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Amanna IJ, Thomas A, Engelmann F, Hammarlund E, Raué HP, Bailey AL, Poore EA, Quintel BK, Lewis AD, Axthelm MK, Johnson AL, Colgin LMA, Diamond MS, Messaoudi I, Slifka MK. Development of a hydrogen peroxide-inactivated vaccine that protects against viscerotropic yellow fever in a non-human primate model. Cell Rep Med 2024; 5:101655. [PMID: 39019010 DOI: 10.1016/j.xcrm.2024.101655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/06/2024] [Accepted: 06/19/2024] [Indexed: 07/19/2024]
Abstract
Yellow fever virus (YFV) is endemic in >40 countries and causes viscerotropic disease with up to 20%-60% mortality. Successful live-attenuated yellow fever (YF) vaccines were developed in the mid-1930s, but their use is restricted or formally contraindicated in vulnerable populations including infants, the elderly, and people with compromised immune systems. In these studies, we describe the development of a next-generation hydrogen peroxide-inactivated YF vaccine and determine immune correlates of protection based on log neutralizing index (LNI) and neutralizing titer-50% (NT50) studies. In addition, we compare neutralizing antibody responses and protective efficacy of hydrogen peroxide-inactivated YF vaccine candidates to live-attenuated YFV-17D (YF-VAX) in a rhesus macaque model of viscerotropic YF. Our results indicate that an optimized, inactivated YF vaccine elicits protective antibody responses that prevent viral dissemination and lethal infection in rhesus macaques and may be a suitable alternative for vaccinating vulnerable populations who are not eligible to receive replicating live-attenuated YF vaccines.
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Affiliation(s)
- Ian J Amanna
- Najít Technologies, Inc., Beaverton, OR 97006, USA
| | - Archana Thomas
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Flora Engelmann
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, College of Medicine, Lexington, KY 40506, USA
| | - Erika Hammarlund
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Hans-Peter Raué
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Adam L Bailey
- Department of Pathology & Laboratory Medicine, University of Wisconsin - Madison, Madison, WI 53706, USA
| | | | | | - Anne D Lewis
- Division of Comparative Medicine, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Michael K Axthelm
- Division of Pathobiology & Immunology, Oregon National Primate Research Center, and The Vaccine & Gene Therapy Institute, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Amanda L Johnson
- Division of Comparative Medicine, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Lois M A Colgin
- Division of Comparative Medicine, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA
| | - Michael S Diamond
- Departments of Medicine, Molecular Microbiology, Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ilhem Messaoudi
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, College of Medicine, Lexington, KY 40506, USA
| | - Mark K Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR 97006, USA.
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2
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Ferrara P, Losa L, Mantovani LG, Ambrosioni J, Agüero F. Humoral immunogenicity of primary yellow fever vaccination in infants and children: a systematic review, meta-analysis and meta-regression. J Travel Med 2024; 31:taae039. [PMID: 38438165 DOI: 10.1093/jtm/taae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Vaccination plays a critical role in mitigating the burden associated with yellow fever (YF). However, there is a lack of comprehensive evidence on the humoral response to primary vaccination in the paediatric population, with several questions debated, including the response when the vaccine is administered at early ages, the effect of co-administration with other vaccines, the duration of immunity and the use of fractional doses, among others. This study summarizes the existing evidence regarding the humoral response to primary YF vaccination in infants and children. METHODS Studies on the humoral response to primary YF vaccination in children aged 12 years or younger were reviewed. The humoral vaccine response rate (VRR), i.e. the proportion of children who tested positive for vaccine-induced YF-specific neutralizing antibodies, was pooled through random-effects meta-analysis and categorized based on the time elapsed since vaccination. Subgroup, meta-regression and sensitivity analyses were performed. RESULTS A total of 33 articles met the inclusion criteria, with all but one conducted in countries where YF is endemic. A total of 14 028 infants and children entered this systematic review. Within three months following vaccination, the pooled VRR was 91.9% (95% CI 89.8-93.9). A lower VRR was observed with the 17DD vaccine at the meta-regression analysis. No significant differences in immunogenicity outcomes were observed based on age, administration route, co-administration with other vaccines, or fractional dosing. Results also indicate a decline in VRR over time. CONCLUSIONS Primary YF vaccination effectively provides humoral immunity in paediatric population. However, humoral response declines over time, and this decline is observable after the first 18 months following vaccination. A differential response according to the vaccine substrain was also observed. This research has valuable implications for stimulating further research on the primary YF vaccination in infants and children, as well as for informing future policies.
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Affiliation(s)
- Pietro Ferrara
- Center for Public Health Research (CESP), University of Milan-Bicocca, Monza, Italy
- Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Lorenzo Losa
- Center for Public Health Research (CESP), University of Milan-Bicocca, Monza, Italy
| | - Lorenzo G Mantovani
- Center for Public Health Research (CESP), University of Milan-Bicocca, Monza, Italy
- Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Juan Ambrosioni
- Infectious Disease Department, School of Medicine, University of Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clinic-Fundació de Recerca Clínic Barcelon-IDIBAPS, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Fernando Agüero
- Unit of Preventive Medicine, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain
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3
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Martin C, Dauby N. Guiding Yellow Fever Vaccination Strategy Worldwide: Booster = Better? Clin Infect Dis 2023; 76:1343-1344. [PMID: 36380420 DOI: 10.1093/cid/ciac890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Charlotte Martin
- Department of Infectious Diseases, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Dauby
- Department of Infectious Diseases, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
- Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium
- School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
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4
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Kling K, Domingo C, Bogdan C, Wilder-Smith A, Harder T. Reply to Martin and Dauby. Clin Infect Dis 2023; 76:1344-1345. [PMID: 36380452 PMCID: PMC10069844 DOI: 10.1093/cid/ciac891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Kerstin Kling
- Department of Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Cristina Domingo
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut – Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich Alexander Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Annelies Wilder-Smith
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Thomas Harder
- Department of Infectious Disease Epidemiology, Immunization Unit, Robert Koch Institute, Berlin, Germany
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5
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Ricciardi MJ, Rust LN, Pedreño-Lopez N, Yusova S, Biswas S, Webb GM, Gonzalez-Nieto L, Voigt TB, Louw JJ, Laurino FD, DiBello JR, Raué HP, Barber-Axthelm AM, Chun K, Uttke S, Raphael LMS, Yrizarry-Medina A, Rosen BC, Agnor R, Gao L, Labriola C, Axthelm M, Smedley J, Julander JG, Bonaldo MC, Walker LM, Messaoudi I, Slifka MK, Burton DR, Kallas EG, Sacha JB, Watkins DI, Burwitz BJ. Therapeutic neutralizing monoclonal antibody administration protects against lethal yellow fever virus infection. Sci Transl Med 2023; 15:eade5795. [PMID: 36989376 PMCID: PMC10617428 DOI: 10.1126/scitranslmed.ade5795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023]
Abstract
Yellow fever virus (YFV) is a reemerging global health threat, driven by several factors, including increased spread of the mosquito vector and rapid urbanization. Although a prophylactic vaccine exists, vaccine hesitancy, supply deficits, and distribution difficulties leave specific populations at risk of severe YFV disease, as evidenced by recent outbreaks in South America. To establish a treatment for patients with severe YFV infection, we tested 37 YFV-specific monoclonal antibodies isolated from vaccinated humans and identified two capable of potently neutralizing multiple pathogenic primary YFV isolates. Using both hamster and nonhuman primate models of lethal YFV infection, we demonstrate that a single administration of either of these two potently neutralizing antibodies during acute infection fully controlled viremia and prevented severe disease and death in treated animals. Given the potential severity of YFV-induced disease, our results show that these antibodies could be effective in saving lives and fill a much-needed void in managing YFV cases during outbreaks.
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Affiliation(s)
- Michael J. Ricciardi
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
- George Washington University, 2121 I St. NW, Washington, DC 20052, USA
| | - Lauren N. Rust
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Nuria Pedreño-Lopez
- George Washington University, 2121 I St. NW, Washington, DC 20052, USA
- IrsiCaixa AIDS Research Institute, Ctra. del Canyet SN, Badalona 08916, Barcelona, Spain
| | - Sofiya Yusova
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Sreya Biswas
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Gabriela M. Webb
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
| | | | - Thomas B. Voigt
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
- George Washington University, 2121 I St. NW, Washington, DC 20052, USA
| | - Johan J. Louw
- George Washington University, 2121 I St. NW, Washington, DC 20052, USA
| | | | - John R. DiBello
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
| | - Hans-Peter Raué
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Aaron M. Barber-Axthelm
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Kimberly Chun
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Samantha Uttke
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Lidiane M. S. Raphael
- Laboratório de Biologia Molecular de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Brandon C. Rosen
- Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Rebecca Agnor
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Lina Gao
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Caralyn Labriola
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Michael Axthelm
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Jeremy Smedley
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Justin G. Julander
- Institute for Antiviral Research, Utah State University, Logan, UT 84322, USA
| | - Myrna C. Bonaldo
- Laboratório de Biologia Molecular de Flavivírus, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Ilhem Messaoudi
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky, Lexington, KY 40536, USA
| | - Mark K. Slifka
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - Dennis R. Burton
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
- Department of Immunology and Microbiology, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Esper G. Kallas
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
- Department of Infectious and Parasitic Diseases, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Jonah B. Sacha
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
| | - David I. Watkins
- Mabloc LLC, 725 21st St. NW, Suite 301, Washington, DC 20052, USA
- George Washington University, 2121 I St. NW, Washington, DC 20052, USA
| | - Benjamin J. Burwitz
- Vaccine and Gene Therapy Institute, Oregon Health and Science University, Beaverton, OR 97006, USA
- Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR 97006, USA
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Kling K, Domingo C, Bogdan C, Mertens T, Wolff R, Wiedermann U. Comment on: “New recommendation on yellow fever booster vaccination in Germany”. Travel Med Infect Dis 2023; 52:102561. [PMID: 36967051 DOI: 10.1016/j.tmaid.2023.102561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/08/2023] [Accepted: 03/02/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Kerstin Kling
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
| | - Cristina Domingo
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany; Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Thomas Mertens
- Institut für Virologie, Universität Ulm und Universitätsklinikum, Ulm, Germany
| | - Robert Wolff
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | - Ursula Wiedermann
- Institut für Spezifische Prophylaxe und Tropenmedizin, Medizinische Universität Wien, Wien, Austria
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De Santis R, Faggioni G, Amoroso A, Ciammaruconi A, Pomponi A, Stella Lia M, Amatore D, Molinari F, Petralito G, Stefanelli P, Rezza G, Lista F. Durability of neutralizing antibodies against yellow fever virus after vaccination in healthy adults. Vaccine 2023; 41:2761-2763. [PMID: 36967285 DOI: 10.1016/j.vaccine.2023.03.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 12/07/2022] [Accepted: 03/10/2023] [Indexed: 04/07/2023]
Abstract
In accordance with the World Health Organization, one dose of yellow fever vaccine may guarantee protection lifelong in healthy adults. However, relatively little information is still available from ad hoc studies. We evaluated the persistence of neutralizing antibodies, which are considered to be an immune correlate of protection, in a large number of military personnel vaccinated up to 47 years before. Overall, 322 individuals were studied. The median time from vaccination to blood collection for neutralizing antibody evaluation was 9 years, ranging from <1 to 47 years. Of the 322 participants, 319 had neutralizing antibodies (99.1 %). The highest median PRNT50 value was observed in those vaccinated ≤1 year before (median PRNT50 = 320). In conclusion, our study confirms on a larger scale that, in healthy adults, neutralizing antibodies may persist as long as 47 years after a single yellow fever vaccines dose.
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8
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Collatuzzo G, De Palma G, Violante FS, Porru S, Larese Filon F, Fabianova E, Violán C, Vimercati L, Leustean M, Rodriguez-Suarez MM, Sansone E, Sala E, Zunarelli C, Lodi V, Monaco MGL, Spiteri G, Negro C, Beresova J, Carrasco-Ribelles LA, Tafuri S, Asafo SS, Ditano G, Abedini M, Boffetta P. Temporal trends of COVID-19 antibodies in vaccinated healthcare workers undergoing repeated serological sampling: An individual-level analysis within 13 months in the ORCHESTRA cohort. Front Immunol 2023; 13:1079884. [PMID: 36713452 PMCID: PMC9875291 DOI: 10.3389/fimmu.2022.1079884] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Short summary We investigated changes in serologic measurements after COVID-19 vaccination in 19,422 subjects. An individual-level analysis was performed on standardized measurements. Age, infection, vaccine doses, time between doses and serologies, and vaccine type were associated with changes in serologic levels within 13 months. Background Persistence of vaccine immunization is key for COVID-19 prevention. Methods We investigated the difference between two serologic measurements of anti-COVID-19 S1 antibodies in an individual-level analysis on 19,422 vaccinated healthcare workers (HCW) from Italy, Spain, Romania, and Slovakia, tested within 13 months from first dose. Differences in serologic levels were divided by the standard error of the cohort-specific distribution, obtaining standardized measurements. We fitted multivariate linear regression models to identify predictors of difference between two measurements. Results We observed a progressively decreasing difference in serologic levels from <30 days to 210-240 days. Age was associated with an increased difference in serologic levels. There was a greater difference between the two serologic measurements in infected HCW than in HCW who had never been infected; before the first measurement, infected HCW had a relative risk (RR) of 0.81 for one standard deviation in the difference [95% confidence interval (CI) 0.78-0.85]. The RRs for a 30-day increase in time between first dose and first serology, and between the two serologies, were 1.08 (95% CI 1.07-1.10) and 1.04 (95% CI 1.03-1.05), respectively. The first measurement was a strong predictor of subsequent antibody decrease (RR 1.60; 95% CI 1.56-1.64). Compared with Comirnaty, Spikevax (RR 0.83, 95% CI 0.75-0.92) and mixed vaccines (RR 0.61, 95% CI 0.51-0.74) were smaller decrease in serological level (RR 0.46; 95% CI 0.40-0.54). Conclusions Age, COVID-19 infection, number of doses, time between first dose and first serology, time between serologies, and type of vaccine were associated with differences between the two serologic measurements within a 13-month period.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesco S. Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy,Occupational Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Eleonora Fabianova
- Occupational Health Department, Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain,Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Barcelona, Spain,Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | | | - Marta Maria Rodriguez-Suarez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA) and Universitario Central de Asturias (HUCA), University of Oviedo, Oviedo, Spain
| | - Emanuele Sansone
- Occupational Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, ASST Ospedali Civili di Brescia, Brescia, Italy
| | - Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vittorio Lodi
- Occupational Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, Verona, Italy
| | - Corrado Negro
- Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Jana Beresova
- Occupational Health Department, Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - LucÌa A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mataró, Spain
| | - Silvio Tafuri
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Shuffield S. Asafo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy,Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, United States,*Correspondence: Paolo Boffetta,
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9
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Kling K, Domingo C, Bogdan C, Duffy S, Harder T, Howick J, Kleijnen J, McDermott K, Wichmann O, Wilder-Smith A, Wolff R. Duration of Protection After Vaccination Against Yellow Fever: A Systematic Review and Meta-Analysis. Clin Infect Dis 2022; 75:2266-2274. [PMID: 35856638 PMCID: PMC9761887 DOI: 10.1093/cid/ciac580] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/30/2022] [Accepted: 07/13/2022] [Indexed: 01/19/2023] Open
Abstract
The duration of protection after a single dose of yellow fever vaccine is a matter of debate. To summarize the current knowledge, we performed a systematic literature review and meta-analysis. Studies on the duration of protection after 1 and ≥2 vaccine doses were reviewed. Data were stratified by time since vaccination. In our meta-analysis, we used random-effects models. We identified 36 studies from 20 countries, comprising more than 17 000 participants aged 6 months to 85 years. Among healthy adults and children, pooled seroprotection rates after single vaccination dose were close to 100% by 3 months and remained high in adults for 5 to 10 years. In children vaccinated before age 2 years, the seroprotection rate was 52% within 5 years after primary vaccination. For immunodeficient persons, data indicate relevant waning. The extent of waning of seroprotection after yellow fever vaccination depends on age and immune status at primary vaccination.
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Affiliation(s)
- Kerstin Kling
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Cristina Domingo
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich Alexander Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Steven Duffy
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | - Thomas Harder
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Jeremy Howick
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
| | | | - Ole Wichmann
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Annelies Wilder-Smith
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Robert Wolff
- Kleijnen Systematic Reviews Ltd, York, United Kingdom
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10
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Douine M, Bonifay T, Lambert Y, Mutricy L, Galindo MS, Godin A, Bourhy P, Picardeau M, Saout M, Demar M, Sanna A, Mosnier E, Blaizot R, Couppié P, Nacher M, Adenis A, Suarez-Mutis M, Vreden S, Epelboin L, Schaub R. Zoonoses and gold mining: A cross-sectional study to assess yellow fever immunization, Q fever, leptospirosis and leishmaniasis among the population working on illegal mining camps in French Guiana. PLoS Negl Trop Dis 2022; 16:e0010326. [PMID: 35969647 PMCID: PMC9410546 DOI: 10.1371/journal.pntd.0010326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/25/2022] [Accepted: 06/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background Most emerging pathogens are zoonoses and have a wildlife origin. Anthropization and disruption of ecosystems favor the crossing of inter-species barriers. We hypothesize that the marginalized population of undocumented goldminers in the Amazon is at risk of acquiring zoonoses. Method A multicentric cross-sectional study included consenting gold-mining adult workers in 2019. A clinical examination recorded dermatological signs of leishmaniosis and past history of yellow fever vaccination. Biological tests were performed for yellow fever, Q fever and leptospirosis serologies. Additional blood samples from a previous study in 2015 were also tested for leptospirosis. Results In 2019, 380 individuals were included in the study, along with 407 samples from the 2015 biological collection. The seroprevalence of leptospirosis was 31.0% [95%CI = 26.4–35.5] in 2015 and 28.1% [23.5–32.7] in 2019. The seroprevalence of Q fever was 2.9% [1.2–4.6]. The majority of participants reported being vaccinated against yellow fever (93.6%) and 97.9% had seroneutralizing antibodies. The prevalence of suspected active mucocutaneous leishmaniasis was 2.4% [0.8–3.9]. Discussion These unique data shed new light on the transmission cycles of zoonoses still poorly understood in the region. They support the existence of a wild cycle of leptospirosis but not of Q fever. Leishmaniasis prevalence was high because of life conditions and tree felling. High yellow fever vaccine coverage was reassuring in this endemic area. In the era of global health, special attention must be paid to these vulnerable populations in direct contact with the tropical ecosystem and away from the health care system. Many pathogens are zoonotic in origin and human transmission can occur via vector, direct contact, inhalation, absorption, among other routes enabling human-reservoir interaction. In Amazonia, the cycle of these pathogens (the reservoir, the mode of transmission …) is not always well known. It is important to better understand these cycles in order to evaluate and anticipate the potential risk for human health, both on an individual and collective scale (risk of epidemic). In French Guiana, a French territory located in the Amazon, undocumented gold miners represent several thousand people mainly from Brazil who work in very remote areas in the middle of the rainforest. Documenting several zoonotic diseases among this population living in the middle of biodiversity is very valuable to better understand these cycles but also to assess the impact for their own health and to identify risks for public health. This article provides new data for four zoonoses: Q-fever, leptospirosis, leishmaniasis and yellow fever in this population and discusses the contributions to the understanding of cycles and public health issues.
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Affiliation(s)
- Maylis Douine
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Cayenne, French Guiana
- * E-mail:
| | - Timothée Bonifay
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Yann Lambert
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Louise Mutricy
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Muriel Suzanne Galindo
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Audrey Godin
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Pascale Bourhy
- National Reference Center for Leptospirosis, Biology of Spirochetes unit, Institut Pasteur, Paris, France
| | - Mathieu Picardeau
- National Reference Center for Leptospirosis, Biology of Spirochetes unit, Institut Pasteur, Paris, France
| | - Mona Saout
- TBIP, Université de la Guyane, Cayenne, French Guiana
| | - Magalie Demar
- TBIP, Université de la Guyane, Cayenne, French Guiana
- University Laboratory of Mycology-Parasitology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Alice Sanna
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Emilie Mosnier
- Delocalized Health Centers, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Romain Blaizot
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Department of Dermatology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Pierre Couppié
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Department of Dermatology, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Cayenne, French Guiana
| | - Antoine Adenis
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Centre de Ressources Biologiques Amazonie, Cayenne, French Guiana
| | - Martha Suarez-Mutis
- Laboratory of Parasitic Diseases, Institute Oswaldo Cruz/Fiocruz, Rio de Janeiro, Brazil
| | - Stephen Vreden
- Foundation for Scientific Research Suriname, Paramaribo, Suriname
| | - Loïc Epelboin
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
- Infectious and Tropical Diseases Unit, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Roxane Schaub
- Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424), Centre Hospitalier de Cayenne, Cayenne, French Guiana
- TBIP, Université de la Guyane, Cayenne, French Guiana
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11
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Wigg de Araújo Lagos L, de Jesus Lopes de Abreu A, Caetano R, Braga JU. Yellow fever vaccine safety in immunocompromised individuals: a systematic review and meta-analysis. J Travel Med 2022; 30:6659960. [PMID: 35947986 DOI: 10.1093/jtm/taac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Yellow fever is an arbovirus with variable severity, including severe forms with high mortality. The vaccination is the most effective measure to protect against the disease. Nonserious and serious adverse events have been described in immunocompromised individuals, but previous studies have failed to demonstrate this association. This systematic review assessed the risk of adverse events after yellow fever vaccination in immunocompromised individuals compared to its use in non-immunocompromised individuals. METHODS A search was conducted in the MEDLINE, LILACS, EMBASE, SCOPUS, DARE, Toxiline, Web of Science and grey literature databases for publications until February 2021. Randomized and quasi-randomized clinical trials and observational studies that included immunocompromised participants (individuals with HIV infection, organ transplants, with cancer, who used immunosuppressive drugs for rheumatologic diseases and those on immunosuppressive therapy for other diseases) were selected. The methodological quality of observational or non-randomized studies was assessed by the ROBINS-I tool. Two meta-analyses were performed, proportion and risk factor analyses, to identify the summary measure of relative risk (RR) in the studies that had variables suitable for combination. RESULTS Twenty-five studies were included, most with risk of bias classified as critical. Thirteen studies had enough data to carry out the proposed meta-analyses. Seven studies without a comparator group had their results aggregated in the proportion meta-analysis, identifying an 8.5% (95% CI 0.07-21.8) risk of immunocompromised individuals presenting adverse events after vaccination. Six cohort studies were combined, with an RR of 1.00 (95% CI 0.78-1.29). Subgroup analysis was performed according to the aetiology of immunosuppression and was also unable to identify an increased risk of adverse events following vaccination. CONCLUSIONS It is not possible to affirm that immunocompromised individuals, regardless of aetiology, have a higher risk of adverse events after receiving the yellow fever vaccine.
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Affiliation(s)
- Letícia Wigg de Araújo Lagos
- Núcleo de Avaliação de Tecnologias em Saúde (NATS), Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil
| | | | - Rosângela Caetano
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - José Ueleres Braga
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
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12
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Oyono MG, Kenmoe S, Abanda NN, Takuissu GR, Ebogo-Belobo JT, Kenfack-Momo R, Kengne-Nde C, Mbaga DS, Tchatchouang S, Kenfack-Zanguim J, Lontuo Fogang R, Zeuko’o Menkem E, Ndzie Ondigui JL, Kame-Ngasse GI, Magoudjou-Pekam JN, Bowo-Ngandji A, Nkie Esemu S, Ndip L. Epidemiology of yellow fever virus in humans, arthropods, and non-human primates in sub-Saharan Africa: A systematic review and meta-analysis. PLoS Negl Trop Dis 2022; 16:e0010610. [PMID: 35867659 PMCID: PMC9307179 DOI: 10.1371/journal.pntd.0010610] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/27/2022] [Indexed: 12/13/2022] Open
Abstract
Yellow fever (YF) has re-emerged in the last two decades causing several outbreaks in endemic countries and spreading to new receptive regions. This changing epidemiology of YF creates new challenges for global public health efforts. Yellow fever is caused by the yellow fever virus (YFV) that circulates between humans, the mosquito vector, and non-human primates (NHP). In this systematic review and meta-analysis, we review and analyse data on the case fatality rate (CFR) and prevalence of YFV in humans, and on the prevalence of YFV in arthropods, and NHP in sub-Saharan Africa (SSA). We performed a comprehensive literature search in PubMed, Web of Science, African Journal Online, and African Index Medicus databases. We included studies reporting data on the CFR and/or prevalence of YFV. Extracted data was verified and analysed using the random effect meta-analysis. We conducted subgroup, sensitivity analysis, and publication bias analyses using the random effect meta-analysis while I2 statistic was employed to determine heterogeneity. This review was registered with PROSPERO under the identification CRD42021242444. The final meta-analysis included 55 studies. The overall case fatality rate due to YFV was 31.1% (18.3–45.4) in humans and pooled prevalence of YFV infection was 9.4% (6.9–12.2) in humans. Only five studies in West and East Africa detected the YFV in mosquito species of the genus Aedes and in Anopheles funestus. In NHP, YFV antibodies were found only in members of the Cercopithecidae family. Our analysis provides evidence on the ongoing circulation of the YFV in humans, Aedes mosquitoes and NHP in SSA. These observations highlight the ongoing transmission of the YFV and its potential to cause large outbreaks in SSA. As such, strategies such as those proposed by the WHO’s Eliminate Yellow Fever Epidemics (EYE) initiative are urgently needed to control and prevent yellow fever outbreaks in SSA.
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Affiliation(s)
- Martin Gael Oyono
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
- Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, University of Yaounde I, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- * E-mail:
| | - Ngu Njei Abanda
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Cyprien Kengne-Nde
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | | | | | | | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
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13
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Yellow Fever: Origin, Epidemiology, Preventive Strategies and Future Prospects. Vaccines (Basel) 2022; 10:vaccines10030372. [PMID: 35335004 PMCID: PMC8955180 DOI: 10.3390/vaccines10030372] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 12/10/2022] Open
Abstract
Yellow fever (YF) virus still represents a major threat in low resource countries in both South America and Africa despite the presence of an effective vaccine. YF outbreaks are not only due to insufficient vaccine coverage for insufficient vaccine supply, but also to the increase in people without history of vaccination living in endemic areas. Globalization, continuous population growth, urbanization associated with inadequate public health infrastructure, and climate changes constitute important promoting factors for the spread of this virus to tropical and subtropical areas in mosquito-infested regions capable of spreading the disease. In the present review, we focus on the origin of the virus and its transmission, representing two debated topics throughout the nineteenth century, going deeply into the history of YF vaccines until the development of the vaccine still used nowadays. Besides surveillance, we highlight the urgent need of routine immunization and vaccination campaigns associated to diverse and innovative mosquito control technologies in endemic areas for YF virus in order to minimize the risk of new YF outbreaks and the global burden of YF in the future.
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14
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Martin C, Domingo C, Bottieau E, Buonfrate D, De Wit S, Van Laethem Y, Dauby N. Immunogenicity and duration of protection after yellow fever vaccine in people living with human immunodeficiency virus: a systematic review. Clin Microbiol Infect 2021; 27:958-967. [PMID: 33813107 DOI: 10.1016/j.cmi.2021.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND We lack the rationale on which to base the development of a yellow fever (YF) vaccination schedule for people living with human immunodeficiency virus (PLWHIV). OBJECTIVES To report on the current evidence regarding the seroconversion rate and the duration of humoral protection after YF vaccine, as well as the impact of revaccination in PLWHIV. DATA SOURCES MEDLINE, Google Scholar, LILACS and Cochrane CENTRAL were searched. METHODS We selected studies on PLWHIV of all ages (including perinatally HIV-infected patients) and all settings (YF endemic and non-endemic zones). Intervention investigated was vaccination against YF, at least once after the HIV diagnosis. The research questions were the seroconversion rate, duration of humoral immunity after YF vaccine and impact of revaccination in PLWHIV. Selected studies were assessed for quality using the Newcastle-Ottawa scale. RESULTS Ten, six and six studies were selected for the systematic review of each question, respectively. Only one study addressed the first question in perinatally HIV-infected children. The quality of the studies was assessed as Poor (n = 16), Fair (n = 2) or Good (n = 4). A meta-analysis demonstrated that 97.6% (95% CI 91.6%-100%) of the included population seroconverted. Between 1 and 10 years after YF vaccine, reported persistence of neutralizing antibodies was 72% (95% CI 53.6%-91%), and it was 62% (95% CI 45.4%-78.6%) more than 10 years after YF vaccine. No conclusions could be drawn on impact of revaccination because of the small number of patients. CONCLUSIONS The current evidence regarding seroconversion rate, duration of humoral protection after YF vaccine and impact of revaccination in PLWHIV is limited by the low number and quality of studies. Based on the presently available data, it is difficult to rationally develop yellow fever vaccination guidelines for PLWHIV.
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Affiliation(s)
- Charlotte Martin
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium.
| | - Cristina Domingo
- Robert Koch Institute, Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dora Buonfrate
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy
| | - Stéphane De Wit
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium
| | - Yves Van Laethem
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Dauby
- Infectious Diseases Department, Centre Hospitalier Universitaire Saint-Pierre-Université Libre de Bruxelles, Brussels, Belgium; Institute for Medical Immunology, Université Libre de Bruxelles, Brussels, Belgium; Environmental Health Research Centre, Public Health School, Université Libre de Bruxelles, Brussels, Belgium
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15
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Uchenna Emeribe A, Nasir Abdullahi I, O R Ajagbe O, Egede Ugwu C, Oloche Onoja S, Dahiru Abubakar S, Modesta Umeozuru C, Sunday Animasaun O, Omoruyi Omosigho P, Mukhtar Danmusa U, Alhaji Baba Mallam M, Saidu Aminu M, Yahaya H, Oyewusi S. Incidence, drivers and global health implications of the 2019/2020 yellow fever sporadic outbreaks in Sub-Saharan Africa. Pathog Dis 2021; 79:6178868. [PMID: 33739369 DOI: 10.1093/femspd/ftab017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
The 2019 and 2020 sporadic outbreaks of yellow fever (YF) in Sub-Saharan African countries had raised a lot of global health concerns. This article aims to narratively review the vector biology, YF vaccination program, environmental factors and climatic changes, and to understand how they could facilitate the reemergence of YF. This study comprehensively reviewed articles that focused on the interplay and complexity of YF virus (YFV) vector diversity/competence, YF vaccine immunodynamics and climatic change impacts on YFV transmission as they influence the 2019/2020 sporadic outbreaks in Sub-Saharan Africa (SSA). Based on available reports, vectorial migration, climatic changes and YF immunization level could be reasons for the re-mergence of YF at the community and national levels. Essentially, the drivers of YFV infection due to spillover are moderately constant. However, changes in land use and landscape have been shown to influence sylvan-to-urban spillover. Furthermore, increased precipitation and warmer temperatures due to climate change are likely to broaden the range of mosquitoes' habitat. The 2019/2020 YF outbreaks in SSA is basically a result of inadequate vaccination campaigns, YF surveillance and vector control. Consequently, and most importantly, adequate immunization coverage must be implemented and properly achieved under the responsibility of the public health stakeholders.
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Affiliation(s)
- Anthony Uchenna Emeribe
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, University of Calabar, PMB 1115, Calabar, Nigeria
| | - Idris Nasir Abdullahi
- Department of Medical Laboratory Science, Faculty of Allied Sciences, Ahmadu Bello University, PMB 05 along Samaru road, Zaria, Nigeria
| | - Odunayo O R Ajagbe
- Department of Medical Laboratory Science, Ebonyi State University, P.M.B. 053, Abakaliki, Nigeria
| | - Charles Egede Ugwu
- Solina Center for International Research and development, 8 Libreville Crescent, Ahmadu Bello Way Wuse II, Abuja 23409, Nigeria
| | - Solomon Oloche Onoja
- Nigeria Field Epidemiology and Laboratory Training Programme, African Field Epidemiology Programme, Plot 801, Ebitu Ukiwe Street, Jabi, Abuja, Nigeria
| | - Sharafudeen Dahiru Abubakar
- Department of Medical Laboratory Science, Faculty of Allied Sciences, Ahmadu Bello University, PMB 05 along Samaru road, Zaria, Nigeria
| | | | | | - Pius Omoruyi Omosigho
- Faculty of Pharmacy, Kaduna State University, Tafawa Balewa Way, PMB 2339, Kaduna, Nigeria
| | - Umar Mukhtar Danmusa
- Department of Medical Laboratory Science, University of Nigeria, PMB, 420001 Nsukka, Nigeria
| | - Mala Alhaji Baba Mallam
- Department of Nursing Science, Maryam Abacha American University of Niger, ADS Avenue, Roi Muhammed VI Du Maroc Maradi, Republique Du Niger
| | - Maijiddah Saidu Aminu
- Department of Nursing Science, Maryam Abacha American University of Niger, ADS Avenue, Roi Muhammed VI Du Maroc Maradi, Republique Du Niger
| | - Hadiza Yahaya
- Department of Nursing Science, Maryam Abacha American University of Niger, ADS Avenue, Roi Muhammed VI Du Maroc Maradi, Republique Du Niger
| | - Silifat Oyewusi
- Department of Nursing Science, Maryam Abacha American University of Niger, ADS Avenue, Roi Muhammed VI Du Maroc Maradi, Republique Du Niger
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16
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Bifani AM, Ong EZ, de Alwis R. Vaccination and Therapeutics: Responding to the Changing Epidemiology of Yellow Fever. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020; 12:398-409. [PMID: 33173445 PMCID: PMC7644428 DOI: 10.1007/s40506-020-00237-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2020] [Indexed: 12/24/2022]
Abstract
At the turn of the nineteenth century, yellow fever (YF) was considered the most dangerous infectious disease with high case fatality. Subsequent, mass vaccination campaigns coupled with widespread elimination of the YF mosquito vector significantly decreased YF cases and reduced outbreaks to the tropical and subtropical forested regions of Africa and South America. However, recent (2016) large outbreaks in Angola, Democratic Republic of Congo (DRC), and South-Eastern Brazil, where previously had been demarcated as low-risk regions, have highlighted the possibility of a rapidly changing epidemiology and the potential re-emergence of yellow fever virus (YFV). Furthermore, the first-ever importation of YFV into Asia has highlighted the potential fear of YFV emerging as a global threat. In this review, we describe the changing epidemiology of YF outbreaks, and highlight the use of public health policies, therapeutics, and vaccination as tools to help eliminate future YFV outbreaks.
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Affiliation(s)
- Amanda Makha Bifani
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
| | - Eugenia Z. Ong
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
- Viral Research and Experimental Medicine Centre @ SingHealth Duke-NUS (VIREMiCS), Singapore, Singapore
| | - Ruklanthi de Alwis
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
- Viral Research and Experimental Medicine Centre @ SingHealth Duke-NUS (VIREMiCS), Singapore, Singapore
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17
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Valim V, Machado KLLL, Miyamoto ST, Pinto AD, Rocha PCM, Serrano EV, Dinis VG, Gouvêa SA, Dias JGF, Campi-Azevedo AC, Teixeira-Carvalho A, Peruhype-Magalhães V, da Costa-Rocha IA, de Lima SMB, Miranda EH, Trindade GF, Maia MDLDS, Gavi MBRDO, da Silva LB, Duque RH, Gianordoli APE, Casagrande TZ, Oliveira KG, Moura BCDM, Nicole-Batista F, Rodrigues LC, Clemente TB, Magalhães ES, Bissoli MDF, Gouvea MDPG, Pinto-Neto LFDS, Costa CZ, Giovelli RA, Brandão LR, Polito ETL, Koehlert IDO, Borjaille BP, Pereira DB, Dias LH, Merlo DL, Genelhu LFF, Pretti FZ, Giacomin MDS, Burian APN, Fantinato FFST, Pileggi GS, da Mota LMH, Martins-Filho OA. Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study. Front Immunol 2020; 11:1382. [PMID: 32765496 PMCID: PMC7379374 DOI: 10.3389/fimmu.2020.01382] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 05/29/2020] [Indexed: 12/16/2022] Open
Abstract
Yellow Fever (YF) vaccination is suggested to induce a large number of adverse events (AE) and suboptimal responses in patients with autoimmune diseases (AID); however, there have been no studies on 17DD-YF primary vaccination performance in patients with AID. This prospective non-interventional study conducted between March and July, 2017 assessed the safety and immunogenicity of planned 17DD-YF primary vaccination in patients with AID. Adult patients with AID (both sexes) were enrolled, along with healthy controls, at a single hospital (Vitória, Brazil). Included patients were referred for planned vaccination by a rheumatologist; in remission, or with low disease activity; and had low level immunosuppression or the attending physician advised interruption of immunosuppression for safety reasons. The occurrence of AE, neutralizing antibody kinetics, seropositivity rates, and 17DD-YF viremia were evaluated at various time points (day 0 (D0), D3, D4, D5, D6, D14, and D28). Individuals evaluated (n = 278), including patients with rheumatoid arthritis (RA; 79), spondyloarthritis (SpA; 59), systemic sclerosis (8), systemic lupus erythematosus (SLE; 27), primary Sjögren's syndrome (SS; 54), and healthy controls (HC; 51). Only mild AE were reported. The frequency of local and systemic AE in patients with AID and HC did not differ significantly (8 vs. 10% and 21 vs. 32%; p = 1.00 and 0.18, respectively). Patients with AID presented late seroconversion profiles according to kinetic timelines of the plaque reduction neutralization test (PRNT). PRNT-determined virus titers (copies/mL) [181 (95% confidence interval (CI), 144–228) vs. 440 (95% CI, 291–665), p = 0.004] and seropositivity rate (78 vs. 96%, p = 0.01) were lower in patients with AID after 28 days, particularly those with SpA (73%) and SLE (73%), relative to HC. The YF viremia peak (RNAnemia) was 5–6 days after vaccination in all groups. In conclusion, consistent seroconversion rates were observed in patients with AID and our findings support that planned 17DD-YF primary vaccination is safe and immunogenic in patients with AID.
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Affiliation(s)
- Valéria Valim
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Ketty Lysie Libardi Lira Machado
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Samira Tatiyama Miyamoto
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Arthur Dalmaso Pinto
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Priscila Costa Martins Rocha
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Erica Vieira Serrano
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Valquiria Garcia Dinis
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.,Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, Brazil
| | - Sônia Alves Gouvêa
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - João Gabriel Fragoso Dias
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | | | | | | | | | - Sheila Maria Barbosa de Lima
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Emily Hime Miranda
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Gisela Freitas Trindade
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | | | | | - Lidia Balarini da Silva
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Ruben Horst Duque
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Ana Paula Espíndula Gianordoli
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Thays Zanon Casagrande
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Karine Gadioli Oliveira
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Bruna Costa da Mata Moura
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Fernanda Nicole-Batista
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Luiza Correa Rodrigues
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Thalles Brandão Clemente
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Enan Sales Magalhães
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Maria de Fatima Bissoli
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | - Maria da Penha Gomes Gouvea
- Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil
| | | | | | | | | | | | | | | | | | - Laiza Hombre Dias
- Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil
| | | | | | - Flavia Zon Pretti
- Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil
| | | | - Ana Paula Neves Burian
- Centro de Referências para Imunobiológicos Especiais (CRIE) da Secretaria de Saúde do Estado do Espírito Santo, Vitória, Brazil
| | | | | | - Lícia Maria Henrique da Mota
- Divisão de Reumatologia do Hospital Universitário de Brasília, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
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Vaccination and Therapeutics: Responding to the Changing Epidemiology of Yellow Fever. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2020; 12:349-360. [PMID: 32837338 PMCID: PMC7351566 DOI: 10.1007/s40506-020-00232-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose of Review At the turn of the nineteenth century, yellow fever (YF) was considered the most dangerous infectious disease with high case fatality. Subsequent, mass vaccination campaigns coupled with widespread elimination of the YF mosquito vector significantly decreased YF cases and reduced outbreaks to the tropical and subtropical forested regions of Africa and South America. Recent Findings However, recent (2016) large outbreaks in Angola, Democratic Republic of Congo (DRC), and South-Eastern Brazil, where previously had been demarcated as low-risk regions, have highlighted the possibility of a rapidly changing epidemiology and the potential re-emergence of yellow fever virus (YFV). Furthermore, the first-ever importation of YFV into Asia has highlighted the potential fear of YFV emerging as a global threat. Summary In this review, we describe the changing epidemiology of YF outbreaks and highlight the use of public health policies, therapeutics, and vaccination as tools to help eliminate future YFV outbreaks.
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Staples JE, Barrett ADT, Wilder-Smith A, Hombach J. Review of data and knowledge gaps regarding yellow fever vaccine-induced immunity and duration of protection. NPJ Vaccines 2020; 5:54. [PMID: 32655896 PMCID: PMC7338446 DOI: 10.1038/s41541-020-0205-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/29/2020] [Indexed: 12/13/2022] Open
Abstract
Yellow fever (YF) virus is a mosquito-borne flavivirus found in Sub-Saharan Africa and tropical South America. The virus causes YF, a viral hemorrhagic fever, which can be prevented by a live-attenuated vaccine, strain 17D. Despite the vaccine being very successful at decreasing disease risk, YF is considered a re-emerging disease due to the increased numbers of cases in the last 30 years. Until 2014, the vaccine was recommended to be administered with boosters every 10 years, but in 2014 the World Health Organization recommended removal of booster doses for all except special populations. This recommendation has been questioned and there have been reports of waning antibody titers in adults over time and more recently in pediatric populations. Clearly, the potential of waning antibody titers is a very important issue that needs to be carefully evaluated. In this Perspective, we review what is known about the correlate of protection for full-dose YF vaccine, current information on waning antibody titers, and gaps in knowledge. Overall, fundamental questions exist on the durability of protective immunity induced by YF vaccine, but interpretation of studies is complicated by the use of different assays and different cut-offs to measure seroprotective immunity, and differing results among certain endemic versus non-endemic populations. Notwithstanding the above, there are few well-characterized reports of vaccine failures, which one would expect to observe potentially more with the re-emergence of a severe disease. Overall, there is a need to improve YF disease surveillance, increase primary vaccination coverage rates in at-risk populations, and expand our understanding of the mechanism of protection of YF vaccine.
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Affiliation(s)
- J. Erin Staples
- Arboviral Diseases Branch, U.S. Centers for Disease Control and Prevention, Fort Collins, CO USA
| | - Alan D. T. Barrett
- Department of Pathology and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX USA
| | - Annelies Wilder-Smith
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
- London School of Hygiene and Tropical Medicine, London, UK
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20
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Kareko BW, Booty BL, Nix CD, Lyski ZL, Slifka MK, Amanna IJ, Messer WB. Persistence of Neutralizing Antibody Responses Among Yellow Fever Virus 17D Vaccinees Living in a Nonendemic Setting. J Infect Dis 2020; 221:2018-2025. [PMID: 31545367 PMCID: PMC7289542 DOI: 10.1093/infdis/jiz374] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 08/13/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The once-in-a-lifetime recommendation for vaccination against yellow fever virus (YFV) has been controversial, leading to increased scrutiny of the durability of immunity after 17D vaccination. METHODS This is a cross-sectional analysis of 17D vaccinees living in nonendemic Portland, Oregon. Neutralization assays were used to determine YFV immunity. The relationships between 17D immunity and vaccination history, demographics, and travel were evaluated using nominal logistic regression. RESULTS Seventy-one of 92 (77.2%) subjects were YFV seropositive (90 percent plaque reduction neutralization test ≥1:10) at all timepoints, and 24 of 38 (63.8%) were YFV seropositive at ≥10 years after single-dose vaccination. No relationship was found between YFV immunity and time in endemic countries, other flavivirus immunity, or demographics. Subjects were most likely to become seronegative between 3 and 12 years postvaccination (logistic regression, odds ratio [OR] = 1.75; 95% confidence interval [CI], 1.12-2.73). A comparison of our results and 4 previous studies of YFV nonendemic vaccinees found that overall, 79% (95% CI, 70%-86%) of vaccinees are likely to be seropositive ≥10 years postvaccination. CONCLUSIONS These results suggest that 1 in 5 17D vaccinees will lack neutralizing antibodies at ~10 years postvaccination, and a booster vaccination should be considered for nonendemic vaccinees before travel to regions where there is a high risk of YFV transmission.
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Affiliation(s)
- Bettie W Kareko
- Department of Molecular Microbiology and Immunology, Portland
| | - Brian L Booty
- Oregon Clinical and Translational Research Institute, Portland
| | - Chad D Nix
- Department of Infection Prevention and Control, Portland
| | - Zoe L Lyski
- Department of Molecular Microbiology and Immunology, Portland
| | - Mark K Slifka
- Department of Molecular Microbiology and Immunology, Portland
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton
| | | | - William B Messer
- Department of Molecular Microbiology and Immunology, Portland
- Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University,, Portland
- OHSU-PSU School of Public Health, Oregon Health and Science University
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21
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Long-Term Protection of Rhesus Macaques from Zika Virus Reinfection. J Virol 2020; 94:JVI.01881-19. [PMID: 31801867 PMCID: PMC7022347 DOI: 10.1128/jvi.01881-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/25/2019] [Indexed: 01/07/2023] Open
Abstract
By the end of the 2016 Zika virus (ZIKV) outbreak, it is estimated that there were up to 100 million infections in the Americas. In approximately one in seven infants born to mothers infected during pregnancy, ZIKV has been linked to microcephaly, developmental delays, or other congenital disorders collectively known as congenital Zika syndrome, as well as Guillain-Barré syndrome, in ZIKV-infected adults. It is a global health priority to develop a vaccine against ZIKV that elicits long-lasting immunity; however, the durability of immunity to ZIKV is unknown. Previous studies in mice and nonhuman primates have been crucial in vaccine development but have not defined the duration of immunity generated by ZIKV infection. In this study, we rechallenged five rhesus macaques with ZIKV 22 to 28 months after a primary ZIKV infection. We show that primary ZIKV infection generates high titers of neutralizing antibodies that protect from detectable plasma viremia following rechallenge and persist for at least 22 to 28 months. While additional longitudinal studies are necessary with longer time frames, this study establishes a new experimentally defined minimal length of protective ZIKV immunity.IMPORTANCE ZIKV emerged as a vector-borne pathogen capable of causing illness in infected adults and congenital birth defects in infants born to mothers infected during pregnancy. Despite the decrease in ZIKV cases since the 2015-2016 epidemic, questions concerning the prevalence and longevity of protective immunity have left vulnerable communities fearful that they may become the center of next ZIKV outbreak. Although preexisting herd immunity in regions of past outbreaks may dampen the potential for future outbreaks to occur, we currently do not know the longevity of protective immunity to ZIKV after a person becomes infected. Here, we establish a new experimentally defined minimal length of protective ZIKV immunity. We show that five rhesus macaques initially infected with ZIKV 22 to 28 months prior to rechallenge elicit a durable immune response that protected from detectable plasma viremia. This study establishes a new minimal length of protective immunity.
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22
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Chen LH, Wilson ME. Yellow fever control: current epidemiology and vaccination strategies. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2020; 6:1. [PMID: 31938550 PMCID: PMC6954598 DOI: 10.1186/s40794-020-0101-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/05/2020] [Indexed: 12/16/2022]
Abstract
Yellow fever (YF) outbreaks continue, have expanded into new areas and threaten large populations in South America and Africa. Predicting where epidemics might occur must take into account local mosquito populations and specific YF virus strain, as well as ecoclimatic conditions, sociopolitical and demographic factors including population size, density, and mobility, and vaccine coverage. Populations of Aedes aegypti and Aedes albopictus from different regions vary in susceptibility to and capacity to transmit YF virus. YF virus cannot be eliminated today because the virus circulates in animal reservoirs, but human disease could be eliminated with wide use of the vaccine. WHO EYE (Eliminate Yellow Fever Epidemics) is a welcome plan to control YF, with strategies to be carried out from 2017 to 2026: to expand use of YF vaccine, to prevent international spread, and to contain outbreaks rapidly. YF vaccination is the mainstay in controlling YF outbreaks, but global supply is insufficient. Therefore, dose-sparing strategies have been proposed including fractional dosing and intradermal administration. Fractional dosing has been effectively used in outbreak control but currently does not satisfy International Health Regulations; special documentation is needed for international travel. Vector control is another facet in preventing YF outbreaks, and novel methods are being considered and proposed.
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Affiliation(s)
- Lin H Chen
- 1Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138 USA.,2Harvard Medical School, Boston, MA USA
| | - Mary E Wilson
- 3Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA USA.,4Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, USA
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23
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Domingo C, Fraissinet J, Ansah PO, Kelly C, Bhat N, Sow SO, Mejía JE. Long-term immunity against yellow fever in children vaccinated during infancy: a longitudinal cohort study. THE LANCET. INFECTIOUS DISEASES 2019; 19:1363-1370. [PMID: 31543249 PMCID: PMC6892259 DOI: 10.1016/s1473-3099(19)30323-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/24/2019] [Accepted: 06/07/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND A single dose of vaccine against yellow fever is routinely administered to infants aged 9-12 months under the Expanded Programme on Immunization, but the long-term outcome of vaccination in this age group is unknown. We aimed to evaluate the long-term persistence of neutralising antibodies to yellow fever virus following routine vaccination in infancy. METHODS We did a longitudinal cohort study, using a microneutralisation assay to measure protective antibodies against yellow fever in Malian and Ghanaian children vaccinated around age 9 months and followed up for 4·5 years (Mali), or 2·3 and 6·0 years (Ghana). Healthy children with available day-0 sera, a complete follow-up history, and no record of yellow fever revaccination were included; children seropositive for yellow fever at baseline were excluded. We standardised antibody concentrations with reference to the yellow fever WHO International Standard. FINDINGS We included 587 Malian and 436 Ghanaian children vaccinated between June 5, 2009, and Dec 26, 2012. In the Malian group, 296 (50·4%, 95% CI 46·4-54·5) were seropositive (antibody concentration ≥0·5 IU/mL) 4·5 years after vaccination. Among the Ghanaian children, 121 (27·8%, 23·5-32·0) were seropositive after 2·3 years. These results show a large decrease from the proportions of seropositive infants 28 days after vaccination, 96·7% in Mali and 72·7% in Ghana, reported by a previous study of both study populations. The number of seropositive children increased to 188 (43·1%, 95% CI 38·5-47·8) in the Ghanaian group 6·0 years after vaccination, but this result might be confounded by unrecorded revaccination or natural infection with wild yellow fever virus during a 2011-12 outbreak in northern Ghana. INTERPRETATION Rapid waning of immunity during the early years after vaccination of 9-month-old infants argues for a revision of the single-dose recommendation for this target population in endemic countries. The short duration of immunity in many vaccinees suggests that booster vaccination is necessary to meet the 80% population immunity threshold for prevention of yellow fever outbreaks. FUNDING Wellcome Trust.
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Affiliation(s)
- Cristina Domingo
- Robert Koch Institute, Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany.
| | - Juliane Fraissinet
- Robert Koch Institute, Highly Pathogenic Viruses (ZBS 1), Centre for Biological Threats and Special Pathogens, WHO Collaborating Centre for Emerging Infections and Biological Threats, Berlin, Germany
| | - Patrick O Ansah
- Navrongo Health Research Centre and Research Laboratory, Navrongo, Ghana
| | | | | | - Samba O Sow
- National Institute of Research on Public Health, Bamako, Mali
| | - José E Mejía
- Centre de Physiopathologie Toulouse-Purpan (CNRS, INSERM, Université Paul Sabatier), Centre Hospitalier Universitaire Purpan, Toulouse, France
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24
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Disease Resurgence, Production Capability Issues and Safety Concerns in the Context of an Aging Population: Is There a Need for a New Yellow Fever Vaccine? Vaccines (Basel) 2019; 7:vaccines7040179. [PMID: 31717289 PMCID: PMC6963298 DOI: 10.3390/vaccines7040179] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/19/2022] Open
Abstract
Yellow fever is a potentially fatal, mosquito-borne viral disease that appears to be experiencing a resurgence in endemic areas in Africa and South America and spreading to non-endemic areas despite an effective vaccine. This trend has increased the level of concern about the disease and the potential for importation to areas in Asia with ecological conditions that can sustain yellow fever virus transmission. In this article, we provide a broad overview of yellow fever burden of disease, natural history, treatment, vaccine, prevention and control initiatives, and vaccine and therapeutic agent development efforts.
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25
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26
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Visser LG, Veit O, Chen LH. Waning immunity after single-dose yellow fever vaccination: Who needs a second shot? J Travel Med 2019; 26:5200559. [PMID: 30476151 DOI: 10.1093/jtm/tay134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/21/2018] [Indexed: 11/13/2022]
Affiliation(s)
- Leo G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Olivia Veit
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Institute of Epidemiology, Biostatistics and Prevention, University of Zürich, Switzerland
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA, USA.,Faculty of Medicine, Harvard Medical School, Boston, MA, USA
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Campi-Azevedo AC, Reis LR, Peruhype-Magalhães V, Coelho-dos-Reis JG, Antonelli LR, Fonseca CT, Costa-Pereira C, Souza-Fagundes EM, da Costa-Rocha IA, Mambrini JVDM, Lemos JAC, Ribeiro JGL, Caldas IR, Camacho LAB, Maia MDLDS, de Noronha TG, de Lima SMB, Simões M, Freire MDS, Martins RDM, Homma A, Tauil PL, Vasconcelos PFC, Romano APM, Domingues CM, Teixeira-Carvalho A, Martins-Filho OA. Short-Lived Immunity After 17DD Yellow Fever Single Dose Indicates That Booster Vaccination May Be Required to Guarantee Protective Immunity in Children. Front Immunol 2019; 10:2192. [PMID: 31616412 PMCID: PMC6775283 DOI: 10.3389/fimmu.2019.02192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/30/2019] [Indexed: 12/27/2022] Open
Abstract
The Yellow Fever (YF) vaccination is recommended for people living in endemic areas and represents the most effective strategy to reduce the risk of infection. Previous studies have warned that booster regimens should be considered to guarantee the long-term persistence of 17DD-YF-specific memory components in adults living in areas with YF-virus circulation. Considering the lower seroconversion rates observed in children (9-12 months of age) as compared to adults, this study was designed in order to access the duration of immunity in single-dose vaccinated children in a 10-years cross-sectional time-span. The levels of neutralizing antibodies (PRNT) and the phenotypic/functional memory status of T and B-cells were measured at a baseline, 30-45 days, 1, 2, 4, 7, and 10 years following primary vaccination. The results revealed that a single dose induced 85% of seropositivity at 30-45 days and a progressive time-dependent decrease was observed as early as 2 years and declines toward critical values (below 60%) at time-spans of ≥4-years. Moreover, short-lived YF-specific cellular immunity, mediated by memory T and B-cells was also observed after 4-years. Predicted probability and resultant memory analysis emphasize that correlates of protection (PRNT; effector memory CD8+ T-cells; non-classical memory B-cells) wane to critical values within ≥4-years after primary vaccination. Together, these results clearly demonstrate the decline of 17DD-YF-specific memory response along time in children primarily vaccinated at 9-12 months of age and support the need of booster regimen to guarantee the long-term persistence of memory components for children living in areas with high risk of YF transmission.
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Affiliation(s)
| | - Laise Rodrigues Reis
- Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | | | | | - Lis Ribeiro Antonelli
- Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Marisol Simões
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | - Marcos da Silva Freire
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Akira Homma
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | - Pedro Luiz Tauil
- Faculdade de Medicina, Universidade de Brasília, Brasilia, Brazil
| | | | - Alessandro Pecego Martins Romano
- Departamento de Imunização e Doenças Transmissíveis (DEIDT) – Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasilia, Brazil
| | - Carla Magda Domingues
- Programa Nacional de Imunizações – Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasilia, Brazil
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Chang L, Lim BCW, Flaherty GT, Torresi J. Travel vaccination recommendations and infection risk in HIV-positive travellers. J Travel Med 2019; 26:5486056. [PMID: 31066446 DOI: 10.1093/jtm/taz034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/26/2019] [Accepted: 04/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND With the advent of highly active antiretroviral drugs for the treatment of human immunodeficiency virus (HIV) it has become possible for people with HIV to travel to destinations that may place them at risk of a number of infectious diseases. Prevention of infections by vaccination is therefore of paramount importance for these travellers. However, vaccine responsiveness in HIV-positive individuals is not infrequently reduced compared to HIV-negative individuals. An understanding of the expected immune responses to vaccines in HIV-positive travellers is therefore important in planning the best approach to a pretravel consultation. METHODS A PubMed search was performed on HIV or acquired immune deficiency syndrome together with a search for specific vaccines. Review of the literature was performed to develop recommendations on vaccinations for HIV-positive travellers to high-risk destinations. RESULTS The immune responses to several vaccines are reduced in HIV-positive people. In the case of vaccines for hepatitis A, hepatitis B, influenza, pneumococcus, meningococcus and yellow fever there is a good body of data in the literature showing reduced immune responsiveness and also to help guide appropriate vaccination strategies. For other vaccines like Japanese encephalitis, rabies, typhoid fever, polio and cholera the data are not as robust; however, it is still possible to gain some understanding of the reduced responses seen with these vaccines. CONCLUSION This review provides a summary of the immunological responses to commonly used vaccines for the HIV-positive travellers. This information will help guide travel medicine practitioners in making decisions about vaccination and boosting of travellers with HIV.
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Affiliation(s)
- Lisa Chang
- Department of Microbiology, Dorevitch Pathology, Melbourne, Victoria, Australia
| | - Bryan Chang Wei Lim
- School of Medicine, National University of Ireland, Galway, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Gerard T Flaherty
- School of Medicine, National University of Ireland, Galway, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Joseph Torresi
- Department of Microbiology and Immunology, Peter Doherty Institute, The University of Melbourne, Parkville, Victoria, Australia
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Campi-Azevedo AC, Peruhype-Magalhāes V, Coelho-Dos-Reis JG, Antonelli LR, Costa-Pereira C, Speziali E, Reis LR, Lemos JA, Ribeiro JGL, Bastos Camacho LA, de Sousa Maia MDL, Barbosa de Lima SM, Simões M, de Menezes Martins R, Homma A, Cota Malaquias LC, Tauil PL, Costa Vasconcelos PF, Martins Romano AP, Domingues CM, Teixeira-Carvalho A, Martins-Filho OA. 17DD Yellow Fever Revaccination and Heightened Long-Term Immunity in Populations of Disease-Endemic Areas, Brazil. Emerg Infect Dis 2019; 25:1511-1521. [PMID: 31298654 PMCID: PMC6649311 DOI: 10.3201/eid2508.181432] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We evaluated the duration of neutralizing antibodies and the status of 17DD vaccine–specific T- and B-cell memory following primary and revaccination regimens for yellow fever (YF) in Brazil. We observed progressive decline of plaque-reduction neutralization test (PRNT) seropositivity and of the levels of effector memory CD4+ and CD8+ T cells, as well as interferon-γ+CD8+ T cells, 10 years after primary vaccination. Revaccination restored PRNT seropositivity as well as the levels of effector memory CD4+, CD8+, and interferon-γ+CD8+ T cells. Moreover, secondary or multiple vaccinations guarantee long-term persistence of PRNT positivity and cell-mediated memory 10 years after booster vaccination. These findings support the relevance of booster doses to heighten the 17DD-YF–specific immune response to guarantee the long-term persistence of memory components. Secondary or multiple vaccinations improved the correlates of protection triggered by 17DD-YF primary vaccination, indicating that booster regimens are needed to achieve efficient immunity in areas with high risk for virus transmission.
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Duration of immunity in recipients of two doses of 17DD yellow fever vaccine. Vaccine 2019; 37:5129-5135. [DOI: 10.1016/j.vaccine.2019.05.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 10/26/2022]
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Ribeiro AF, Cavalin RF, Abdul Hamid Suleiman JM, Alves da Costa J, Januaria de Vasconcelos M, Sant’Ana Málaque CM, Sztajnbok J. Yellow Fever: Factors Associated with Death in a Hospital of Reference in Infectious Diseases, São Paulo, Brazil, 2018. Am J Trop Med Hyg 2019; 101:180-188. [PMID: 31134884 PMCID: PMC6609182 DOI: 10.4269/ajtmh.18-0882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 04/10/2019] [Indexed: 11/07/2022] Open
Abstract
Faced with the reemergence of yellow fever (YF) in the metropolitan region of São Paulo, Brazil, we developed a retrospective study to describe the cases of YF attended at the Institute of Infectology Emilio Ribas from January to March 2018 and analyze the factors associated with death, from the information obtained in the hospital epidemiological investigation. A total of 72 cases of sylvatic YF were confirmed, with 21 deaths (29.2% lethality rate). Cases were concentrated in males (80.6%) and in the age group of 30 to 59 years (56.9%). Two logistic regression models were performed, with continuous variables adjusted for the time between onset of symptoms and hospitalization. The first model indicated age (odds ratiosadjusted [ORadj]: 1.038; CI 95%: 1.008-1.212), aspartate aminotransferase (AST) (ORadj: 1.038; CI 95%: 1.005-1.072), and creatinine (ORadj: 2.343; CI 95%: 1.205-4.553) were independent factors associated with mortality. The second model indicated age (ORadj: 1.136; CI 95%: 1.013-1.275), alanine aminotransferase (ALT) (ORadj: 1.118; CI 95%: 1.018-1.228), and creatinine (ORadj: 2.835; CI 95%: 1.352-5,941). The risk of death in the model with continuous variables was calculated from the increase of 1 year (age), 1 mg/dL (creatinine), and 100 U/L for AST and ALT. Another logistic regression analysis with dichotomous variables indicated AST > 1,841 IU/L (ORadj: 12.92; CI 95%: 1.50-111.37) and creatinine > 1.2 mg/dL (ORadj: 81.47; CI 95%: 11.33-585.71) as independent factors associated with death. These results may contribute to the appropriate clinical management of patients with YF in health-care services and improve the response to outbreaks and public health emergencies.
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Affiliation(s)
- Ana Freitas Ribeiro
- Institute of Infectology Emilio Ribas, São Paulo, Brazil
- Nove de Julho University, São Paulo, Brazil
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Slifka MK, Amanna IJ. Role of Multivalency and Antigenic Threshold in Generating Protective Antibody Responses. Front Immunol 2019; 10:956. [PMID: 31118935 PMCID: PMC6504826 DOI: 10.3389/fimmu.2019.00956] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/15/2019] [Indexed: 12/03/2022] Open
Abstract
Vaccines play a vital role in protecting our communities against infectious disease. Unfortunately, some vaccines provide only partial protection or in some cases vaccine-mediated immunity may wane rapidly, resulting in either increased susceptibility to that disease or a requirement for more booster vaccinations in order to maintain immunity above a protective level. The durability of antibody responses after infection or vaccination appears to be intrinsically determined by the structural biology of the antigen, with multivalent protein antigens often providing more long-lived immunity than monovalent antigens. This forms the basis for the Imprinted Lifespan model describing the differential survival of long-lived plasma cell populations. There are, however, exceptions to this rule with examples of highly attenuated live virus vaccines that are rapidly cleared and elicit only short-lived immunity despite the expression of multivalent surface epitopes. These exceptions have led to the concept that multivalency alone may not reliably determine the duration of protective humoral immune responses unless a minimum number of long-lived plasma cells are generated by reaching an appropriate antigenic threshold of B cell stimulation. Examples of long-term and in some cases, potentially lifelong antibody responses following immunization against human papilloma virus (HPV), Japanese encephalitis virus (JEV), Hepatitis B virus (HBV), and Hepatitis A virus (HAV) provide several lessons in understanding durable serological memory in human subjects. Moreover, studies involving influenza vaccination provide the unique opportunity to compare the durability of hemagglutinin (HA)-specific antibody titers mounted in response to antigenically repetitive whole virus (i.e., multivalent HA), or detergent-disrupted “split” virus, in comparison to the long-term immune responses induced by natural influenza infection. Here, we discuss the underlying mechanisms that may be associated with the induction of protective immunity by long-lived plasma cells and their importance in future vaccine design.
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Affiliation(s)
- Mark K Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, OR, United States
| | - Ian J Amanna
- Najít Technologies, Inc., Beaverton, OR, United States
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Pileggi GS, Da Mota LMH, Kakehasi AM, De Souza AW, Rocha A, de Melo AKG, da Fonte CAM, Bortoletto C, Brenol CV, Marques CDL, Zaltman C, Borba EF, Reis ER, Freire EAM, Klumb EM, Christopoulos GB, Laurindo IMM, Ballalai I, Da Costa IP, Michelin L, de Azevêdo Valadares LD, Chebli LA, Lacerda M, Toscano MAF, Yazbek MA, De Abreu Vieira RMR, Magalhães R, Kfouri R, Richtmann R, Merenlender SDCS, Valim V, De Assis MR, Kowalski SC, Trevisani VFM. Brazilian recommendations on the safety and effectiveness of the yellow fever vaccination in patients with chronic immune-mediated inflammatory diseases. Adv Rheumatol 2019; 59:17. [PMID: 31036077 DOI: 10.1186/s42358-019-0056-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Brazil, we are facing an alarming epidemic scenario of Yellow fever (YF), which is reaching the most populous areas of the country in unvaccinated people. Vaccination is the only effective tool to prevent YF. In special situations, such as patients with chronic immune-mediated inflammatory diseases (CIMID), undergoing immunosuppressive therapy, as a higher risk of severe adverse events may occur, assessment of the risk-benefit ratio of the yellow fever vaccine (YFV) should be performed on an individual level. Faced with the scarcity of specific orientation on YFV for this special group of patients, the Brazilian Rheumatology Society (BRS) endorsed a project aiming the development of individualized YFV recommendations for patients with CIMID, guided by questions addressed by both medical professionals and patients, followed an internationally validated methodology (GIN-McMaster Guideline Development). Firstly, a systematic review was carried out and an expert panel formed to take part of the decision process, comprising BRS clinical practitioners, as well as individuals from the Brazilian Dermatology Society (BDS), Brazilian Inflammatory Bowel Diseases Study Group (GEDIIB), and specialists on infectious diseases and vaccination (from Tropical Medicine, Infectious Diseases and Immunizations National Societies); in addition, two representatives of patient groups were included as members of the panel. When the quality of the evidence was low or there was a lack of evidence to determine the recommendations, the decisions were based on the expert opinion panel and a Delphi approach was performed. A recommendation was accepted upon achieving ≥80% agreement among the panel, including the patient representatives. As a result, eight recommendations were developed regarding the safety of YFV in patients with CIMID, considering the immunosuppression degree conferred by the treatment used. It was not possible to establish recommendations on the effectiveness of YFV in these patients as there is no consistent evidence to support these recommendations. CONCLUSION This paper approaches a real need, assessed by clinicians and patient care groups, to address specific questions on the management of YFV in patients with CIMID living or traveling to YF endemic areas, involving specialists from many areas together with patients, and might have global applicability, contributing to and supporting vaccination practices. We recommended a shared decision-making approach on taking or not the YFV.
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Affiliation(s)
- Gecilmara Salviato Pileggi
- SBR. Faculdade de Ciências da Saúde de Barretos - FACISB, Barretos, São Paulo, Brazil. .,School of Medical Science Barretos- FACISB, Avenue Masonic Lodge Renovadora 68, No. 100 - Airport Neighborhood, Barretos/SP, 14785-002, Brazil.
| | | | - Adriana Maria Kakehasi
- SBR. Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Aline Rocha
- Pós graduanda do programa de Medicina Baseada em Evidências, Universidade Federal do Estado de São Paulo (UNIFESP), São Paulo, Brazil
| | - Ana Karla Guedes de Melo
- SBR. Hospital Universitário Lauro Wanderley, Universidade Federal da Paraíba (UFPB), João Pessoa, Brazil
| | | | | | - Claiton Viegas Brenol
- SBR. Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Cyrla Zaltman
- GEDIIB. Presidente do GEDIIB 2017-2019, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eduardo Ferreira Borba
- SBR. Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Enio Ribeiro Reis
- SBR. Diretor médico do Centro de infusão do Hospital Humanitas, Varginha, Brazil
| | | | - Evandro Mendes Klumb
- SBR. Unidade Docente Assistencial de Reumatologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Isabella Ballalai
- SBIm. Vice-Presidente da Sociedade Brasileira de Imunizações (SBIm), SBiM, Rio de Janeiro, Brazil
| | - Izaias Pereira Da Costa
- SBR. Professor da Faculdade de Medicina da Universidade Federal do Mato Grosso do Sul, Cuiabá, Brazil
| | - Lessandra Michelin
- SBI. Professora na faculdade de Medicina, Universidade de Caxias do Sul, Caxias do Sul, Brazil
| | | | - Liliana Andrade Chebli
- GEDIIB, Faculdade de Medicina da Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Marcus Lacerda
- SMBT. Instituto Leônidas e Maria Deane (Fiocruz - Amazônia), Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Maceio-AL, Brazil
| | | | | | | | - Renata Magalhães
- SBD. Faculdade de Medicina da Universidade Estadual de Campinas, Campinas, Brazil
| | - Renato Kfouri
- SBIm. Presidente do Departamento de Imunizações da Sociedade Brasileira de Pediatria (SBP), Maceio-AL, Brazil
| | | | | | - Valeria Valim
- SBR. Faculdade de Medicina, Universidade Federal do Espírito Santo, Vitória, Brazil
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Cohen C, Moreira ED, Nañez H, Nachiappan JP, Arvinder-Singh HS, Huoi C, Nealon J, Sarti E, Puentes-Rosas E, Moureau A, Khromava A. Incidence rates of neurotropic-like and viscerotropic-like disease in three dengue-endemic countries: Mexico, Brazil, and Malaysia. Vaccine 2019; 37:1868-1875. [PMID: 30826144 DOI: 10.1016/j.vaccine.2019.01.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The background incidence of viscerotropic- (VLD) and neurotropic-like disease (NLD) unrelated to immunization in dengue-endemic countries is currently unknown. METHODS This retrospective population-based analysis estimated crude and standardized incidences of VLD and NLD in twelve hospitals in Brazil (n = 3), Mexico (n = 3), and Malaysia (n = 6) over a 1-year period before the introduction of the tetravalent dengue vaccine. Catchment areas were estimated using publicly available population census information and administrative data. The denominator population for incidence rates was calculated, and sensitivity analyses assessed the impact of important assumptions. RESULTS Total cases adjudicated as definite VLD were 5, 57, and 56 in Brazil, Mexico, and Malaysia, respectively. Total cases adjudicated as definite NLD were 103, 29, and 26 in Brazil, Mexico, and Malaysia, respectively. Crude incidence rates of cases adjudicated as definite VLD in Brazil, Mexico, and Malaysia were 1.17, 2.60, and 1.48 per 100,000 person-years, respectively. Crude incidence rates of cases adjudicated as definite NLD in Brazil, Mexico, and Malaysia were 4.45, 1.32, and 0.69 per 100,000 person-years, respectively. CONCLUSIONS Background incidence estimates of VLD and NLD obtained in Mexico, Brazil, and Malaysia could provide context for cases occurring after the introduction of the tetravalent dengue vaccine.
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Affiliation(s)
| | - Edson D Moreira
- Associação Obras Sociais Irmã Dulce and Oswaldo Cruz Foundation, Brazilian Ministry of Health, Bahia, Brazil.
| | - Homero Nañez
- University Hospital Dr. José E. González, Faculty of Medicine Universidad Autonoma de Nuevo León, Monterrey N.L., Mexico.
| | | | | | | | | | - Elsa Sarti
- Sanofi Pasteur LATAM, Coyoacán, CDMX, Mexico.
| | | | - Annick Moureau
- Clinical Development, Sanofi Pasteur, Marcy l'Etoile, Lyon, France.
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Abstract
OBJECTIVES The objective of this study is to investigate immunogenicity and safety of the yellow fever vaccine (YFV) in HIV-infected (HIV+) patients with high CD4 T-cell counts. DESIGN In this prospective, comparative study of YFV-naive adults: 40 HIV+ under antiretroviral therapy (ART) with CD4 T-cell count above 350 cells/μl and plasma HIV-RNA less than 50 copies/ml for at least 6 months and 31 HIV-negative (HIV-) received one injection of the YF-17D strain vaccine. METHODS Serologic response was assessed by using a plaque reduction neutralizing test and YFV-specific T cells by using an INFγ-Elispot assay. RESULTS YFV was well tolerated in both groups. Most participants had asymptomatic YFV viremia at day (D) 7 after vaccination (77% of HIV- and 82% of HIV+, P = 0.58), with higher plasma level of YFV RNA in HIV+ than in HIV- (median 2.46 log10 copies/ml (range: 1.15-4.16) and 1.91 log10 copies/ml (1.15-3.19), respectively, P = 0.011). A significant but transient decrease in CD4 cell counts was seen at D7 in both groups, more pronounced in HIV- than in HIV+ patients (-261.5 versus -111.5 cells/μl, respectively, P = 0.0003), but no HIV breakthrough was observed in plasma. All participants developed protective neutralizing antibody levels from D28 and up to 1 year after injection. At D91, fewer HIV+ than HIV- participants exhibited YFV T-cell response (20 versus 54%, respectively, P = 0.037). CONCLUSION At 1 year, YFV was immunogenic and well tolerated in HIV-infected adults under ART with CD4 T-cell counts above 350 cells/μl. However, a lower immunity of YFV T cells in HIV-infected patients was observed as compared with HIV- participants. CLINICAL TRIALS REGISTRATION NCT01426243.
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Willcox AC, Collins MH, Jadi R, Keeler C, Parr JB, Mumba D, Kashamuka M, Tshefu A, de Silva AM, Meshnick SR. Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo. Am J Trop Med Hyg 2018; 99:756-763. [PMID: 29988000 DOI: 10.4269/ajtmh.18-0156] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Flaviviruses such as Zika, dengue, and yellow fever cause epidemics throughout the tropics and account for substantial global morbidity and mortality. Although malaria and other vector-borne diseases have long been appreciated in Africa, flavivirus epidemiology is incompletely understood. Despite the existence of an effective vaccine, yellow fever continues to cause outbreaks and deaths, including at least 42 fatalities in the Democratic Republic of the Congo (DRC) in 2016. Here, we leveraged biospecimens collected as part of the nationally representative 2013-2014 Demographic and Health Survey in the DRC to examine serological evidence of flavivirus infection or vaccination in children aged 6 months to 5 years. Even in this young stratum of the Congolese population, we find evidence of infection by dengue and Zika viruses based on results from enzyme-linked immunosorbent assay and neutralization assay. Surprisingly, there was remarkable discordance between reported yellow fever vaccination status and results of serological assays. The estimated seroprevalences of neutralizing antibodies against each virus are yellow fever, 6.0% (95% confidence interval [CI] = 4.6-7.5%); dengue, 0.4% (0.1-0.9%); and Zika, 0.1% (0.0-0.5%). These results merit targeted, prospective studies to assess effectiveness of yellow fever vaccination programs, determine flavivirus seroprevalence across a broader age range, and investigate how these emerging diseases contribute to the burden of acute febrile illness in the DRC.
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Affiliation(s)
- Alexandra C Willcox
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Matthew H Collins
- Department of Medicine, Division of Infectious Diseases, Hope Clinic of the Emory Vaccine Center, Emory School of Medicine, Decatur, Georgia
| | - Ramesh Jadi
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Corinna Keeler
- Department of Geography, University of North Carolina, Chapel Hill, North Carolina
| | - Jonathan B Parr
- Department of Medicine, Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Dieudonné Mumba
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Melchior Kashamuka
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Antoinette Tshefu
- Ecole de Santé Publique, Faculté de Médecine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Aravinda M de Silva
- Department of Microbiology and Immunology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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Plotkin SA. Ten yearly yellow fever booster vaccinations may still be justified. J Travel Med 2018; 25:5194703. [PMID: 30462249 DOI: 10.1093/jtm/tay130] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Stanley A Plotkin
- University of Pennsylvania, Vaxconsult, 4650 Wismer Road, Doylestown, PA, USA
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Lindsey NP, Horiuchi KA, Fulton C, Panella AJ, Kosoy OI, Velez JO, Krow-Lucal ER, Fischer M, Staples JE. Persistence of yellow fever virus-specific neutralizing antibodies after vaccination among US travellers. J Travel Med 2018; 25:5139702. [PMID: 30346562 PMCID: PMC7135922 DOI: 10.1093/jtm/tay108] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/18/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Few studies have assessed the duration of humoral immunity following yellow fever (YF) vaccination in a non-endemic population. We evaluated seropositivity among US resident travellers based on time post-vaccination. METHODS We identified serum samples from US travellers with YF virus-specific plaque reduction neutralization testing (PRNT) performed at CDC from 1988 to 2016. Analyses were conducted to assess the effect of time since vaccination on neutralizing antibody titer counts. RESULTS Among 234 travellers who had neutralizing antibody testing performed on a specimen obtained ≥1 month after vaccination, 13 received multiple YF vaccinations and 221 had one dose of YF vaccine reported. All 13 who received more than one dose of YF vaccine had a positive PRNT regardless of the amount time since most recent vaccination. Among the 221 travellers with one reported dose of YF vaccine, 155 (70%) were vaccinated within 10 years (range 1 month-9 years) and 66 (30%) were vaccinated ≥10 years (range 10-53 years) prior to serum collection. Among the 155 individuals vaccinated, <10 years prior to serum collection, 146 (94%) had a positive PRNT compared with 82% (54/66) of individuals vaccinated ≥10 years prior to serum collection (P = 0.01). Post-vaccination PRNT titers showed a time-dependent decrease. Individuals with immunocompromising conditions were less likely to have a positive PRNT (77%) compared with those who were not immunocompromised (92%; P = 0.04). CONCLUSION Although the percentage of vaccinees with a positive PRNT and antibody titers decreased over time, a single dose of YF vaccine provided long-lasting protection in the majority of US travellers. A booster dose could be considered for certain travellers who are planning travel to a high risk area based on immune competence and time since vaccination.
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Affiliation(s)
- Nicole P Lindsey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Kalanthe A Horiuchi
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Corey Fulton
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Amanda J Panella
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Olga I Kosoy
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Jason O Velez
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Elizabeth R Krow-Lucal
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Marc Fischer
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - J Erin Staples
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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An Atypical Local Vesicular Reaction to the Yellow Fever Vaccine. Vaccines (Basel) 2017; 5:vaccines5030026. [PMID: 28925936 PMCID: PMC5620557 DOI: 10.3390/vaccines5030026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/01/2017] [Accepted: 09/14/2017] [Indexed: 11/23/2022] Open
Abstract
Yellow fever vaccine is a live attenuated viral inoculation indicated for patients traveling to endemic areas. The vaccine is generally well tolerated with minimal adverse effects. Typical side effects include malaise, pain at the injection site, and, albeit rarely, immediate hypersensitivity reactions. We present a case of a rare adverse reaction to yellow fever vaccine in which a patient developed vesicular lesions resulting in bullae and circumferential hyperpigmentation.
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Collins ND, Barrett ADT. Live Attenuated Yellow Fever 17D Vaccine: A Legacy Vaccine Still Controlling Outbreaks In Modern Day. Curr Infect Dis Rep 2017; 19:14. [PMID: 28275932 DOI: 10.1007/s11908-017-0566-9] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Live attenuated 17D vaccine is considered one of the safest and efficacious vaccines developed to date. This review highlights what is known and the gaps in knowledge of vaccine-induced protective immunity. RECENT FINDINGS Recently, the World Health Organization modifying its guidance from 10-year booster doses to one dose gives lifelong protection in most populations. Nonetheless, there are some data suggesting immunity, though protective, may wane over time in certain populations and more research is needed to address this question. Despite having an effective vaccine to control yellow fever, vaccine shortages were identified during outbreaks in 2016, eventuating the use of a fractional-dosing campaign in the Democratic Republic of the Congo. Limited studies hinder identification of the underlying mechanism(s) of vaccine longevity; however, concurrent outbreaks during 2016 provide an opportunity to evaluate vaccine immunity following fractional dosing and insights into vaccine longevity in populations where there is limited information.
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Affiliation(s)
- Natalie D Collins
- Departments of Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX, 77555-0436, USA
| | - Alan D T Barrett
- Department of Microbiology & Immunology, Department of Pathology Sealy Center for Vaccine Development, University of Texas Medical Branch, Galveston, TX, 77555-0436, USA.
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