Under International Health Regulations (IHR) (2005), yellow fever (YF) vaccine can only be administered at centres designated by the health administration for the territory in which it is situated.
“State Parties shall designate specific yellow fever vaccination centres (YFVCs) within their territories in order to ensure the quality and safety of the procedures and materials employed.” (IHR, May 2005, Annex 7.2.f)
Effective from date of designation for new YFVCs/renewal of registration for existing YFVCs (or sooner on request) the following conditions will apply to centres seeking designation as a YFVC in England, Wales and Northern Ireland (EWNI). The status as a designated YFVC is dependent on the YFVC having valid training and registration and the YFVC continuing to meet the Conditions of Designation and Code of Practice. The Code of Practice has to be signed by the Responsible Supervising Clinician (RSC) on initial registration, on renewal of registration and on re-instatement following de-designation.
These conditions are designed to ensure that individuals seeking YF vaccine prior to travelling abroad have access to a formally registered YFVC, are provided with appropriate travel advice, and to help assure the quality and the safety of the procedures and materials employed.
1. Requirements of Health Professionals and other key staff working at the YFVC
1.1 The Responsible Supervising Clinician (RSC) must assume responsibility for the YFVC and adhere to the conditions for designated status.
The RSC must be one of the following:
The RSC must be registered with a UK professional body (with unrestricted practice, and no ongoing investigations pending, warnings, cautions or suspensions), in accordance with the General Medical Council’s (GMC) Fitness to Practise procedures, NMC Code of Conduct or GPhC fitness to practise procedures.
1.2 The RSC is responsible for risk assessment and the administration of YF vaccine or can delegate the responsibility to another health professional (doctor, nurse or pharmacist), working at the YFVC.
1.3 Health professionals within the YFVC responsible for the administration of YF vaccine must be registered with their professional body (with unrestricted practice, and no ongoing investigations pending, warnings, cautions or suspensions), in accordance with the GMC’s Fitness to Practise procedures, NMC Code of Conduct or GPhC fitness to practise procedures.
1.4 All health professionals responsible for the administration of YF vaccine must comply with the requirements
necessary for designated status as a YFVC, including training recommendations and requirements.
1.5 An Administrative Lead, who will take responsibility for the administrative management of the YFVC, must be nominated for each YFVC. The Administrative Lead can be the Practice Manager or a nurse, doctor or pharmacist working at the YFVC and will be the first contact for the National Travel Health Network and Centre (NaTHNaC).
*Nurse independent prescribers are nurses who have successfully completed an NMC Independent Nurse Prescribing Course (also known as v200 or v300 courses).
2. Responsibilities of the RSC
The RSC shall:
2.1 Ensure compliance with the Conditions of Designation and the Code of Practice.
2.2 Ensure that all health professionals within the YFVC responsible for the administration of YF vaccine meet the criteria described in Condition 1.3.
2.3 Confirm that the clinic is registered with the relevant UK healthcare regulatory body (where appropriate), has an acceptable rating from this regulatory body (where appropriate) and is not in breach of the regulations relating to healthcare delivery of any authority.
2.3.1 Where a clinic is registered with the Care Quality Commission (CQC), the RSC shall confirm that in the most recent CQC inspection (where an inspection has been undertaken), a minimum rating of ‘good’ for each of the safe, effective and well-led domains*, was achieved.
2.3.2 Any clinic failing to meet these standards must notify NaTHNaC to discuss possible implications relating to designated status or re-designation. NaTHNaC must be assured that improvement measures will be undertaken and notified when a satisfactory re-inspection takes place. (not applicable to any existing or prospective YFVC awaiting inspection by the regulator)**.
2.4 Ensure that the YFVC notifies NaTHNaC within five working days of any breach of regulations leading to actions under the Health and Social Care Act 2008 or other relevant legislation. Such a breach may result in temporary suspension or de-designation with immediate effect.
2.5 Notify NaTHNaC within five working days of any changes at the YFVC that might affect the designation status of the YFVC. Changes include, but are not restricted to:
2.6 Be responsible for developing policies and ensuring health professionals working at the YFVC are appropriately trained (see Conditions 3.1 - 3.9) and competent to advise travellers in situations in which YF vaccine should be administered. Such knowledge and training should include:
2.7 Ensure the YFVC advises the traveller of risks related to YF, recommendation for YF vaccination and of certificate requirements for YF vaccination under International Health Regulations (IHR 2005). In circumstances where this is not possible, the RSC should ensure that the YFVC advises accordingly and if appropriate directs the traveller to an alternative source of such advice.
2.8 Recommend that all health professionals responsible for the administration of YF vaccine have completed classroom or online YF training and the YF online test according to Conditions 3.2, 3.5.
*Or where registered with the equivalent regulator in Wales (Healthcare Inspectorate Wales) or Northern Ireland (Regulation and Quality Improvement Authority, Northern Ireland), have met the standards required in equivalent domains, as required by that regulator.
**Revised: 17 November 2016
3. Training and Continuing Professional Development
4. Immunisation practices/medicines management
5. Record keeping and audit
|*YFVC should be aware that, due to lifelong validity, duplicate certificates can now be requested many years after vaccination but can only be issued where a satisfactory record exists.|
6. Designated status and renewal
i. All health professionals at YFVCs responsible for the administration of YF vaccine will be registered with a UK professional body (registration to be current and unrestricted as a Condition of Designation 1.1).
ii. Premises designated as a YFVC are required to be registered with the relevant UK healthcare regulatory body (where appropriate), will have an acceptable rating from the regulatory body, and will not be in breach of any regulations relating to any authority (as Conditions of Designation 2.3 - 2.3.2).
iii. All health professionals responsible for the administration of YF vaccine must comply with the requirements necessary for designated status as a YFVC including training recommendations and requirements.
iv. All health professionals administering YF vaccine must be appropriately trained and competent to advise travellers on issues relating to YF risk, vaccination and International Health Regulations.
v. Only YF vaccine approved by the World Health Organization (WHO) will be administered at the YFVC and facilities for administering, storing and disposal of vaccine will conform to recommended local policy and national standards.
vi. All records of vaccination for adults and children will be maintained, archived or disposed of in accordance with best practice (Condition of Designation 5.2).
vii. The International Certificate of Vaccination or Prophylaxis (ICVP) will be signed by an authorised health professional in accordance with International Health Regulations (2005).
viii. Vaccine associated adverse events will be reported to the Medicines and Healthcare products Regulatory Agency (MHRA), the vaccine manufacturer, and NaTHNaC.
ix. Annual returns of YF vaccine use will be provided electronically to NaTHNaC when requested.
x. Self-audit of clinical practice will be undertaken annually.
xi. Where any situation arises which may affect the designated status of the YFVC, as defined in the Conditions of Designation, the YFVC lead must notify NaTHNaC regarding continued designated status of the YFVC.
This is the member of staff nominated on behalf of your centre who is responsible for the administrative management of the YFVC, including ensuring YFVC details held by NaTHNaC are current; If the RSC leaves or changes it is the YFVC Admin Lead's responsibility to update the centre details on the Yellow Fever Zone (see Conditions of Designation and Code of Practice).
The YFVC Admin Lead role should not to be confused with the Responsible Supervising Clinican (RSC) role (please see below).
The YFVC Admin Lead can be the practice manager, practice nurse, doctor, or pharmacist with authorised access to the Yellow Fever Zone to help manage their centre(s). The portal contains their centre information, RSC details, annual returns, training and centre registration due dates, and allows the YFVC Admin Lead to arrange training through the online booking system.
Each prospective YFVC must nominate a RSC who will assume responsibility for the YFVC once designated status is confirmed, or may be the replacement of the previous RSC. There can only be one RSC for one YFVC, but multiple YFVC may have the same RSC.
The RSC must be a doctor, nurse or pharmacist registered with a UK professional body (with unrestricted practice, and no ongoing investigations pending, warnings, cautions or suspensions), in accordance with the General Medical Council’s (GMC) Fitness to Practise procedures, NMC Code of Conduct or GPhC fitness to practise procedures. Nurse RSCs must hold a prescribing qualification which is recognised by the Nursing and Midwifery Council (NMC) and recorded on the NMC register*. Pharmacist RSCs must hold a prescribing qualification which is recognised by the General Pharmaceutical Council (GPhC) and recorded on the GPhC register.
The RSC is bound by these Conditions of Designation and Code of Practice on behalf of the YFVC and is responsible for risk assessment and the administration of YF vaccine, or can delegate the responsiblity to health professionals (doctor, nurse or pharmacist only) working at the YFVC.
The RSC is responsible for ensuring health professionals are trained and competent to advise travellers as required in the context of YF and other travel health issues (or direct to source of advice).
The RSC must notify NaTHNaC (within five working days) of any situation which may compromise their own fitness to practise or that of other health professional to whom they have delegated responsibility for risk assessment and administration of YF vaccine.
*Nurse independent prescribers are nurses who have successfully completed an NMC Independent Nurse Prescribing Course (also known as v200 or v300 courses).
Other health professionals can be any doctor, nurse or pharmacist responsible for the risk assessment and the administration of YF vaccines at a YFVC who is not the RSC.
NaTHNaC yellow fever training (either online or classroom) is required of at least one health professional, working at the YFVC or multiple YFVCs, every 2 years. However, we recommend (i.e. this is preferred but optional) all those responsible for administering the vaccine to complete training for their own accountability and good practice.
Health professionals within the YFVC responsible for the administration of YF vaccine must be registered with their professional body (with unrestricted practice, and no ongoing investigations pending, warnings, cautions or suspensions), in accordance with the GMC’s Fitness to Practise procedures, NMC Code of Conduct or GPhC fitness to practise procedures.
YFVC registration is the payment of a non-refundable fee to confirm YFVC designation agreement with NaTHNaC after designated status approval has been confirmed (prospective centres) or during renewal (current YFVCs).
The current registration fee is £145 (annual) or £265 (biennial). The registration fee is reviewed periodically and subject to change at any time. The additional fee (difference) may be required if applicable.
All payments are currently paid to and processed by our Registration Fee Payment Centre: The Stationery Office (TSO).
Designated status must be initiated through YFVC registration (see Become a YFVC). For prospective YFVCs, registration is pending until all the designation requirements are met. Upon successful training completion, centres are required to pay the initial registration fee to TSO within 28 days of designation approval notification. This is the final and concluding process of becoming a YFVC. The process should take six weeks from the point of completing initial application to being designated. Designation approval for prospective centres will be revoked if registration is not completed.
Please note additional YFVC at different geographical location(s) or the same building require separate YFVC designation.
The centre registration renewal is a mandatory requirement in order to retain YFVC designated status. The registration fee must be paid annually or biennial by the YFVC registration renewal date to retain designated status.
Currently, centres will be sent registration renewal reminders and payment instructions by our agent, TSO. If you have any queries regarding registration payments, telephone TSO directly on 0333 200 2419.
NaTHNaC must be notified if registration cannot be renewed when due. NaTHNaC will only consider special and extenuating circumstances that are beyond YFVCs’ control.
YFVCs will be suspended from administering YF vaccine on the day current registration expires and subsequently de-designated (meaning enforced closure) if the registration fee is not paid to renew YFVC registration during suspension period. In accordance with the de-designation procedures, the centre is required to cease administering yellow fever vaccinations immediately and will no longer be able to purchase yellow fever vaccine(s).
Prospective centres and YFVCs must enrol at least one eligible person (RSC or health professional) to successfully complete the initial YF classroom training. RSCs administering YF vaccines on their own are required to successfully complete the initial YF classroom training. Thereafter, the same RSC, health professional or another eligible health worker must successfully complete update training (online or classroom if preferred) every two years.
Prospective YFVCs will not gain designated status if initial YF classroom training is not successfully completed as required or fails to provide evdience of a valid classroom training certificate at the time of their designation application. Online training is not accepted for prospective centres unless the centre can provide evidence of previous YF classroom training undertaken within an appropriate time period.
The YF classroom and online training both require booking, card payment (non-refundable) and trainee enrolment via the NaTHNaC Training Portal.
The current training fees are £105 (online training) and £195 (classroom training). The training fees are reviewed periodically and subject to change at any time.
All enrolled and trained persons will have their names held on the NaTHNaC learning management system.
Successfully completed YF training may be transferable to, or shared by different designated YFVC if the trained person(s) will be the individual or part of the team administering YF vaccines at these designated YFVC. The Admin Lead should notify NaTHNaC by email if this situation applies to the YFVC.
RSCs and/or Admin Leads will be notified if YF training is not successfully completed as required.
Prospective centres will not gain designated status if YF training is not successfully completed as required.
YFVCs will be suspended from administering YF vaccine on the day current YF training expires and subsequently de-designated if YF training is not successfully completed during suspension period.
NaTHNaC must be notified if YF training cannot be completed or renewed when due. NaTHNaC will only consider special and extenuating circumstances that are beyond centres’ control.
Prospective centres and YFVCs may re-enrol training applicant(s) if initial training was not successfully completed. Re-enrolment is unlimited until training is successfully completed but will required new training application and fee for each enrolment period (special and extenuating circumstances may be considered on a case-by-case basis). See Special Training Conditions at the NaTHNaC Training Portal.
All RSCs and health professionals advising on immunisation or administering vaccines must have received specific training in immunisation, including the recognition and treatment of anaphylaxis. Training must follow local policy in terms of frequency (at least biennial updates are recommended).
The compulsory training must be met by the YFVC (see above).
All RSCs and health professionals are accountable for their own practice and therefore, YF training (either online or classroom) is encouraged and recommended for all who administer YF vaccination.
A full day of study where you will be introduced to the epidemiology of yellow fever (YF), International Health Regulations (IHR), YF vaccine and risk assessment of the traveller visiting areas where YF vaccination is either recommended for personal protection, required to comply with IHR, or both. Lead by NaTHNaC trainers, the classroom experience has been designed to be stimulating and interactive, providing the opportunity to discuss a variety of scenarios that might be encountered in clinical practice. Classroom training aims to prepare health professionals who will provide a YF risk assessment and vaccination service, whether new to YF or working within an established Yellow Fever Vaccination Centre (YFVC).
Choose this option if you are:
A valid email address is also required for the person booking and paying for training if this is not the applicant.
Payment will only be accepted via online payment. The payment confirmation email will be sent to the email address provided. Check your junk or spam mail folder if the email is not in your inbox.
A valid email address and centre details must be provided for the trainee.
The Special Training Conditions on the NaTHNaC Training Portal contains all the information you need on the booking policy, training requirements, validity periods, cancellations, booking amends, refunds and late booking charge.
Classroom training enrolment
Online training enrolment
Only YF vaccine approved by World Health Organization will be administered.
Facilities for administering and storing vaccines must conform to recommended national standards.
NaTHNaC has no control over the manufacturing process and supply of YF vaccine, but if necessary NaTHNaC will work with the distributors of YF vaccine, the Medicines and Healthcare products Regulatory Agency (MHRA), public health authorities in EWNI and the Department of Health to address any vaccine availability issues in the UK.
YFVCs are responsible for the reporting and follow up of all vaccine associated adverse events. Vaccine associated adverse events must be reported to the MHRA via the yellow card system.
All serious adverse events related to YF vaccine should also be reported to NaTHNaC and the vaccine manufacturer.
The International Certificate of Vaccination or Prophylaxis (ICVP) must be completed and signed by the RSC or the health worker authorised by the RSC or a health professional in accordance with IHR (2005).
Children and Young Persons – Records of vaccination will be maintained until at least the traveller’s 25th birthday or 26th if the young person was 17 at the time of YF vaccination.
In the event of a closure of a YFVC, YF vaccination records must be archived according to the Data Protection Act 1998 and local guidelines.
An accurate log of vaccine refrigerator temperature (according to national guidance) must be maintained and made available for NaTHNaC inspection. Representatives of NaTHNaC may require access to YFVCs or request copies of all YFVC records.
It is now possible to order ICVP online using the NaTHNaC online shop.
Alternatively, orders and payment can placed by telephone on 0191 203 2329.
An information leaflet about yellow fever vaccine aimed at patients, and other resources are also available at the online shop.
YFVCs are required to use an official stamp on all ICVP.
In order to fit into the space provided in the ICVP supplied in the UK, the stamp should be approximately 10mm high and 20mm wide, using 6 – 8 point text size, preferable in Arial font.
The text should include only the UKYFVC identification number and the words United Kingdom:
(Please note, this image is not actual size)
Effective from 1 August 2014 conditions will apply to suppliers in relation to the supply of YF vaccine. The Supplier will assume responsibility for the supply of YF vaccine and adhere to the conditions outlined below, and this code will be reviewed on an annual basis.
These conditions are designed to ensure that only YFVC designated by the NaTHNaC in England, Wales, and Northern Ireland (EWNI) will be supplied with YF vaccine.
Suspension (temporary halt of YFVC service) will be initiated as a result of a breach of the Code of Practice or upon request. Suspension is for a 3 months period (maximum of 6 months in exceptional cases). YFVCs in breach of the Code of Practice must rectify the breach(es) during the suspension period. Suspension requests from YFVCs (e.g. due to staffing problems, vaccine supply/storage issues, site closure or repair work) must be submitted in writing to NaTHNaC and will be considered on a case-by-case basis.
YFVCs under suspension must not administer YF vaccine or provide any YFVC service during suspension and will be blocked from appearing on the NaTHNaC website YFVC directory.
NaTHNaC will send suspension notification to the YFVC and notify the vaccine manufacturer/suppliers. NaTHNaC will lift suspension once the breach(es) is rectified or when required within the agreed time frame and confirm this in writing.
De-designation will be initiated if the breach(es) is not remedied within the agreed time frame. YFVCs can appeal against suspension in writing but NaTHNaC reserves the right to deny an appeal request.
NaTHNaC may consider appeal requests on a case-by-case basis.
De-designation (cancellation of designated status) may either be initiated instantly or after a suspension period if the breach(es) is not remedied.
A de-designated YFVC will be removed from the NaTHNaC website YFVC directory, will no longer be able to purchase or administer YF vaccines and cannot continue as a YFVC.
NaTHNaC will send a de-designation notification to the YFVC and inform the vaccine manufacturer/suppliers. Please note that any continued use of YF vaccine at de-designated YFVC breaches the International Health Regulations (2005) and NaTHNaC will be obliged to report such practice accordingly.
De-designated YFVC can apply for designated status to be reinstated.
De-designated YFVC can appeal against de-designation in writing but NaTHNaC reserves the right to deny an appeal request. NaTHNaC may consider appeal requests on a case-by-case basis.
Where a YFVC wishes to withdraw designated status, the Admin Lead for that YFVC must notify NaTHNaC in writing. Verbal withdrawal requests cannot be accepted.
Withdrawn YFVC will be removed from the NaTHNaC website YFVC directory, will no longer be able to purchase or administer YF vaccines and cannot continue as a YFVC.
NaTHNaC will send a withdrawal notification to the YFVC and inform the vaccine manufacturer/suppliers.
Please note that any continued use of YF vaccine by a withdrawn YFVC breaches the International Health Regulations (2005) and NaTHNaC will be obliged to report such practice accordingly.
Withdrawn YFVC can apply online for designated status to be reinstated in accordance with the policies and procedures applicable at the time.
Any centre registration and/or training fees paid already are non-refundable as stipulated in the Conditions of Designation and Code of Practice.
If you wish to withdraw from being a YFVC, please contact NaTHNaC with your UKYFVC number, Centre address, postcode and a brief summary of your reasons for withdrawal.
To help you understand and prepare for submitting valid data, please familiarise yourself with the following:
Do not submit the Best Practice Checklist when submitting your Annual Return
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