A 76 year old couple with no major medical history are going on a trip to Africa. They fly from Miami ,Florida to Barcelona, Spain to spend a few days with their family. Then they fly to Nairobi, Kenya to change planes for a flight to Cape Town , SA. From South Africa they will go on a train to Tanzania and continue on a safari trip . This trip also includes a visit to the Victoria Falls.
It seems to me that this travel should not require a YF vaccine for this older couple. However, I'm worried that they may run into a problem with authorities in SA or Tanzania because of the transit through Nairobi. They may not have much problem in SA but I'm concerned about Tanzanian health policy and practice ( recent posts on this site have discussed some inconsistency ). I understand that South Africa, Mozambique and Tanzania do not require Yellow fever vaccination if traveling from the USA or Spain. This is an unusual situation as most my patients go straight to SA and then on to Tanzania and none of them had any issues with health authorities.
Should I give a certificate of waiver for YF? or....
I will appreciate any comments or suggestions .