1793 Philadelphia yellow fever epidemic immune to the fever. Many of the slaves in Charleston in 1742 could have gained immunity before having been transported from Africa, by having been exposed to yellow fever in a mild case. People who survived one attack gained immunity. A total of 240 blacks died, in proportion to their population at the same rate as whites. Given the limited resources and knowledge of the times, the city's response was credible. The medical community did not know the natural history of yellow fever, a viral infection spread by the "Aedes aegypti" mosquito. Efforts to clean the city did not defeat
Yellow fever vaccine of age. Those travelling to areas where the disease occurs should also be immunized. Additional doses after the first are generally not needed. Yellow fever vaccine is generally safe. This includes in those with HIV infection but without symptoms. Mild side effects may include headache, muscle pains, pain at the injection site, fever, and rash. Severe allergies occur in about eight per million doses, serious neurological problems occur in about four per million doses, and organ failure occurs in about three per million doses. It is likely safe in pregnancy and therefore recommended among those who will be potentially exposed.