't schedule in time, medfinder for providers can help. Providers can use medfinder to identify which authorized clinics near their patients currently have YF-Vax in stock, reducing patient frustration and ensuring they're vaccinated in time for their travel.

See also our full provider guide: How to help your patients find YF-Vax in stock and our patient-facing YF-Vax shortage update for 2026.