Becoming a Yellow Fever Vaccine Provider
International Travel Clinics
An International Travel Clinic provides pre-travel risk assessments and education about health concerns to patients and provides necessary prophylaxis and vaccinations (including the yellow fever vaccine) as recommended or required for travel abroad.
Many countries require specific travel immunizations for visitors. International health regulations require that the yellow fever vaccine be administered only at designated yellow fever vaccination centers. In Indiana, healthcare providers who wish to become International Travel Clinics and administer yellow fever vaccine must apply and be approved by the Indiana Department of Health. Any physician (M.D. or D.O.) licensed in Indiana is eligible to become a certified yellow fever provider.
Application Process
1. Review the Yellow Fever Vaccine Certified Provider Application and verify that you meet the requirements to become a certified yellow fever vaccine provider.
2. Order your Uniform Stamp. Uniform stamps can be ordered at a local stationary office supply store. Physicians will use their Indiana medical license number for the third line of the uniform stamp, while local health departments will use county and city codes.
3. Submit the completed application form (including the imprint of the Uniform Stamp) to IDOH:
- Scan and e-mail your application to TravelHealth@health.IN.gov; OR
- Fax to 317-234-2812
4. Upon receipt of your application, IDOH staff will verify that all information is complete and accurate. Your approval to administer the yellow fever vaccine will be submitted to Sanofi Pasteur (manufacturer of the yellow fever vaccine). Orders for vaccines are placed by the provider directly through the manufacturer. Note that the yellow fever vaccine is shipped only to the provider and to the address indicated on the Yellow Fever Vaccine Certified Provider Application.
5. An annual report of vaccination and clinic activity will be requested by the IDOH International Travel Clinic program.
6. Notify the IDOH Travel Clinic program if there are any changes in the information (e.g., address, phone number, contact information, physician) included on your application.
Yellow Fever Vaccine Provider Forms
- Yellow Fever Vaccine Certified Provider Application Form
- Format of Yellow Fever Uniform Stamp
- City and County Codes (for LHDs only)
International Health Regulations
To comply with the International Health Regulations (2005), the CDC revised the International Certificate of Vaccination or Prophylaxis (ICVPs) in 2007. 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. The certificate of vaccination is valid for a period of 10 years, beginning 10 days after the date of vaccination. When a booster dose of the vaccine is given within this 10-year period, the certificate is considered valid from the date of revaccination. Travelers
should keep the ICVP with their passports at all times.
- Government Printing Office Bookstore (purchase ICVPs Cards)
Resources on Travel Health
- Centers for Disease Control and Prevention (CDC) - Travelers' Health
- CDC Yellow Book
- CDC Yellow Book - Vaccine-Preventable Diseases
- CDC Travelers' Health - Clinician Information Center
- Vaccine Information Statements (including Yellow Fever)
- Yellow Fever Vaccine Package Insert
- Vaccine Adverse Event Reporting System (VAERS)
- CDC Travelers' Health Medscape Video Blogs for Clinicians
- CDC Travelers' Health CE Courses and Training
Additional Travel Resources
- U.S. Department of State
- U.S. Citizenship and Immigration Services
- Immunization Action Coalition: International Travel Vaccinations
- The American Society of Tropical Medicine and Hygiene
- International Society of Travel Medicine
Contact Us
Sarah Bennett
sabennett@health.in.gov
463-203-3246
