Requirements for validity
This certificate is valid only if the vaccine or prophylaxis
used has been approved by the World Health Organiza
tion.
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This certificate must be signed in the hand of the
clinician, who shall be a medical practitioner or other
authorized health worker, supervising the administra
tion of the vaccine or prophylaxis. The certificate must
also bear the official stamp of the administering centre;
however, this shall not be an accepted substitute for the
signature.
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Any amendment of this certificate, or erasure, or
failure to complete any part of it, may render it invalid.
The validity of this certificate shall extend until the
date indicated for the particular vaccination or prophy
laxis. The certificate shall be fully completed in English
or in French. The certificate may also be completed in
another language on the same document, in addition to
either English or French.
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Notes
The only disease specifically designated in the Interna
tional Health Regulations (2005) for which proof of vac
cination or prophylaxis may be required as a condition of
entry to a State Party, is yellow fever. When administering
this vaccine, the clinician must write “Yellow Fever” in the
space provided on this certificate.
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This same certificate will also be used in the event that
these Regulations are amended or a recommendation is
made under these Regulations by the World Health Orga
nization to designate another disease.
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