As deadly yellow fever spreads to seven provinces of the Democratic Republic of Congo (DRC), new measures have been introduced to ensure that as many people as possible are immunised, despite global shortages of the yellow fever vaccine.
Global emergency stocks of just 6 million yellow fever vaccines have been strained by the current outbreak, which began in Angola and has now spread to neighbouring DRC.
To reach as many people as possible with the limited supply of vaccines, the World Health Organization (WHO) has started recommending the use of partial doses.
"Studies done in adults show that fractional dosing using one fifth of the regular dose provides effective immunity against yellow fever for at least 12 months and possibly much longer," WHO Spokesperson Tarik Jašarević told IPS.
The WHO began recommending that fractional doses could be used as an emergency measure in June 2016, ensuring additional doses would be available for mass vaccination campaigns in Angola and the DRC.
The WHO has also recently changed its recommendations for those who have already been immunised with a complete dose of the yellow fever vaccine.
"We know now that a single complete dose provides lifelong protection," said Jašarević.
"There is a global shortage and yellow fever vaccines take quite a long time to produce and I think there are only five outlets in the world that manufacture the vaccine," Heather Kerr, Save the Children.
The change in recommendation happened on 11 July 2016, but also applies retrospectively to those already carrying certificates of immunisation required for travel.
"This lifetime validity of these certificates applies automatically to certificates issued after 11 July 2016, as well as certificates already issued," said Jašarević.
The new measures will potentially mean that more doses are available for mass vaccination campaigns such as the one the DRC government began in Kinshasa this week.
IPS spoke with Heather Kerr who is the DRC Country Director of Save the Children, which is providing support to the DRC Ministry of Health's mass vaccination campaign.
"So far in DRC there are 74 actual confirmed cases and there've been 16 deaths from those cases," she said. This means that more than 20 percent of people who have contracted yellow fever in the DRC have died. The number of suspected cases in the DRC and Angola is much higher.
"Obviously a big city like Kinshasa worries us, we don't really know how many people there are in Kinshasa, no census has been done since the 1980s but we estimate around 10 million."
The current campaign aims to reach 420,000 people in Kinshasa over 10 days, said Kerr.
"The governments decision was in Kinshasa to use what's called the fractionalised dose, so it's a fifth of the normal dose."
Kerr says that since the fractional doses only provide protection for one year, revaccination will be required, but that hopefully by this time there will be more vaccines available globally.
"There is a global shortage and yellow fever vaccines take quite a long time to produce and I think there are only five outlets in the world that manufacture the vaccine," she said.
"There's no known cure for yellow fever," said Kerr. "Prevention is better than cure always, but in this case it really is, so that's why this vaccination campaign is so important."
In the early stages Kerr says that yellow fever either has hardly any symptoms or symptoms such as fever, nausea and diarrhea "which could be confused also with something like malaria."
"Then the more severe symptoms are bleeding because it's a haemorrhagic fever, and then people can become severely jaundiced and can go into organ failure and that's why it's called yellow fever."
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