Another possible side effect is an infection of the nervous system, which occurs in one in 200,000 to 300,000 cases, causing yellow fever vaccine-associated neurotropic disease, which can lead to meningoencephalitis and is fatal in less than 5% of cases.The Yellow Fever Initiative, launched by the WHO in 2006, vaccinated more than 105 million people in 14 countries in West Africa. No outbreaks were reported during 2015. The campaign was supported by the GAVI alliance and governmental organizations in Europe and Africa. According to the WHO, mass vaccination cannot eliminate yellow fever because of the vast number of infected mosquitoes in urban areas of the target countries, but it will significantly reduce the number of people infected.Demand for yellow fever vaccine has continued to increase due to the growing number of countries implementing yellow fever vaccination as part of their routine immunization programmes. Recent upsurges in yellow fever outbreaks in Angola (2015), the Democratic Republic of Congo (2016), Uganda (2016), and more recently in Nigeria and Brazil in 2017 have further increased demand, while straining global vaccine supply. Therefore, to vaccinate susceptible populations in preventive mass immunization campaigns during outbreaks, fractional dosing of the vaccine is being considered as a dose-sparing strategy to maximize limited vaccine supplies. Fractional dose yellow fever vaccination refers to administration of a reduced volume of vaccine dose, which has been reconstituted as per manufacturer recommendations.
Mees lines or Aldrich–Mees lines, also called leukonychia striata, are white lines of discoloration across the nails of the fingers and toes (leukonychia). Presentation
They are typically white bands traversing the width of the nail. As the nail grows they move towards the end, and finally disappear when trimmed. Causes
Mees lines appear after an episode of poisoning with arsenic, thallium or other heavy metals or selenium, opioid MT-45, and can also appear if the subject is suffering from kidney failure. They have been observed in chemotherapy patients. Eponym and history
Although the phenomenon is named after Dutch physician R. A. Mees, who described the abnormality in 1919, earlier descriptions of the same abnormality were made by Englishman E. S. Reynolds in 1901 and by American C. J. Aldrich in 1904. See also
Leukonychia
List of cutaneous conditions
Muehrckes nails – a similar condition, except the lines are underneath the nails and so do not move as the nail grows

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