An official yellow fever uniform stamp holder has the authority granted by the State of Wisconsin to administer yellow fever vaccine to the public. An official yellow fever stamp holder authorization is required to order and administer yellow fever vaccine. A uniform stamp on the International Certificate of Vaccination or Prophylaxis (ICVP) card is the international verification that an individual has been vaccinated against yellow fever.
Due to the risk of serious adverse events that can occur following yellow fever vaccine administration, providers should only vaccinate persons who: 1) are at risk for exposure to yellow fever virus, or 2) require proof of vaccination for country entry. To further minimize the risk of serious adverse events, medical providers should carefully observe the contraindications and consider the precautions to administration of yellow fever vaccine.
Wisconsin requirements to become an official Yellow Fever Uniform Stamp Holder:
- Applicants must be a physician (medical doctor or doctor of osteopathic medicine), physician assistant, or nurse practitioner licensed in the State of Wisconsin.
- Complete the Wisconsin State Uniform Stamp Application.
- Must complete the Yellow Fever Vaccine Course: Information for Health Care Professionals Advising Travelers online training course. Any staff advising travelers on the vaccine on behalf of the physician, physician assistant, or nurse practitioner should also complete the course.
- Read and understand the recommendations outlined by the CDC's Advisory Committee on Immunization Practices (ACIP).
- Agree to record each dose of yellow fever vaccine administered in the Wisconsin Immunization Registry (WIR). If you are not currently a WIR user please contact the WIR Help Desk at 608-266-9691. If providers are Regional Early Childhood Immunization Network (RECIN) users they will not need to become WIR users.
- Purchase an official yellow fever uniform stamp for each official Wisconsin Yellow Fever Vaccination Center.
- Give the Vaccine Information Statement (VIS) to every yellow fever vaccine recipient prior to administering the vaccine.
- Adhere to administration, storage, and handling requirements as indicated by ACIP and the yellow fever vaccine manufacturer.
- Administer yellow fever vaccine only at an official Wisconsin Yellow Fever Vaccination Center.
- Record yellow fever vaccine with official uniform stamp on the ICVP card. You can order the ICVP online or call 866-512-1800.
- Recertify as a yellow fever vaccination center every three years. The manufacturer will not ship yellow fever vaccine after the expiration date of the official yellow fever uniform stamp.
- Notify the Wisconsin Immunization Program if there is an address change for the yellow fever vaccination center.
- A maximum of five yellow fever centers may be registered under one provider.
Please submit the following:
- Wisconsin - State Yellow Fever Uniform Stamp Application F-00375 (PDF, 32 KB)
- Yellow Fever Vaccination Center Certification Acknowledgement Form F00376 (PDF, 17 KB)
- Health Care Professionals Advising Travelers online training course
Items must be mailed to:
Yellow Fever Certification
Wisconsin Immunization Program
1 W Wilson Street - Room 272
Madison WI 53701-2659
Or faxed to:
Once all information has been received and approved, you will be sent information on how to order your official yellow fever uniform stamp.
To locate Yellow Fever Vaccination Clinics in Wisconsin:
For questions about Yellow Fever Certification or Recertification:
Elise Balzer, Public Health Advisor
Wisconsin Division of Public Health
Bureau of Communicable Diseases
(Phone 608-266-7550) (Fax 608-267-9493)