Stamaril

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Stamaril

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Method of action: Vaccine

Treatment option: Fever

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Stamaril

What is Stamaril?

Property Description
Active Ingredient Yellow fever virus strain 17D-204 live antigen
Form Powder and diluent for suspension for injection
Pharmacological Class Viral Vaccine (Immunological Agent)
Common Use Prophylaxis against yellow fever disease
Origin Biological product; produced in specified pathogen-free chick embryos

What Type of Medicine is the Stamaril Vaccine?

Stamaril is formally known as Yellow Fever Vaccine Live, a prescription-only, highly specific prophylactic immunological agent. It is classified within the pharmacological class of viral vaccines and, more specifically, as a live attenuated virus vaccine. This formulation, developed by Sanofi Pasteur, is clinically recognized for its ability to generate long-lasting immunity after administration. The fundamental purpose of this vaccine type is to confer active protection against a disease before exposure, rather than serving as a treatment for an existing infection.

Composition: Live Attenuated Strain 17D-204

The product's composition relies on the Yellow fever virus strain 17D-204 live antigen, which is derived from the original virulent Asibi strain through an established attenuation process. The vaccine is a biological product, with the antigen cultivated in specified pathogen-free chick embryos. The pharmaceutical form is a powder and diluent for suspension for injection, with the antigen supplied as a lyophilized (freeze-dried) powder that must be reconstituted with the accompanying sterile sodium chloride solution before administration. This stability-driven formulation is a differentiating factor ensuring the viability of the live antigen.

General Purpose: Prophylaxis Against Yellow Fever

The overarching purpose of Stamaril is to confer active immunization to individuals, typically nine months of age and older, against yellow fever disease, a serious acute viral illness caused by a mosquito-borne flavivirus. The use of the attenuated 17D-204 strain is intended to prompt the immune system to produce the necessary neutralizing antibodies and immunological memory. The vaccine is recommended for those traveling to or residing in areas of Africa and South America where the virus is known to be transmitted, supporting its role as an essential public health measure.

Regulatory References

  1. European Commission Public Health

What side effects are possible with Stamaril?

The possible side effects and safety profile of Stamaril, a live attenuated virus vaccine, are strictly documented in official regulatory labeling by frequency and affected body system.

Frequency-Classified Adverse Reactions

The most commonly reported adverse reactions are generally mild and transient. Very Common (ge 1/10) effects include headache, muscle pain (myalgia), general weakness (asthenia), and injection site pain/tenderness. In children, fever, vomiting, irritability, and appetite loss are also classified as very common. Common (ge 1/100 to < 1/10) reactions include fever (in adults), joint pain (arthralgia), nausea, rash, and injection site swelling or bruising. Reactions of Rare or Unknown frequency include diarrhea, swollen glands (lymphadenopathy), and severe allergic reactions like anaphylaxis.

Serious Adverse Reactions

The label details two specific, very rare adverse reactions associated with the live attenuated virus:

  • Yellow Fever Vaccine-Associated Neurotropic Disease (YEL-AND): A rare neurological syndrome with a reported onset typically within 30 days of vaccination.
  • Yellow Fever Vaccine-Associated Viscerotropic Disease (YEL-AVD): A rare, severe, multisystem illness resembling wild-type yellow fever infection, with a reported onset typically within 10 days of vaccination.

Population-Specific Safety Considerations

Official regulatory documents identify certain groups as having an increased documented risk for YEL-AND and YEL-AVD. This includes individuals aged 60 years and older and those with a history of thymus dysfunction or compromised immune systems. Due to the potential for transmission, a probable risk of YEL-AND in the infant is noted for infants exposed to the vaccine through breastfeeding. Additionally, the label documents that vaccination may lead to false positive results in serological tests for other flavivirus infections, such as dengue.

Overdose and Emergency Response

Overdose and When to Seek Help

Regulatory information on Stamaril overdose indicates that manifestations resulting from the administration of more than the recommended dose are consistent with the known safety profile of the vaccine. This means overdose primarily presents as the potential for severe, life-threatening adverse reactions.

Documented Manifestations and Severe Outcomes

The officially documented severe outcomes associated with the safety profile include Yellow Fever Vaccine-Associated Viscerotropic Disease (YEL-AVD) and Neurotropic Disease (YEL-AND).

  • Neurotropic Disease (YEL-AND) may involve high fever, confusion, seizures, or focal neurological deficit.
  • Viscerotropic Disease (YEL-AVD) may present with fever, hypotension, and can progress to multi-organ failure affecting the liver and kidneys.

Anaphylaxis or severe allergic reactions are also a documented, immediate risk.

Official Emergency Action Requirements

Immediate medical attention is required upon the onset of any symptoms suggestive of YEL-AND, YEL-AVD, or severe hypersensitivity reactions. Vaccinees should contact emergency services immediately if these symptoms develop.

Management for the associated severe reactions involves symptomatic and supportive treatment. Appropriate medical supervision must be readily available, and Adrenaline (epinephrine) must be accessible for the immediate management of anaphylactic shock. Individuals aged 60 years and older and infants below 9 months of age are officially noted as having an increased risk for these severe outcomes.

Therapeutic Uses of Stamaril

What Stamaril Treats: Main Uses and Benefits

The primary therapeutic benefit of Stamaril plays a role in managing the risk of Yellow Fever, a disease characterized by acute and disruptive episodes. Vaccination is a relevant preventive measure generally used when individuals are traveling to or residing in high-risk geographic zones, including parts of Africa and South America. This prophylactic approach is applied across domains where additional symptomatic support is needed, used to address symptom clusters that may become intense or disruptive.


In its role as a preventative treatment, Stamaril is relevant for managing symptoms associated with conditions marked by increased physiological stress. The vaccine helps ease the overall symptom burden, which may assist with reducing the risk of experiencing severe symptoms that interfere with daily functioning. This supports general well-being by helping to manage the risk of symptoms related to physical discomfort and systemic imbalance.

“The vaccine is considered relevant for individuals entering high-risk regions where the disease is prevalent.”

This preventative domain is applicable within clinical settings that involve acute or unstable symptom patterns, and it is commonly used when short-term symptomatic assistance is needed for travel and regulatory compliance. For the patient, this assists with maintaining functional stability and helps maintain a sense of stability by mitigating the risks associated with travel.


Quick Fact: Supports Systemic Stability

Eligibility and Restrictions for Use

The eligibility for Stamaril, a live attenuated virus vaccine, is strictly defined by regulatory bodies based on age, immune status, and specific health conditions. It is intended for active immunization in persons aged 9 months and older who are at risk of yellow fever or require proof of vaccination for travel.


Contraindications and Restrictions

Absolute Contraindications (Must Not Use):

Population Condition
Immune Status Severe immune suppression (congenital/acquired, e.g., symptomatic HIV, high-dose systemic steroids, history of thymus dysfunction or thymectomy).
Allergy History of severe allergic reactions to the vaccine, its components, eggs, or chicken proteins.
Age Children less than 6 months of age.

Conditional or Restricted Use:

Population Restriction Status
Older Adults (ge 60 years) Not routinely recommended; should be given only when the risk of infection is significant and unavoidable.
Infants (6–9 months) Not routinely recommended; use only under special circumstances and official advice.
Pregnancy/Lactation Should not be used unless clearly needed; requires a risk-benefit assessment by a healthcare professional.

Individuals with a bleeding disorder or on anticoagulant therapy are eligible but must not receive the vaccine via the intramuscular route; the subcutaneous route must be used instead. Vaccination must also be postponed in the presence of a moderate or severe acute illness.

What should I know about interactions with other medicines?

Interactions with other medicines and products for Stamaril are primarily classified as pharmacodynamic interactions, focusing on the vaccine's nature as a live attenuated virus.

Contraindicated Combinations

Co-administration with any immunosuppressant therapies is formally contraindicated. This class includes treatments such as cytotoxic agents, radiotherapy, and specific regimens of high-dose systemic corticosteroids. This strict prohibition is based on the official regulatory determination that immunosuppression carries a high risk of severe, vaccine-associated adverse reactions.

Timing and Separation Rules

If Stamaril is not administered concurrently with other live attenuated vaccines, regulatory labeling requires a minimum interval of 30 days or four weeks to avoid potential immune interference. In contrast, inactivated vaccines may be administered simultaneously or at any interval without required timing separation. Additionally, following a course of high-dose systemic corticosteroid therapy lasting 14 days or more, administration must be delayed until at least one month after the course is completed.

Pharmacokinetic Non-Interactions

Official regulatory documents confirm that Stamaril is not associated with documented interactions involving hepatic cytochrome P450 enzymes or drug transporters. Furthermore, no specific interaction warnings are noted in official labeling regarding food, alcohol, or herbal products. The labeling includes a specific note regarding individuals aged 60 years and older, who have an increased risk for rare, serious adverse events.

Mechanism of Action

Initial Immune System Engagement and Antigen Presentation

The core mechanism begins with the introduction of a weakened, live viral antigen (YFV 17D strain) that initiates a limited, non-pathogenic replication cycle within the body's local cells. This process acts directly upon Antigen-Presenting Cells (APCs), which capture the viral components and transport them to the lymph nodes, fulfilling the first critical step of immune signaling.


Activation of Adaptive Immunity and Humoral/Cellular Response

Once presented, the antigens engage the adaptive immune system, specifically triggering the proliferation and differentiation of T-cells and B-cells. This cascade modulates the immune response pathways, leading to the sustained production of neutralizing antibodies (humoral immunity) and the formation of memory lymphocytes (cellular immunity). This dual output results in a state where future exposure to the wild-type virus triggers both immediate neutralization by antibodies and cell destruction by T-cells, thereby limiting viral dissemination.


Establishing Long-Term Immunological Memory

The final, enduring physiological effect is the establishment of immunological memory, where highly specialized T-cells and B-cells are retained in a state of readiness. This provides a physiological defense system with a lowered activation threshold, enabling the immune system to launch an accelerated secondary response upon re-encounter with the pathogen. This rapid immune response modifies the course of subsequent viral exposure by limiting systemic dissemination.

Dosage and Administration Information

The administration of Stamaril is a standardized, single-dose protocol defined by regulatory documents. The product is supplied as a lyophilized powder and solvent for suspension for injection, and must be reconstituted immediately before use by mixing the powder with the accompanying sterile 0.4% sodium chloride solution diluent. This process ensures the proper preparation of the vaccine prior to administration.

The official administration routes for Stamaril are primarily by subcutaneous (SC) injection, though the intramuscular (IM) route may be used in accordance with official recommendations. The vaccine must not be mixed with any other medicinal product in the same syringe and must not be injected intravascularly (into a blood vessel). Administration is required to be performed by a qualified healthcare professional.

The standard primary regimen for active immunization is a single 0.5 mL dose, containing not less than 1000 International Units (IU) of the 17D-204 strain. This dose is uniform for adults and for most children aged nine months and older. The usage protocol is highly time-dependent, requiring administration at least 10 days prior to entering an area where the yellow fever virus is present. While official documentation states that protection from this single dose is expected to be long-lasting, a re-vaccination dose of 0.5 mL may be required every ten years, depending on current local regulations or for individuals at continued risk. For patients with bleeding disorders, special procedural instructions confirm that the SC route is utilized over the IM route.

Recent Clinical Evidence

Clinical Research on Active Immunization against Yellow Fever

The following overview synthesizes the clinical and scientific findings as described by regulatory and scientific sources regarding the Stamaril vaccine.

Research relevant to this indication was evaluated in randomized controlled trials (RCTs) and systematic reviews. Studies explored the development of neutralizing antibodies (seroconversion rate and GMT), which are used as a scientific surrogate endpoint instead of measuring rare clinical disease prevention. Findings demonstrated high measurements of these antibody outcomes during the first month following administration.

Research on the Durability of Protection and Follow-up

Research has specifically monitored the duration of the immune response in long-term observational cohorts. Studies tracked the persistence of neutralizing antibodies for follow-up durations that may extend up to 20 years and beyond. Findings indicate that the levels often appear to persist for long-term intervals in most individuals observed, contributing to the broader evidence landscape.

Evidence in Special Populations Studied

Studies evaluated the antibody outcomes in specific groups, including infants and children (starting from 9 months), older adults (60 years and over), and individuals with certain levels of immunocompromised conditions. Findings were generally consistent across many populations but may show varying patterns compared to healthy young adults, particularly in the youngest children.

Key Scientific Uncertainties and Research Gaps

What remains uncertain:

  • Surrogate Endpoints: The evidence is limited because the assessment relies on a surrogate endpoint (antibody level). Research is still clarifying the strength of the link between declining antibody levels and the maintenance of clinical protection.
  • Persistence in Subgroups: Data for certain groups remain insufficient, including those who are pregnant or severely immunocompromised. The consistency of antibody persistence may vary in infants vaccinated before 2 years of age, and this is an area where research is ongoing.
  • Applicability: Study results reflect the specific conditions under which they were conducted and apply only to the populations studied.

Frequently Asked Questions (FAQ)

Common questions about Stamaril (FAQ)

Q: How quickly do most people start to feel side effects after receiving the injection?

A: According to official product information, certain side effects—such as fever, headache, muscle stiffness, or tiredness—may occur roughly four to seven days after administration. This timing is typical as it aligns with the expected period for the immune system to begin its response to the vaccine.

Q: Why is a documented International Certificate of Vaccination often required for Stamaril?

A: The International Certificate of Vaccination (ICV) may be required by certain countries as a condition for entry, a rule established under the World Health Organization's International Health Regulations (IHR). This requirement supports the goal of limiting the international spread of yellow fever.

Q: Does Stamaril protect against other similar viruses, besides Yellow Fever?

A: Stamaril is strictly licensed and indicated for preventing yellow fever. While it is not intended to protect against other viruses, the official documentation notes that the vaccine may cause 'false positive results' in laboratory tests for similar flavivirus diseases, such as dengue or Japanese encephalitis.

Q: Why is Stamaril sometimes described as a vaccine with a low frequency of serious events?

A: This description is supported by pharmacovigilance data, which estimate the reporting rate for the most serious adverse events, like Yellow Fever Vaccine-Associated Viscerotropic Disease (YEL-AVD), to be very low. Data often cites a rate of serious reactions around 1 case per million doses administered globally.

Q: Why is the Yellow Fever virus described as being endemic in certain regions?

A: A region is classified as endemic where ongoing surveillance has shown a persistent risk of the disease, based on the presence of the virus in humans or animals, the presence of the mosquito vector, or the results of population sero-surveys.

Q: Where is the official regulatory information about Stamaril typically published?

A: Official information about Stamaril is published in documents such as the Summary of Product Characteristics (SmPC) in Europe, the Data Sheet in Australia and New Zealand, and similar Prescribing Information released by agencies like the FDA.

Q: Can Stamaril be given to individuals who have certain chronic health conditions?

A: If a chronic condition is not explicitly listed as a contraindication or special warning, it is generally not a required reason for postponement in official labeling.

Q: Are there known interactions between Stamaril and widely used medicines?

A: Official labeling strictly contraindicates the vaccine with immunosuppressive drugs. Beyond this, regulatory documents contain no general warnings regarding interactions with common food, alcohol, herbal products, or those involving liver enzymes.

Q: What safety classifications are applied to Stamaril in official documents?

A: The label emphasizes that certain risk groups, such as those 60 years and older, are subject to special warnings and require a risk-benefit assessment, as outlined in the official documentation.

Q: What is the definition of a contraindication related to Stamaril?

A: A contraindication is a condition or factor that prevents the administration of the vaccine because it would significantly increase the risk of a severe adverse reaction or render the vaccine ineffective. Therefore, a contraindication is a condition under which the product is designated as not for use.

Q: Is it acceptable to receive Stamaril if a person is mildly ill on the day of administration?

A: The official documentation specifies that postponement is required only for moderate or severe febrile or acute illness.

Q: Are there any known interactions between Stamaril and blood thinners?

A: While there is no pharmaceutical interaction that affects the vaccine's efficacy, official labeling specifies that the subcutaneous route is utilized over the intramuscular route for persons on anticoagulant therapy (blood thinners) or with bleeding disorders.

Q: What is the general expectation for onset of protective immunity after receiving Stamaril?

A: Studies and official information indicate that protective immunity begins to appear between 7 and 10 days after the primary dose. For this reason, official health regulations specify that the vaccine is administered at least 10 days before entering an area where yellow fever is a risk.

Q: What constitutes a rare side effect in the official safety information for Stamaril?

A: A rare side effect is defined as occurring in ge 1/10,000 to < 1/1,000 vaccinated individuals.

Q: Can Stamaril be administered to individuals with known HIV infection?

A: The official documentation indicates that eligibility for individuals with asymptomatic HIV infection requires a professional assessment based on their immune function status.

How should Stamaril be stored and disposed of?

Storage and Disposal Requirements

Requirement Category Official Storage Condition
Temperature Requirement Store in a refrigerator between 2 C and 8 C.
Protection Conditions Must be kept in the original outer carton to protect from light.
Freezing Restriction Do not freeze the vaccine under any circumstances.
Post-Reconstitution Stability The vaccine must be used immediately after reconstitution.
Child Safety Keep out of the sight and reach of children.
Disposal Rule Do not dispose of via wastewater or household waste.

Regulatory documents strictly define the storage environment for STAMARIL. The product requires a mandatory cold chain, maintaining a temperature between 2 C and 8 C, and must not be frozen. The active components are protected from light by requiring storage in the original packaging. After the powder is mixed with the solvent, the vaccine must be used immediately. All unused, expired, or reconstituted vaccine must be disposed of according to a pharmacist's guidance or local requirements for pharmaceutical waste.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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