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Vianna CM, Noronha TG, Camacho LAB, Andrade RC, de Souza Brum RC, Dos Santos EM, Aguiar DF, Dos Santos MLB, de Souza Cruz RL, de Lima SMB, de Souza Azevedo Soares A, Schwarcz WD, da Matta de Castro T, Xavier JR, da Conceição DA, Homma A, de Lourdes de Sousa Maia M. Duration of post-vaccination immunity to yellow fever in volunteers ten years after a dose-response study - A complementary study. Vaccine 2024:S0264-410X(24)00724-2. [PMID: 38926068 DOI: 10.1016/j.vaccine.2024.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
A single dose of standard yellow fever (YF) vaccine is considered to provide life-long protection. In this study, we evaluate the seropositivity conferred by lower doses 10 years post-vaccination. In 2009, Bio-Manguinhos/Fiocruz performed a dose-response study with the 17DD yellow fever vaccine, administering the vaccine in the usual mean dose of 27.476 IU and in decreasing doses (10.447 IU, 3.013 IU, 587 IU, 158 IU and 31 IU), with the usual volume and route (0,5 ml subcutaneous). The decreasing doses were obtained by dilution in the laboratory of the manufacturer and the lots in test had standard quality control and were produced by good manufacturing practices (GMP). Around 30 days after the vaccination, doses down to 587 IU had similar immunogenicity and the 158 IU and 31 IU were inferior to the full dose. The seropositivity was maintained for 10 months, except on the 31 IU group. Eight years after, 85 % of 318 participants evaluated in a follow-up, maintained seropositivity that was similar across groups. Consistently, antibody titers in the reduced-dose groups were also comparable to those of the full-dose group. The current study, 10 years later, showed similarity between the vaccine groups (six arms who received the YF vaccine in decreasing doses: 27.476 IU, 10.447 IU, 3.013 IU, 587 IU, 158 IU, 31 IU) both in relation of seropositivity and in the evaluation of the geometric mean titers. The seropositivity rates across subgroups were 83,1%, 90 %, 87 %, 93 %, 83,8% and 85 %, correspondingly. These findings provides further support to the long-term immunogenicity of lower doses. Clinical trial registry: NCT04416477.
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Affiliation(s)
- Clarice Monteiro Vianna
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil.
| | | | | | - Raissa Coelho Andrade
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Eliane Matos Dos Santos
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | | | - Waleska Dias Schwarcz
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Janaína Reis Xavier
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Akira Homma
- Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
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Reis LR, Costa-Rocha IA, Abdala-Torres T, Campi-Azevedo AC, Peruhype-Magalhães V, Araújo MSS, Spezialli E, do Valle Antonelli LR, da Silva-Pereira RA, Almeida GG, Fernandes EG, Fantinato FFST, Domingues CMAS, Lemos MCF, Chieppe A, Lemos JAC, Coelho-Dos-Reis JG, de Lima SMB, de Souza Azevedo A, Schwarcz WD, Camacho LAB, de Lourdes de Sousa Maia M, de Noronha TG, Duault C, Rosenberg-Hasson Y, Teixeira-Carvalho A, Maecker HT, Martins-Filho OA. Comprehensive landscape of neutralizing antibody and cell-mediated response elicited by the 1/5 fractional dose of 17DD-YF primary vaccination in adults. Sci Rep 2024; 14:7709. [PMID: 38565882 PMCID: PMC10987530 DOI: 10.1038/s41598-024-57645-3] [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: 10/11/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
The present study aimed at evaluating the YF-specific neutralizing antibody profile besides a multiparametric analysis of phenotypic/functional features of cell-mediated response elicited by the 1/5 fractional dose of 17DD-YF vaccine, administered as a single subcutaneous injection. The immunological parameters of each volunteer was monitored at two time points, referred as: before (Day 0) [Non-Vaccinated, NV(D0)] and after vaccination (Day 30-45) [Primary Vaccinees, PV(D30-45)]. Data demonstrated high levels of neutralizing antibodies for PV(D30-45) leading to a seropositivity rate of 93%. A broad increase of systemic soluble mediators with a mixed profile was also observed for PV(D30-45), with IFN-γ and TNF-α presenting the highest baseline fold changes. Integrative network mapping of soluble mediators showed increased correlation numbers in PV(D30-45) as compared to NV(D0) (532vs398). Moreover, PV(D30-45) exhibited increased levels of Terminal Effector (CD45RA+CCR7-) CD4+ and CD8+ T-cells and Non-Classical memory B-cells (IgD+CD27+). Dimensionality reduction of Mass Cytometry data further support these findings. A polyfunctional cytokine profile (TNF-α/IFN-γ/IL-10/IL-17/IL-2) of T and B-cells was observed upon in vitro antigen recall. Mapping and kinetics timeline of soluble mediator signatures for PV(D30-45) further confirmed the polyfunctional profile upon long-term in vitro culture, mediated by increased levels of IFN-γ and TNF-α along with decreased production of IL-10. These findings suggest novel insights of correlates of protection elicited by the 1/5 fractional dose of 17DD-YF vaccine.
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Affiliation(s)
- Laise Rodrigues Reis
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | | | - Thais Abdala-Torres
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | - Elaine Spezialli
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | | | | | | | | | | | | | | | - Alexandre Chieppe
- Superintendência de Vigilância em Saúde, Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Jordana Grazziela Coelho-Dos-Reis
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas da Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil
| | - Sheila Maria Barbosa de Lima
- Departamento de Desenvolvimento Experimental e Pré-Clínico, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Adriana de Souza Azevedo
- Laboratório de Análise Imunomolecular, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Waleska Dias Schwarcz
- Laboratório de Análise Imunomolecular, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | | | - Tatiana Guimarães de Noronha
- Assessoria Clínica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos - FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Caroline Duault
- Human Immune Monitoring Center, Stanford University, Stanford, CA, USA
| | | | | | - Holden Terry Maecker
- Human Immune Monitoring Center, Stanford University, Stanford, CA, USA.
- Department of Microbiology and Immunology, Stanford University, Stanford, USA.
| | - Olindo Assis Martins-Filho
- Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ-Minas, Belo Horizonte, MG, Brazil.
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz - FIOCRUZ-Minas, Belo Horizonte, MG, Brazil.
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Abdala-Torres T, Campi-Azevedo AC, da Silva-Pereira RA, Dos Santos LI, Henriques PM, Costa-Rocha IA, Otta DA, Peruhype-Magalhães V, Teixeira-Carvalho A, Araújo MSS, Fernandes EG, Sato HK, Fantinato FFST, Domingues CMAS, Kallás EG, Tomiyama HTI, Lemos JAC, Coelho-Dos-Reis JG, de Lima SMB, Schwarcz WD, de Souza Azevedo A, Trindade GF, Ano Bom APD, da Silva AMV, Fernandes CB, Camacho LAB, de Sousa Maia MDL, Martins-Filho OA, do Antonelli LRDV. Immune response induced by standard and fractional doses of 17DD yellow fever vaccine. NPJ Vaccines 2024; 9:54. [PMID: 38459059 PMCID: PMC10923915 DOI: 10.1038/s41541-024-00836-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/05/2024] [Indexed: 03/10/2024] Open
Abstract
The re-emergence of yellow fever (YF) urged new mass vaccination campaigns and, in 2017, the World Health Organization approved the use of the fractional dose (FD) of the YF vaccine due to stock shortage. In an observational cross-sectional investigation, we have assessed viremia, antibodies, soluble mediators and effector and memory T and B-cells induced by primary vaccination of volunteers with FD and standard dose (SD). Similar viremia and levels of antibodies and soluble markers were induced early after immunization. However, a faster decrease in the latter was observed after SD. The FD led to a sustained expansion of helper T-cells and an increased expression of activation markers on T-cells early after vaccination. Although with different kinetics, expansion of plasma cells was induced upon SD and FD immunization. Integrative analysis reveals that FD induces a more complex network involving follicular helper T cells and B-cells than SD. Our findings substantiate that FD can replace SD inducing robust correlates of protective immune response against YF.
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Affiliation(s)
- Thais Abdala-Torres
- Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Carolina Campi-Azevedo
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | - Rosiane Aparecida da Silva-Pereira
- Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | | | - Priscilla Miranda Henriques
- Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | - Ismael Artur Costa-Rocha
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | - Dayane Andriotti Otta
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | - Vanessa Peruhype-Magalhães
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | - Andréa Teixeira-Carvalho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | | | - Eder Gatti Fernandes
- Divisão de Imunização, Secretaria de Estado de Saúde de São Paulo, São Paulo, SP, Brazil
- Departamento de Vigilância das Doenças Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
| | - Helena Keico Sato
- Divisão de Imunização, Secretaria de Estado de Saúde de São Paulo, São Paulo, SP, Brazil
| | | | | | - Esper Georges Kallás
- Departamento de Doenças Infecciosas e Parasitárias, Escola de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Jordana Grazziela Coelho-Dos-Reis
- Laboratório de Virologia Básica e Aplicada, Instituto de Ciências Biológicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sheila Maria Barbosa de Lima
- Departamento de Desenvolvimento Experimental e Pré-clínico, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Waleska Dias Schwarcz
- Laboratório de Análise Imunomecular, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Adriana de Souza Azevedo
- Laboratório de Análise Imunomecular, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Gisela Freitas Trindade
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Ana Paula Dinis Ano Bom
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Andrea Marques Vieira da Silva
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Camilla Bayma Fernandes
- Laboratório de Tecnologia Imunológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | | | - Maria de Lourdes de Sousa Maia
- Departamento de Assuntos Médicos, Estudos Clínicos e Vigilância Pós-Registro, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil.
| | - Lis Ribeiro do Valle do Antonelli
- Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil.
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Hansen CA, Staples JE, Barrett ADT. Fractional Dosing of Yellow Fever Live Attenuated 17D Vaccine: A Perspective. Infect Drug Resist 2023; 16:7141-7154. [PMID: 38023411 PMCID: PMC10640814 DOI: 10.2147/idr.s370013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023] Open
Abstract
Yellow fever virus (YFV) is a mosquito-borne flavivirus that causes over 109,000 severe infections and over 51,000 deaths annually in endemic areas of sub-Saharan Africa and tropical South America. The virus has a transmission cycle involving mosquitoes and humans or non-human primates (NHPs) as the vertebrate hosts. Although yellow fever (YF) is prevented by a live attenuated vaccine (strain 17D), recent epidemics in Angola, the Democratic Republic of the Congo (DRC), and Brazil put great pressure on vaccine stockpiles. This resulted in the World Health Organization (WHO) and Pan American Health Organization (PAHO) implementing, on an emergency basis only, off-label dose-sparing techniques and policies during 2016-2018 to protect as many people in DRC and Brazil as possible from disease during unexpected large outbreaks of YF. Subsequently non-inferiority studies involving full doses compared to fractional doses indicated promising results, leading some policy-makers and scientists to consider utilizing YF vaccine fractional doses in non-emergency scenarios. Although the additional data on the immunogenicity and safety of fractional doses are promising, there are several questions and considerations that remain regarding the use of fractional doses, including differences in the initial antibody kinetics, differences in the immune response in certain populations, and durability of the immune response to fractional doses compared to full doses. Until the remaining knowledge gaps are addressed, full doses instead of fractional doses should continue to be used unless there are insufficient doses of the vaccine available to control outbreaks of YF.
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Affiliation(s)
- Clairissa A Hansen
- Department of Pathology and Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX, 77555-4036, USA
| | - 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, 77555-4036, USA
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Fradico JRB, Campi-Azevedo AC, Speziali E, do Valle Antonelli LR, Peruhype-Magalhães V, de Rezende IM, Alves PA, Pascoal-Xavier MA, Pereira LS, Dutra MRT, Ramalho DB, Cenachi A, de Paula L, Santos TA, do Carmo Said RF, Calzavara-Silva CE, Coelho-Dos-Reis JGA, de Magalhães CR, Rabelo LLC, Valim V, Brito-de-Sousa JP, da Costa-Rocha IA, de Souza Gomes M, Amaral LR, de Lima SMB, Trindade GF, Santos RT, da Silva JFA, Monath T, LaBeaud AD, Drumond BP, Martins-Filho OA, Teixeira-Carvalho A. Serum soluble mediators as prognostic biomarkers for morbidity, disease outcome, and late-relapsing hepatitis in yellow fever patients. Clin Immunol 2023; 251:109321. [PMID: 37019421 DOI: 10.1016/j.clim.2023.109321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
This study described a soluble mediator storm in acute Yellow Fever/YF infection along the kinetic timeline towards convalescent disease. The analyses of the YF Viral RNAnemia, chemokines, cytokines, and growth factors were performed in YF patients at acute/(D1-15) and convalescent/(D16-315) phases. Patients with acute YF infection displayed a trimodal viremia profile spreading along D3, D6, and D8-14. A massive storm of mediators was observed in acute YF. Higher levels of mediators were observed in YF with higher morbidity scores, patients under intensive care, and those progressing to death than in YF patients who progress to late-relapsing hepatitis/L-Hep. A unimodal peak of biomarkers around D4-6 with a progressive decrease towards D181-315 was observed in non-L-Hep patients, while a bimodal pattern with a second peak around D61-90 was associated with L-Hep. This study provided a comprehensive landscape of evidence that distinct immune responses drive pathogenesis, disease progression, and L-Hep in YF patients.
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Affiliation(s)
| | | | - Elaine Speziali
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil
| | | | | | - Izabela Maurício de Rezende
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Pedro Augusto Alves
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil
| | - Marcelo Antônio Pascoal-Xavier
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil; Departamento de Anatomia Patológica e Medicina Legal, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leonardo Soares Pereira
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Hospital Eduardo de Menezes (HEM), Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | - Maria Rita Teixeira Dutra
- Hospital Eduardo de Menezes (HEM), Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | - Dario Brock Ramalho
- Hospital Eduardo de Menezes (HEM), Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | - Adriana Cenachi
- Hospital Eduardo de Menezes (HEM), Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | - Ludmila de Paula
- Hospital Eduardo de Menezes (HEM), Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | - Tayrine Araujo Santos
- Hospital Eduardo de Menezes (HEM), Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, MG, Brazil
| | | | | | - Jordana Grazziela Alves Coelho-Dos-Reis
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil; Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Valéria Valim
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM/UFES/EBSERH), Vitória, ES, Brazil
| | | | | | - Matheus de Souza Gomes
- Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, Campus Patos de Minas, MG, Brazil
| | - Laurence Rodrigues Amaral
- Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, Campus Patos de Minas, MG, Brazil
| | - Sheila Maria Barbosa de Lima
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Gisela Freitas Trindade
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Renata Tourinho Santos
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | | | | | - Angelle Desiree LaBeaud
- Department of Pediatrics, Infectious Disease Division, Stanford University School of Medicine, Stanford, CA, USA
| | - Betânia Paiva Drumond
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Fantinato FFST, Wachira VK, Porto VBG, Peixoto HM, Duarte EC. Factors associated with yellow fever vaccine failure: A systematic literature review. Vaccine 2023; 41:2155-2169. [PMID: 36841725 DOI: 10.1016/j.vaccine.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/23/2022] [Accepted: 02/03/2023] [Indexed: 02/26/2023]
Abstract
INTRODUCTION Considering that vaccination with yellow fever vaccine (YFV) is the most important method to prevent and control yellow fever (YF), this study synthesized evidence on factors associated with YFV failure. METHODS A systematic review (SR) was performed in the PubMed, Cochrane CENTRAL, Embase, and LILACS databases up to November 2019. Observational and experimental analytical epidemiological studies that analyzed the failure of YFV were included. This review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and meta-Analyses. RESULTS A total of 1,466 articles were identified after searching the databases of which 46 were included in the qualitative analysis after applying the elegibility criteria. Our findings indicated that YFV confers protective immunity in different age groups; when produced by different producers; when administered simultaneously with a range of other vaccines; when used as fractional doses and when used with prophylactic and immunosuppressive therapies. It failed to produce a protective response in some pregnant women, children under two years of age, children with Kwashiorkor and when long periods of time have passed after vaccination. For individuals with human immunodeficiency virus (HIV), the results were divergent. CONCLUSIONS The results of this SR revealed the factors associated with the failure of the YFV, and the results can support recommendations on vaccination policies, support the safety of health professionals who work directly with immunization in the implementation of the vaccination schedule, in addition to guiding future research and enhance the credibility of YFV in the prevention of a serious disease such as YF.
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Affiliation(s)
| | | | | | - Henry Maia Peixoto
- University of Brasília, Brazil; National Institute of Science and Technology for Health Techology Assessment, Porto Alegre (RS), Brazil
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Fernandes EG, Gomes Porto VB, de Oliveira PMN, Duarte-Neto AN, de Sousa Maia MDL, Lignani LK, Nogueira JS, Teixeira GV, Iglezias SD, Blanco RM, Sato HK. Yellow Fever Vaccine-Associated Viscerotropic Disease among Siblings, São Paulo State, Brazil. Emerg Infect Dis 2023; 29:493-500. [PMID: 36823036 PMCID: PMC9973707 DOI: 10.3201/eid2903.220989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
We describe 5 cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) in 2 familial clusters during the 2017-2018 yellow fever (YF) vaccination campaign in São Paulo state, Brazil. The first case was that of a 40-year-old white man who died of icterohemorrhagic syndrome, which was confirmed to be YEL-AVD by using real-time reverse transcription PCR to detect 17DD YF vaccine in the liver. Ten years previously, his brother died of a clinically similar disease without a confirmed diagnosis 9 days after YF vaccination. The second cluster included 3 of 9 siblings in whom hepatitis developed in the first week after receiving fractionated doses of YF vaccine. Two of them died of hemorrhagic diathesis and renal and respiratory failure, and 17DD-YF vaccine was detected in serum samples from all patients and in the liver in 1 case. Genetic factors might play a substantial role in the incidence of YEL-AVD.
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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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9
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Rhodes S, Smith N, Evans T, White R. Identifying COVID-19 optimal vaccine dose using mathematical immunostimulation/immunodynamic modelling. Vaccine 2022; 40:7032-7041. [PMID: 36272876 PMCID: PMC9574467 DOI: 10.1016/j.vaccine.2022.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/03/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Identifying optimal COVID-19 vaccine dose is essential for maximizing their impact. However, COVID-19 vaccine dose-finding has been an empirical process, limited by short development timeframes, and therefore potentially not thoroughly investigated. Mathematical IS/ID modelling is a novel method for predicting optimal vaccine dose which could inform future COVID-19 vaccine dose decision making. METHODS Published clinical data on COVID-19 vaccine dose-response was identified and extracted. Mathematical models were calibrated to the dose-response data stratified by subpopulation, where possible to predict optimal dose. Predicted optimal doses were summarised across vaccine type and compared to chosen dose for the primary series of COVID-19 vaccines to identify vaccine doses that may benefit from re-evaluation. RESULTS 30 clinical dose-response datasets in adults and elderly population were extracted for four vaccine types and optimal doses predicted using the models. Results suggest that, if re-assessed for dose, COVID-19 vaccines Ad26.cov, ChadOx1 n-Cov19, BNT162b2, Coronavac, and NVX-CoV2373 could benefit from increased dose in adults and mRNA-1273 and Coronavac, could benefit from increased and decreased dose for the elderly population, respectively. DISCUSSION Future iterations of COVID-19 vaccines could benefit from re-evaluating dose to ensure most effective use of the vaccine and mathematical modelling can support this.
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Affiliation(s)
- Sophie Rhodes
- TB Modelling Group, CMMID, TB Centre, London School of Hygiene and Tropical Medicine, UK,Corresponding author
| | - Neal Smith
- Defence and Science Technology Laboratory, UK
| | | | - Richard White
- TB Modelling Group, CMMID, TB Centre, London School of Hygiene and Tropical Medicine, UK
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10
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Casagrande TZ, Costa-Rocha IAD, Gavi MBRDO, Miyamoto ST, Martins PC, Serrano ÉV, Dinis VG, Machado KLLL, Gouvea SA, Caser LC, Campi-Azevedo AC, Teixeira-Carvalho A, Peruhype-Magalhães V, Bissoli MDF, Gouvea MDPG, Lima SMBD, Miranda EH, Trindade GF, Lyra DGP, Burian APN, Neto LFDSP, da Mota LMH, Martins-Filho OA, Valim V. Previous biological therapy and impairment of the IFN-γ/IL-10 axis are associated with low immune response to 17DD-YF vaccination in patients with spondyloarthritis. Vaccine 2022; 40:4580-4593. [PMID: 35728990 DOI: 10.1016/j.vaccine.2022.05.071] [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: 10/26/2021] [Revised: 04/21/2022] [Accepted: 05/24/2022] [Indexed: 11/19/2022]
Abstract
Yellow fever (YF) vaccination is known to induce a suboptimal response in patients with autoimmune diseases (AIDs). To date, few studies have focused on the performance of 17DD-YF vaccination in patients with spondyloarthritis (SpA). In general, patients with SpA are young and have less comorbidities than other patients with AIDs, and frequently receive biological disease-modifying antirheumatic drugs (DMARDs) that may impact their response to vaccines. Taking this background information, the present study aimed to investigate whether the use of biological DMARDs, even after planned washout, or disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), would impact the overall performance of planned 17DD-YF primary vaccination in patients with SpA. For this purpose, 74 subjects were enrolled in a prospective study, including adult patients with SpA (SpA; n = 51) and a healthy control (HC; n = 23) group. Analysis of YF specific neutralizing antibodies test (PRNT), along with YF viremia and the levels of serum chemokines, cytokines, and growth factors were performed at distinct time points (D0, D3, D4, D5, D6, D7, D14, and D28). The BASDAI scores were evaluated at D0 and D180. Data demonstrated that overall, the SpA group presented lower PRNT titers and seropositivity rates as compared to the HC group (GeoMean = 112 vs. 440; 73% vs. 96%, respectively). In SpA subgroup analyses, previous biological DMARDs (BIO-IT) led to a lower PRNT titers (BIO-IT 79, 95% CI [39-150] vs. without biological DMARDs [non-BIO-IT] 159, 95% CI [94-267], p < 0.001). The non-BIO-IT group achieved a response similar to the HC group (81% vs. 96%, p = 0.112), whereas the BIO-IT group had a lower seroconversion rate (64% vs. 96% HC, p = 0.007). The BASDAI was not associated with PRNT levels and did not change after 6 months of follow-up. No differences in YF viremia were observed amongst subgroups. Higher baseline levels of serum biomarkers were observed in the BIO-IT group vs. the non-BIO-IT group, as well as in those with a BASDAI ≥ 4 vs. those with a BASDAI < 4. Increasing levels of several biomarkers were observed in SpA, especially in the BIO-IT and BASDAI ≥ 4 subgroups throughout the timeline kinetics, with impairment/disturbance in the IFN-γ/IL-10 axis around the peak of viremia (D5). Altogether, these findings suggested that the use of biological DMARDs impacts the response to the 17DD-YF vaccine, even after planned washout. Therefore, previous biological DMARD therapy, the inflammatory status prior vaccination, and impairment of the IFN-γ/IL-10 axis at the peak of viremia may determine the immunogenicity of 17DD-YF vaccination in patients with SpA.
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Affiliation(s)
- Thays Zanon Casagrande
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | | | | | - Samira Tatiyama Miyamoto
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Priscila Costa Martins
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Érica Vieira Serrano
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Valquiria Garcia Dinis
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, ES, Brazil
| | - Ketty Lysie Libardi Lira Machado
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Sonia Alves Gouvea
- Programa de Pós-graduação em Biotecnologia da Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Larissa Carvalho Caser
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | | | | | | | - Maria de Fatima Bissoli
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Maria da Penha Gomes Gouvea
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Sheila Maria Barbosa de Lima
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Emily Hime Miranda
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Gisela Freitas Trindade
- Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Danielle Grillo Pacheco Lyra
- Departamento de Vigilância das Doenças Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
| | | | | | - Licia Maria Henrique da Mota
- Serviço de Reumatologia do Hospital Universitário de Brasília, Programa de Pós-graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brazil
| | | | - Valéria Valim
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva da Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil.
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11
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Blyth DM, Liang Z, Williams M, Murray CK. Immune interference revisited: Impact of live-attenuated influenza vaccine prior to yellow fever vaccination. Vaccine 2022; 40:961-966. [PMID: 35031146 DOI: 10.1016/j.vaccine.2021.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 11/12/2021] [Accepted: 12/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND During routine mass live-attenuated influenza vaccination (LAIV) for military personnel, emergent deployment for Ebola humanitarian assistance (OUA) required mass yellow fever vaccination (YF17D), often < 4-weeks recommended timing post-LAIV-triggering concerns for immune interference. We compared YF17D seroconversion rates in personnel who received YF17D as recommended (vaccinated by guidelines [VBG]) to those who received the vaccine outside the recommended timing following LAIV (not vaccinated by guidelines [NVBG]). METHODS OUA deploying personnel who received LAIV simultaneously or before YF17D and had pre- and post-vaccination archived serum were included. VBG was defined as YF17D given concurrently or ≥ 30 days post-LAIV and NVBG as YF17D given 1-29 days post-LAIV. YF17D seroresponse was determined by screening ELISA confirmed with plaque reduction neutralization testing (PRNT) on positive ELISA samples. Exclusion criteria were prior YF17D and pre-vaccination YF17D positive PRNT. RESULTS Of the 660 personnel included, 507 were VBG and 153 were NVBG. Median age was 25 years for both groups. Men accounted for 84% of those VBG and 79% NVBG (p = 0.194). Seroconversion rates were 97.8% for VBG and 95.4% for NVBG (p = 0.15). Multivariate logistic regression revealed that YF17D on days 7-21 post-LAIV (adjusted odds ratio [aOR] 0.304, p = 0.017; confidence interval [CI] 0.114-0.810) and female sex (aOR 0.330, p = 0.026; CI 0.124-0.879) were associated with decreased seroresponse. CONCLUSIONS In this healthy, young adult military population, there was high seroconversion following YF17D when administered simultaneously and at various time points after LAIV. Slight decreases in seroresponse were seen in women and those receiving YF17D 7-21 days following LAIV.
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Affiliation(s)
- Dana M Blyth
- Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, 3551 Roger Brooke Dr, JBSA Ft Sam Houston, TX 78234, USA; Infectious Disease Service, Directorate of Medicine, Walter Reed National Military Medical Center, 8960 Brown Drive, Bethesda, MD 20889, USA; Uniformed Services University of the Health Sciences, Bethesda, MA 20889, USA.
| | - Zhaodong Liang
- Henry M. Jackson Foundation and Viral and Rickettsial Diseases Department, Naval Medical Research Center, 503 Robert Grant Ave, Silver Spring, MD, USA
| | - Maya Williams
- Henry M. Jackson Foundation and Viral and Rickettsial Diseases Department, Naval Medical Research Center, 503 Robert Grant Ave, Silver Spring, MD, USA; Infectious Diseases Directorate, Naval Medical Research Center, 503 Robert Grant Ave, Silver Spring, MD, USA
| | - Clinton K Murray
- Uniformed Services University of the Health Sciences, Bethesda, MA 20889, USA; Walter Reed Army Institute for Research, 503 Robert Grant Ave, Silver Spring, MD, USA
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12
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Tonacio AC, do Nascimento Pedrosa T, Borba EF, Aikawa NE, Pasoto SG, Filho JCRF, Sampaio Barros MM, Leon EP, Lombardi SCFS, Junior AM, Azevedo ADS, Schwarcz WD, Fuller R, Yuki EFN, Ugolini Lopes MR, Rodrigues Pereira RM, Sampaio Barros PD, de Andrade DCO, de Medeiros-Ribeiro AC, de Moraes JCB, Shinjo SK, Miossi R, da Silva Duarte AJ, Lopes MH, Kallás EG, Almeida da Silva CA, Bonfá E. Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases. PLoS Negl Trop Dis 2021; 15:e0010002. [PMID: 34843469 PMCID: PMC8659329 DOI: 10.1371/journal.pntd.0010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/09/2021] [Accepted: 11/16/2021] [Indexed: 12/05/2022] Open
Abstract
Background Brazil faced a yellow fever(YF) outbreak in 2016–2018 and vaccination was considered for autoimmune rheumatic disease patients(ARD) with low immunosuppression due to YF high mortality. Objective This study aimed to evaluate, prospectively for the first time, the short-term immunogenicity of the fractional YF vaccine(YFV) immunization in ARD patients with low immunossupression. Methods and Results A total of 318 participants(159 ARD and 159 age- and sex-matched healthy controls) were vaccinated with the fractional-dose(one fifth) of 17DD-YFV. All subjects were evaluated at entry(D0), D5, D10, and D30 post-vaccination for clinical/laboratory and disease activity parameters for ARD patients. Post-vaccination seroconversion rate(83.7%vs.96.6%, p = 0.0006) and geometric mean titers(GMT) of neutralizing antibodies[1143.7 (95%CI 1012.3–1292.2) vs.731 (95%CI 593.6–900.2), p<0.001] were significantly lower in ARD compared to controls. A lower positivity rate of viremia was also identified for ARD patients compared to controls at D5 (53%vs.70%, p = 0.005) and the levels persisted in D10 for patients and reduced for controls(51%vs.19%, p = 0.0001). The viremia was the only variable associated with seroconvertion. No serious adverse events were reported. ARD disease activity parameters remained stable at D30(p>0.05). Conclusion Fractional-dose 17DD-YF vaccine in ARD patients resulted in a high rate of seroconversion rate(>80%) but lower than controls, with a longer but less intense viremia. This vaccine was immunogenic, safe and did not induce flares in ARD under low immunosuppression and may be indicated in YF outbreak situations and for patients who live or travel to endemic areas. Trial registration This clinical trial was registered with Clinicaltrials.gov (#NCT03430388). Yellow fever is a viral hemorragic fever with high mortality rate and the vaccine is a remarkably successful way of preventing it. As a live attenuated virus vaccine, it is not recommended for rheumatic and other immunossupressed patients in general. However, in an outbreak scenario, the risk of dying of the disease can be higher than the risk of a vaccine serious adverse event. In 2018, the fractional-dose yellow fever vaccine was offered to the hospital employees and to the rheumatic patients without or with low immunossupression therapy in Hospital das Clinicas of University of São Paulo, during the yellow fever outbreak in São Paulo, Brazil. In order to optimize the yellow fever vaccine (YFV) supply, the fractional-dose (corresponding to one fifth) was adopted in the public vaccine campaign. This is the first study evaluating the primary vaccination with fractional-dose YFV in autoimmune rheumatic diseases(ARD) patients (n = 159) under low immunosuppression. Most vaccinated participants were able to produce enough neutralizing antibodies to be protected against yellow fever (seroconversion rate of 84% versus 96% in healthy controls). Neither activity of the rheumatic disease or serious adverse event was identified during the 30 days of followup after the vaccination.
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Affiliation(s)
- Adriana Coracini Tonacio
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- * E-mail:
| | - Tatiana do Nascimento Pedrosa
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Ferreira Borba
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Nadia Emi Aikawa
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sandra Gofinet Pasoto
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | - Elaine Pires Leon
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Alfredo Mendrone Junior
- Laboratório de Segurança Transfusional, Divisão de Pesquisa e Ensino, Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, Brazil
| | - Adriana de Souza Azevedo
- Institute of Technology in Immunobiologicals, Bio-Manguinhos, Fundação Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Waleska Dias Schwarcz
- Institute of Technology in Immunobiologicals, Bio-Manguinhos, Fundação Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, Brazil
| | - Ricardo Fuller
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Emily Figueiredo Neves Yuki
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Michelle Remião Ugolini Lopes
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rosa Maria Rodrigues Pereira
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | | | | | | | - Samuel Katsuyuki Shinjo
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Renata Miossi
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alberto José da Silva Duarte
- Clinical Laboratory Division—Department of Pathology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Marta Heloisa Lopes
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Esper Georges Kallás
- Department of Infectious and Parasitic Diseases, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Clovis Artur Almeida da Silva
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eloisa Bonfá
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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13
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Hansen CA, Barrett ADT. The Present and Future of Yellow Fever Vaccines. Pharmaceuticals (Basel) 2021; 14:ph14090891. [PMID: 34577591 PMCID: PMC8468696 DOI: 10.3390/ph14090891] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/05/2022] Open
Abstract
The disease yellow fever (YF) is prevented by a live-attenuated vaccine, termed 17D, which has been in use since the 1930s. One dose of the vaccine is thought to give lifelong (35+ years) protective immunity, and neutralizing antibodies are the correlate of protection. Despite being a vaccine-preventable disease, YF remains a major public health burden, causing an estimated 109,000 severe infections and 51,000 deaths annually. There are issues of supply and demand for the vaccine, and outbreaks in 2016 and 2018 resulted in fractional dosing of the vaccine to meet demand. The World Health Organization (WHO) has established the “Eliminate Yellow Fever Epidemics” (EYE) initiative to reduce the burden of YF over the next 10 years. As with most vaccines, the WHO has recommendations to assure the quality, safety, and efficacy of the YF vaccine. These require the use of live 17D vaccine only produced in embryonated chicken eggs, and safety evaluated in non-human primates only. Thus, any second-generation vaccines would require modification of WHO recommendations if they were to be used in endemic countries. There are multiple second-generation YF vaccine candidates in various stages of development that must be shown to be non-inferior to the current 17D vaccine in terms of safety and immunogenicity to progress through clinical trials to potential licensing. The historic 17D vaccine continues to shape the global vaccine landscape in its use in the generation of multiple licensed recombinant chimeric live vaccines and vaccine candidates, in which its structural protein genes are replaced with those of other viruses, such as dengue and Japanese encephalitis. There is no doubt that the YF 17D live-attenuated vaccine will continue to play a role in the development of new vaccines for YF, as well as potentially for many other pathogens.
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Affiliation(s)
- Clairissa A. Hansen
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-4036, USA;
| | - Alan D. T. Barrett
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555-4036, USA;
- Sealy Institute for Vaccine Sciences, University of Texas Medical Branch, Galveston, TX 77555-4036, USA
- Correspondence:
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14
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Catalioto RM, Valenti C, Bellucci F, Cialdai C, Altamura M, Digilio L, Pellacani AUE, Meini S. Booster immunization with a fractional dose of Prevnar 13 affects cell-mediated immune response but not humoral immunity in CD-1 mice. Heliyon 2021; 7:e07314. [PMID: 34195422 PMCID: PMC8239470 DOI: 10.1016/j.heliyon.2021.e07314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 04/02/2021] [Accepted: 06/10/2021] [Indexed: 12/01/2022] Open
Abstract
Achieving durable protective immunity following vaccination is dependent on many factors, including vaccine composition and antigen dose, and it has been investigated for various types of vaccines. Aim of the present study was to investigate the overall immune response elicited by two different booster doses in CD-1 mice, by exploiting the largely used 13-valent pneumococcal conjugate vaccine Prevnar 13® (PCV13). Immunization was performed by two primary doses of PCV13 two weeks apart, and a full or fractional (1/5) booster dose on week 10. Serotype-specific antibody titer, avidity, and opsonophagocytic activity were evaluated one week later, and compared to cell-mediated immunity (CMI) responses determined as the frequency of cytokines producing splenocytes by in vitro recall with the antigens (carrier protein and polysaccharides). Data showed that regardless of the booster dose, a comparable humoral response was produced, characterized by similar amounts of serotype-specific antibodies, with analog avidity and opsonophagocytic properties. On the other hand, when CMI was evaluated, the presence of CRM197-specific IL-5 and IL-2 producing cells was evident in splenocytes from mice immunized with the full dose, while in those immunized with the fractional booster dose, IFN-γ producing cells responsive to both protein and polysaccharide antigens were significantly increased, whereas the number of IL-5 and IL-2 positive cells remained unaffected. Overall the present findings show that PCV13 humoral response in mice is associated to a Th2 predominant response at the full booster dose, while the fractional one favors a mixed Th1/Th2 response, suggesting an important role of CMI besides measurement of functional protective antibodies, as an additional and important key information in vaccine development.
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Affiliation(s)
- Rose-Marie Catalioto
- Experimental Pharmacology Department, Menarini Ricerche S.p.A., Via dei Sette Santi 1, I-50131 Florence, Italy
| | - Claudio Valenti
- Experimental Pharmacology Department, Menarini Ricerche S.p.A., Via dei Sette Santi 1, I-50131 Florence, Italy
| | - Francesca Bellucci
- Experimental Pharmacology Department, Menarini Ricerche S.p.A., Via dei Sette Santi 1, I-50131 Florence, Italy
| | - Cecilia Cialdai
- Experimental Pharmacology Department, Menarini Ricerche S.p.A., Via dei Sette Santi 1, I-50131 Florence, Italy
| | - Maria Altamura
- Corporate Preclinical Development for New Technologies, Antiinfectives and Non-oncological Drugs, A. Menarini NewTech S.r.l., Via dei Sette Santi 1, I-50131 Florence, Italy
| | | | | | - Stefania Meini
- Experimental Pharmacology Department, Menarini Ricerche S.p.A., Via dei Sette Santi 1, I-50131 Florence, Italy
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15
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Serum biomarker profile orchestrating the seroconversion status of patients with autoimmune diseases upon planned primary 17DD Yellow fever vaccination. Sci Rep 2021; 11:10431. [PMID: 34001945 PMCID: PMC8128885 DOI: 10.1038/s41598-021-89770-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/30/2021] [Indexed: 12/15/2022] Open
Abstract
The present study aimed to investigate whether the serum biomarkers of immune response orchestrate the seroconversion status in patients with autoimmune diseases (AID) upon planned primary 17DD-YF vaccination. For this purpose a total of 161 individuals were enrolled in a prospective study, including patients with Rheumatoid Arthritis (RA = 38), Spondyloarthritis (SpA = 51), Systemic Lupus Erythematosus (SLE = 21) and Sjögren's Syndrome (SS = 30) along with a group of healthy controls (HC = 21). Analysis of plaque reduction neutralization test (PRNT) titers and seropositivity rates along with the 17DD-YF viremia and serum biomarkers were carried out at distinct time points (D0/D3-4/D5-6/D7/D14-28). The results demonstrated an overall lower PRNT titer and seropositivity rate (170 vs. 448; 77 vs. 95%) in AID as compared to HC, especially in SpA and SLE subgroups. No significant differences were observed in the viremia levels amongst groups. In general, a more prominent serum biomarker response was observed in AID as compared to HC, throughout the timeline kinetics. Remarkably, AID/PRNT(-) exhibited higher levels of several biomarkers at baseline as compared to AID/PRNT+. Moreover, while AID/PRNT(+) exhibited earlier increase in serum biomarkers at D3-4/D5-6, the AID/PRNT(-) displayed higher response at later time points (D7/D14-D28). Of note, a synchronic increase of IFN-γ at the peak of viremia (D5-6) was observed in HC and AID/PRNT(+) groups, whereas a later asynchronous IFN-γ response was reported for AID/PRNT(-) at D7. The biomarker profile tends to deflate at post-vaccination timeline, highlighting a putative immunomodulatory effect of live attenuated 17DD-YF vaccine in AID/PRNT(+), but not in AID/PRNT(-). Altogether these data suggested that inflammatory status prior vaccination, low IFN-γ at viremia peak and the occurrence of asynchronous biomarker storm after 17DD-YF vaccination may orchestrate the lack of neutralizing antibody response γ.
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Bovay A, Fuertes Marraco SA, Speiser DE. Yellow fever virus vaccination: an emblematic model to elucidate robust human immune responses. Hum Vaccin Immunother 2021; 17:2471-2481. [PMID: 33909542 PMCID: PMC8475614 DOI: 10.1080/21645515.2021.1891752] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
By preventing infectious diseases, vaccines contribute substantially to public health. Besides, they offer great opportunities to investigate human immune responses. This is particularly true for live-attenuated virus vaccines which cause resolving acute infections and induce robust immunity. The fact that one can precisely schedule the time-point of vaccination enables complete characterization of the immune response over time, short-term and over many years. The live-attenuated Yellow Fever virus vaccine strain YF-17D was developed in the 1930's and gave rise to the 17D-204 and 17DD vaccine sub-strains, administered to over 600 million individuals worldwide. YF vaccination causes a systemic viral infection, which induces neutralizing antibodies that last for a lifetime. It also induces a strong T cell response resembling the ones of acute infections, in contrast to most other vaccines. In spite of its use since 1937, learning how YF vaccination stimulates such strong and persistent immune responses has gained substantial knowledge only in the last decades. Here we summarize the current state of knowledge on the immune response to YF vaccination, and discuss its contribution as a human model to address complex questions on optimal immune responses.
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Affiliation(s)
- Amandine Bovay
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Silvia A Fuertes Marraco
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Daniel E Speiser
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Juan-Giner A, Kimathi D, Grantz KH, Hamaluba M, Kazooba P, Njuguna P, Fall G, Dia M, Bob NS, Monath TP, Barrett AD, Hombach J, Mulogo EM, Ampeire I, Karanja HK, Nyehangane D, Mwanga-Amumpaire J, Cummings DAT, Bejon P, Warimwe GM, Grais RF. Immunogenicity and safety of fractional doses of yellow fever vaccines: a randomised, double-blind, non-inferiority trial. Lancet 2021; 397:119-127. [PMID: 33422245 PMCID: PMC7794660 DOI: 10.1016/s0140-6736(20)32520-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/28/2020] [Accepted: 11/04/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Stocks of yellow fever vaccine are insufficient to cover exceptional demands for outbreak response. Fractional dosing has shown efficacy, but evidence is limited to the 17DD substrain vaccine. We assessed the immunogenicity and safety of one-fifth fractional dose compared with standard dose of four WHO-prequalified yellow fever vaccines produced from three substrains. METHODS We did this randomised, double-blind, non-inferiority trial at research centres in Mbarara, Uganda, and Kilifi, Kenya. Eligible participants were aged 18-59 years, had no contraindications for vaccination, were not pregnant or lactating, had no history of yellow fever vaccination or infection, and did not require yellow fever vaccination for travel. Eligible participants were recruited from communities and randomly assigned to one of eight groups, corresponding to the four vaccines at standard or fractional dose. The vaccine was administered subcutaneously by nurses who were not masked to treatment, but participants and other study personnel were masked to vaccine allocation. The primary outcome was proportion of participants with seroconversion 28 days after vaccination. Seroconversion was defined as post-vaccination neutralising antibody titres at least 4 times pre-vaccination measurement measured by 50% plaque reduction neutralisation test (PRNT50). We defined non-inferiority as less than 10% decrease in seroconversion in fractional compared with standard dose groups 28 days after vaccination. The primary outcome was measured in the per-protocol population, and safety analyses included all vaccinated participants. This trial is registered with ClinicalTrials.gov, NCT02991495. FINDINGS Between Nov 6, 2017, and Feb 21, 2018, 1029 participants were assessed for inclusion. 69 people were ineligible, and 960 participants were enrolled and randomly assigned to vaccine manufacturer and dose (120 to Bio-Manguinhos-Fiocruz standard dose, 120 to Bio-Manguinhos-Fiocruz fractional dose, 120 to Chumakov Institute of Poliomyelitis and Viral Encephalitides standard dose, 120 to Chumakov Institute of Poliomyelitis and Viral Encephalitides fractional dose, 120 to Institut Pasteur Dakar standard dose, 120 to Institut Pasteur Dakar fractional dose, 120 to Sanofi Pasteur standard dose, and 120 to Sanofi Pasteur fractional dose). 49 participants had detectable PRNT50 at baseline and 11 had missing PRNT50 results at baseline or 28 days. 900 were included in the per-protocol analysis. 959 participants were included in the safety analysis. The absolute difference in seroconversion between fractional and standard doses by vaccine was 1·71% (95% CI -2·60 to 5·28) for Bio-Manguinhos-Fiocruz, -0·90% (-4·24 to 3·13) for Chumakov Institute of Poliomyelitis and Viral Encephalitides, 1·82% (-2·75 to 5·39) for Institut Pasteur Dakar, and 0·0% (-3·32 to 3·29) for Sanofi Pasteur. Fractional doses from all four vaccines met the non-inferiority criterion. The most common treatment-related adverse events were headache (22·2%), fatigue (13·7%), myalgia (13·3%) and self-reported fever (9·0%). There were no study-vaccine related serious adverse events. INTERPRETATION Fractional doses of all WHO-prequalified yellow fever vaccines were non-inferior to the standard dose in inducing seroconversion 28 days after vaccination, with no major safety concerns. These results support the use of fractional dosage in the general adult population for outbreak response in situations of vaccine shortage. FUNDING The study was funded by Médecins Sans Frontières Foundation, Wellcome Trust (grant no. 092654), and the UK Department for International Development. Vaccines were donated in kind.
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Affiliation(s)
| | - Derick Kimathi
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
| | - Kyra H Grantz
- Department of Biology, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mainga Hamaluba
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
| | | | - Patricia Njuguna
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | | | | | - Alan D Barrett
- Sealy Institute for Vaccines Sciences and Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA
| | - Joachim Hombach
- Immunization, Vaccines & Biologicals, WHO, Geneva, Switzerland
| | - Edgar M Mulogo
- Department of Community Health, Mbarara University of Science & Technology, Mbarara, Uganda
| | | | - Henry K Karanja
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - Derek A T Cummings
- Department of Biology, University of Florida, Gainesville, FL, USA; Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Philip Bejon
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
| | - George M Warimwe
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine & Global Health, University of Oxford, Oxford, UK
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Staples JE, Alvarez AMR. Public health role for fractional dosage of yellow fever vaccine. Lancet 2021; 397:76-77. [PMID: 33422247 DOI: 10.1016/s0140-6736(20)32707-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Affiliation(s)
- J Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA.
| | - Alba-Maria Ropero Alvarez
- Comprehensive Family Immunization, Family, Health Promotion, and Life Course, Pan American Health Organization, Washington DC USA
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19
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Bonin CRB, Fernandes GC, de Menezes Martins R, Camacho LAB, Teixeira-Carvalho A, da Mota LMH, de Lima SMB, Campi-Azevedo AC, Martins-Filho OA, Dos Santos RW, Lobosco M. Validation of a yellow fever vaccine model using data from primary vaccination in children and adults, re-vaccination and dose-response in adults and studies with immunocompromised individuals. BMC Bioinformatics 2020; 21:551. [PMID: 33308151 PMCID: PMC7733702 DOI: 10.1186/s12859-020-03845-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An effective yellow fever (YF) vaccine has been available since 1937. Nevertheless, questions regarding its use remain poorly understood, such as the ideal dose to confer immunity against the disease, the need for a booster dose, the optimal immunisation schedule for immunocompetent, immunosuppressed, and pediatric populations, among other issues. This work aims to demonstrate that computational tools can be used to simulate different scenarios regarding YF vaccination and the immune response of individuals to this vaccine, thus assisting the response of some of these open questions. RESULTS This work presents the computational results obtained by a mathematical model of the human immune response to vaccination against YF. Five scenarios were simulated: primovaccination in adults and children, booster dose in adult individuals, vaccination of individuals with autoimmune diseases under immunomodulatory therapy, and the immune response to different vaccine doses. Where data were available, the model was able to quantitatively replicate the levels of antibodies obtained experimentally. In addition, for those scenarios where data were not available, it was possible to qualitatively reproduce the immune response behaviours described in the literature. CONCLUSIONS Our simulations show that the minimum dose to confer immunity against YF is half of the reference dose. The results also suggest that immunological immaturity in children limits the induction and persistence of long-lived plasma cells are related to the antibody decay observed experimentally. Finally, the decay observed in the antibody level after ten years suggests that a booster dose is necessary to keep immunity against YF.
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Affiliation(s)
- Carla Rezende Barbosa Bonin
- Institute of Education, Science and Technology of Southeast of Minas Gerais - Cataguases Advanced Campus, Chácara Granjaria, s/n - Granjaria, 36773-563, Cataguases, Brazil.
| | | | | | - Luiz Antonio Bastos Camacho
- Sergio Arouca National School of Public Health (ENSP), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | | | | | | | | | | | - Rodrigo Weber Dos Santos
- Graduate Program in Computational Modeling, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Marcelo Lobosco
- Graduate Program in Computational Modeling, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
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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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21
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Idoko OT, Domingo C, Tapia MD, Sow SO, Geldmacher C, Saathoff E, Kampmann B. Serological Protection 5-6 Years Post Vaccination Against Yellow Fever in African Infants Vaccinated in Routine Programmes. Front Immunol 2020; 11:577751. [PMID: 33133096 PMCID: PMC7578390 DOI: 10.3389/fimmu.2020.577751] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/03/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Although effective live attenuated yellow fever (YF) vaccines have been available for over 9 decades sporadic outbreaks continue to occur in endemic regions. These may be linked to several factors including epidemiological factors such as vector and intermediate host distribution or vaccine coverage and efficacy. The World Health Organization's research priorities include gathering systematic evidence around the potential need for booster vaccination with YF vaccine whether this follows full or fractional doses in children. Knowledge on the longevity of response to YF vaccine and the implications of this response needs to be consolidated to guide future vaccination policy. Methods: We measured anti-YF IgG by microneutralization assay in a group of 481 African infants who had received YF vaccine as part of routine EPI programmes, to explore serological protection from YF 5-6 years post YF vaccination, as well as the effect of co variates. Findings: Notably, 22.2% of the cohort had undetectable antibody concentrations, with another 7.5% revealing concentrations below the threshold of seropositivity of 0.5 IU/mL. Sex, season, country and time since vaccination did not affect the longevity of antibody concentration or having antibody concentrations above a defined threshold. Conclusion: Roughly 30% of children in this cohort did not demonstrate anti-yellow fever antibody concentrations above the defined threshold of protection, with 20% having no demonstrable antibody. Knowledge on the longevity of response to YF vaccine and the implications needs to be consolidated to guide future vaccination policy.
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Affiliation(s)
- Olubukola T. Idoko
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
- CIH Center for International Health, Medical Center of the University of Munich (Ludwig-Maximilians-Universität München), Munich, Germany
| | - Cristina Domingo
- Centre for Biological Threats and Special Pathogens, Robert Koch Institute, Berlin, Germany
| | - Milagritos D. Tapia
- Centre pour le Développement des Vaccins, University of Maryland, Bamako, Mali
| | - Samba O. Sow
- Centre pour le Développement des Vaccins, University of Maryland, Bamako, Mali
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München Munich, Munich, Germany
- German Centre for Infection Research (Deutsches Zentrum für Infektionsforschung), Munich, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität München Munich, Munich, Germany
- German Centre for Infection Research (Deutsches Zentrum für Infektionsforschung), Munich, Germany
| | - Beate Kampmann
- Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
- The Vaccine Centre, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Abstract
PURPOSE OF REVIEW Climate change, deforestation, urbanization, and increased population mobility have made the risk of large outbreaks of yellow fever more likely than ever. Yellow fever vaccine production barely meets demands. In this review, we address the causes of the recent yellow fever outbreaks, why fractional dose yellow fever vaccination works, the role of virus neutralizing antibodies in the protection against yellow fever, and the need for revaccination. RECENT FINDINGS Human activities have profoundly changed the epidemiology of yellow fever. The excess of infectious viral particles in routine yellow fever vaccine batches allows for off-label use of fractional dose yellow fever vaccination in response to emergency situations. Two studies have confirmed long-term protection after fractional dose yellow fever vaccination. The need for the presence of virus neutralizing antibodies (VNA) to protect an individual against yellow fever depends on the epidemiological setting. In case of sylvatic transmission, population immunity is irrelevant for individual protection, as mosquitoes are transmitting the virus from infected nonhuman primates to human. SUMMARY With the growing connectivity through air travel, countries with high densities of nonimmune populations and of the urban mosquito vector, Aedes aegypti, should ensure that their citizens are properly vaccinated against yellow fever before traveling to a yellow fever endemic country. In the situation of sylvatic transmission, the presence of protective levels of VNA will determine the outcome and may require revaccination at some point in time.
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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; 12:349-360. [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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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 (VIREMiCS), SingHealth Duke-NUS, Singapore, Singapore
| | - Ruklanthi de Alwis
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
- Viral Research and Experimental Medicine Centre (VIREMiCS), SingHealth Duke-NUS, Singapore, Singapore
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Afrough S, Rhodes S, Evans T, White R, Benest J. Immunologic Dose-Response to Adenovirus-Vectored Vaccines in Animals and Humans: A Systematic Review of Dose-Response Studies of Replication Incompetent Adenoviral Vaccine Vectors when Given via an Intramuscular or Subcutaneous Route. Vaccines (Basel) 2020; 8:E131. [PMID: 32192058 PMCID: PMC7157626 DOI: 10.3390/vaccines8010131] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/09/2020] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
Optimal vaccine dosing is important to ensure the greatest protection and safety. Analysis of dose-response data, from previous studies, may inform future studies to determine the optimal dose. Implementing more quantitative modelling approaches in vaccine dose finding have been recently suggested to accelerate vaccine development. Adenoviral vectored vaccines are in advanced stage of development for a variety of prophylactic and therapeutic indications, however dose-response has not yet been systematically determined. To further inform adenoviral vectored vaccines dose identification, historical dose-response data should be systematically reviewed. A systematic literature review was conducted to collate and describe the available dose-response studies for adenovirus vectored vaccines. Of 2787 papers identified by Medline search strategy, 35 were found to conform to pre-defined criteria. The majority of studies were in mice or humans and studied adenovirus serotype 5. Dose-response data were available for 12 different immunological responses. The majority of papers evaluated three dose levels, only two evaluated more than five dose levels. The most common dosing range was 107-1010 viral particles in mouse studies and 108-1011 viral particles in human studies. Data were available on adenovirus vaccine dose-response, primarily on adenovirus serotype 5 backbones and in mice and humans. These data could be used for quantitative adenoviral vectored vaccine dose optimisation analysis.
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Affiliation(s)
- Sara Afrough
- Vaccitech Ltd., The Schrodinger Building, Heatley Road, The Oxford Science Park, Oxford OX4 4GE, UK;
| | - Sophie Rhodes
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (S.R.); (R.W.); (J.B.)
| | - Thomas Evans
- Vaccitech Ltd., The Schrodinger Building, Heatley Road, The Oxford Science Park, Oxford OX4 4GE, UK;
| | - Richard White
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (S.R.); (R.W.); (J.B.)
| | - John Benest
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; (S.R.); (R.W.); (J.B.)
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Nnaji CA, Shey MS, Adetokunboh OO, Wiysonge CS. Immunogenicity and safety of fractional dose yellow fever vaccination: A systematic review and meta-analysis. Vaccine 2020; 38:1291-1301. [PMID: 31859201 DOI: 10.1016/j.vaccine.2019.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/08/2019] [Accepted: 12/08/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Recent upsurges in yellow fever outbreaks are increasing the demand for yellow fever vaccine, while enormously straining global vaccine supply. Fractional dose yellow fever vaccination is being considered as a dose-sparing strategy to address current vaccine shortages. This systematic review and meta-analysis aimed to assess the effects of fractional dose yellow fever vaccination, in comparison with those of standard dose vaccination. METHODS We registered this review on the International Prospective Register of Systematic Reviews (PROSPERO, registration number: CRD42018084214), developed the protocol in line with the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) and synthesised the evidence in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). We stratified meta-analyses by vaccine dose. RESULTS We retrieved 2524 records from the literature search, eleven of them potentially eligible. From these studies, we included eight eligible trials, with a total of 2371 participants. Seroconversion rates at four to five weeks following vaccination were similar between participants who received standard doses and participants who received fractional doses containing one-third (547 participants: risk ratio [RR] 1.02, 95% confidence interval [CI] 1.00-1.04), one-fifth (155 participants: RR 1.00, 95% CI 0.98-1.03), one-tenth (890 participants: RR 0.99, 95% CI 0.96-1.01), and one-fiftieth (661 participants: RR 0.97, 95% CI 0.92-1.02) of the standard dose. However, the rates of seroconversion were substantially lower among participants who received fractional doses containing one-hundredth and lower fractions of the standard dose. Immunogenicity similarly persisted 8-10 years following both fractional and standard dose vaccination. Minor adverse events following vaccination did not differ across doses, and no serious adverse events were reported in any study arm. CONCLUSIONS These findings support the use of fractional dosing as a strategy for mitigating vaccine shortages. The strategy should be specifically considered for individuals who are young, immuno-competent and well nourished.
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Affiliation(s)
- Chukwudi A Nnaji
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
| | - Muki S Shey
- Department of Medicine & Wellcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), University of Cape Town, Cape Town, South Africa
| | - Olatunji O Adetokunboh
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa; Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Charles S Wiysonge
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
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Girard YA, Santa Maria F, Lanteri MC. Inactivation of yellow fever virus with amotosalen and ultraviolet A light pathogen-reduction technology. Transfusion 2020; 60:622-627. [PMID: 31957887 PMCID: PMC7078960 DOI: 10.1111/trf.15673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/14/2019] [Accepted: 10/30/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The reemergence of yellow fever virus (YFV) in Africa and Brazil, and massive vaccine campaigns triggered to contain the outbreaks, have raised concerns over blood transfusion safety and availability with increased risk of YFV transfusion-transmitted infections (TTIs) by native and vaccine-acquired YFV. Blood donor deferral for 2 to 4 weeks following live attenuated YFV vaccination, and deferral for travel to endemic/epidemic areas, may result in blood donor loss and impact platelet component (PC) stocks. This study investigated the efficacy of INTERCEPT Blood System pathogen reduction (PR) with use of amotosalen and ultraviolet A (UVA) light to inactivate high levels of YFV in PCs. MATERIALS Four units of apheresis platelets prepared in 35% plasma/65% platelet additive solution (PC-PAS) and 4 units of PC in 100% human plasma (PC-Plasma) were spiked with high infectious titers of YFV (YFV-17D vaccine strain). YFV-17D infectious titers were measured by plaque assay and expressed as plaque-forming units (PFU) before and after amotosalen/UVA treatment to determine log reduction. RESULTS The mean YFV-17D infectious titers in PC before inactivation were 5.5 ± 0.1 log PFU/mL in PC-PAS and 5.3 ± 0.1 log PFU/mL in PC-Plasma. No infectivity was detected immediately after amotosalen/UVA treatment. CONCLUSION The amotosalen/UVA PR system inactivated high titers of infectious YFV-17D in PC. This PR technology could reduce the risk of YFV TTI and help secure PC supplies in areas experiencing YFV outbreaks where massive vaccination campaigns are required.
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Affiliation(s)
- Yvette A Girard
- Department of Microbiology, Cerus Corporation, Concord, California
| | | | - Marion C Lanteri
- Department of Scientific Affairs, Cerus Corporation, Concord, California
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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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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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Kimathi D, Juan A, Bejon P, Grais RF, Warimwe GM. Randomized, double-blinded, controlled non-inferiority trials evaluating the immunogenicity and safety of fractional doses of Yellow Fever vaccines in Kenya and Uganda. Wellcome Open Res 2019; 4:182. [PMID: 31984244 PMCID: PMC6971842 DOI: 10.12688/wellcomeopenres.15579.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2019] [Indexed: 01/22/2023] Open
Abstract
Introduction: Yellow fever is endemic in specific regions of sub-Saharan Africa and the Americas, with recent epidemics occurring on both continents. The yellow fever vaccine is effective, affordable and safe, providing life-long immunity following a single dose vaccination. However, the vaccine production process is slow and cannot be readily scaled up during epidemics. This has led the World Health Organization (WHO) to recommend the use of fractional doses as a dose-sparing strategy during epidemics, but there are no randomized controlled trials of fractional yellow fever vaccine doses in Africa. Methods and analysis: We will recruit healthy adult volunteers, adults living with HIV, and children to a series of randomized controlled trials aiming to determine the immunogenicity and safety of fractional vaccine doses in comparison to the standard vaccine dose. The trials will be conducted across two sites; Kilifi, Kenya and Mbarara, Uganda. Recruited participants will be randomized to receive fractional or standard doses of yellow fever vaccine. Scheduled visits will include blood collection for serum and peripheral blood mononuclear cells (PBMCs) before vaccination and on various days - up to 2 years - post-vaccination. The primary outcome is the rate of seroconversion as measured by the plaque reduction neutralization test (PRNT 50) at 28 days post-vaccination. Secondary outcomes include antibody titre changes, longevity of the immune response, safety assessment using clinical data, the nature and magnitude of the cellular immune response and post-vaccination control of viremia by vaccine dose. Ethics and dissemination: The clinical trial protocols have received approval from the relevant institutional ethics and regulatory review committees in Kenya and Uganda, and the WHO Ethics Review Committee. The research findings will be disseminated through open-access publications and presented at relevant conferences and workshops. Registration: ClinicalTrials.gov NCT02991495 (registered on 13 December 2016) and NCT04059471 (registered on 15 August 2019).
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Affiliation(s)
- Derick Kimathi
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - George M. Warimwe
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - YEFE and NIFTY vaccine trials teams
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Epicentre, Paris, France
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Chen Z, Liu K, Liu X, Lou Y. Modelling epidemics with fractional-dose vaccination in response to limited vaccine supply. J Theor Biol 2019; 486:110085. [PMID: 31758966 DOI: 10.1016/j.jtbi.2019.110085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 10/10/2019] [Accepted: 11/16/2019] [Indexed: 11/26/2022]
Abstract
The control strategies of emergency infectious diseases are constrained by limited medical resources. The fractional dose vaccination strategy as one of feasible strategies was proposed in response to global shortages of vaccine stockpiles. Although a variety of epidemic models have been developed under the circumstances of limited resources in treatment, few models particularly investigated vaccination strategies in resource-limited settings. In this paper, we develop a two-group SIR model with incorporation of proportionate mixing patterns and n-fold fractional dose vaccination related parameters to evaluate the efficiency of fractional dose vaccination on disease control at the population level. The existence and uniqueness of the final size of the two-group SIR epidemic model, the formulation of the basic reproduction number and the relationship between them are established. Moreover, numerical simulations are performed based on this two-group vector-free model to investigate the effectiveness of n-fold fractional dose vaccination by using the emergency outbreaks of yellow fever in Angola in 2016. By employing linear and nonlinear dose-response relationships, we compare the resulting fluctuations of four characteristics of the epidemics, which are the outbreak size, the peak time of the outbreak, the basic reproduction number and the infection attack rate (IAR). For both types of dose-response relationships, dose-fractionation takes positive effects in lowering the outbreak size, delay the peak time of the outbreak, reducing the basic reproduction number and the IAR of yellow fever only when the vaccine efficacy is high enough. Moreover, five-fold fractional dose vaccination strategy may not be the optimal vaccination strategy as proposed by the World Health Organization if the dose-response relationship is nonlinear.
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Affiliation(s)
- Zhimin Chen
- School of Mathematical Sciences, South China Normal University, Guangzhou 510631, PR China.
| | - Kaihui Liu
- Faculty of Science, Jiangsu University, Zhenjiang, Jiangsu 212013, PR China.
| | - Xiuxiang Liu
- School of Mathematical Sciences, South China Normal University, Guangzhou 510631, PR China.
| | - Yijun Lou
- Department of Applied Mathematics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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Casey RM, Harris JB, Ahuka-Mundeke S, Dixon MG, Kizito GM, Nsele PM, Umutesi G, Laven J, Kosoy O, Paluku G, Gueye AS, Hyde TB, Ewetola R, Sheria GKM, Muyembe-Tamfum JJ, Staples JE. Immunogenicity of Fractional-Dose Vaccine during a Yellow Fever Outbreak - Final Report. N Engl J Med 2019; 381:444-454. [PMID: 29443626 PMCID: PMC7064153 DOI: 10.1056/nejmoa1710430] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In 2016, the response to a yellow fever outbreak in Angola and the Democratic Republic of Congo led to a global shortage of yellow fever vaccine. As a result, a fractional dose of the 17DD yellow fever vaccine (containing one fifth [0.1 ml] of the standard dose) was offered to 7.6 million children 2 years of age or older and nonpregnant adults in a preemptive campaign in Kinshasa. The goal of this study was to assess the immune response to the fractional dose in a large-scale campaign. METHODS We recruited participants in four age strata at six vaccination sites. We assessed neutralizing antibody titers against yellow fever virus in blood samples obtained before vaccination and at 1 month and 1 year after vaccination, using a plaque reduction neutralization test with a 50% cutoff (PRNT50). Participants with a PRNT50 titer of 10 or higher were considered to be seropositive. Those with a baseline titer of less than 10 who became seropositive at follow-up were classified as having undergone seroconversion. Participants who were seropositive at baseline and who had an increase in the titer by a factor of 4 or more at follow-up were classified as having an immune response. RESULTS Among 716 participants who completed the 1-month follow-up, 705 (98%; 95% confidence interval [CI], 97 to 99) were seropositive after vaccination. Among 493 participants who were seronegative at baseline, 482 (98%; 95% CI, 96 to 99) underwent seroconversion. Among 223 participants who were seropositive at baseline, 148 (66%; 95% CI, 60 to 72) had an immune response. Lower baseline titers were associated with a higher probability of having an immune response (P<0.001). Among 684 participants who completed the 1-year follow-up, 666 (97%; 95% CI, 96 to 98) were seropositive for yellow fever antibody. The distribution of titers among the participants who were seronegative for yellow fever antibody at baseline varied significantly among age groups at 1 month and at 1 year (P<0.001 for both comparisons). CONCLUSIONS A fractional dose of the 17DD yellow fever vaccine was effective at inducing seroconversion in participants who were seronegative at baseline. Titers remained above the threshold for seropositivity at 1 year after vaccination in nearly all participants who were seropositive at 1 month after vaccination. These findings support the use of fractional-dose vaccination for outbreak control. (Funded by the U.S. Agency for International Development and the Centers for Disease Control and Prevention.).
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Affiliation(s)
- Rebecca M Casey
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Jennifer B Harris
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Steve Ahuka-Mundeke
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Meredith G Dixon
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Gabriel M Kizito
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Pierre M Nsele
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Grace Umutesi
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Janeen Laven
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Olga Kosoy
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Gilson Paluku
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Abdou S Gueye
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Terri B Hyde
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Raimi Ewetola
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Guylain K M Sheria
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - Jean-Jacques Muyembe-Tamfum
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
| | - J Erin Staples
- From the Global Immunization Division (R.M.C., J.B.H., M.G.D., G.U., G.P., T.B.H.) and the Epidemic Intelligence Service (R.M.C.), Centers for Disease Control and Prevention (CDC), Atlanta; Institut National de Recherche Biomédicale (S.A.-M., P.M.N., G.M.K., J.-J.M.-T.), Division of Global Health Protection (A.S.G.), Division of Global HIV and Tuberculosis (R.E.), CDC, and Programme Elargi de Vaccination, Ministère de la Santé (G.K.M.S.) - all in Kinshasa, Democratic Republic of Congo; and the Division of Vector-Borne Diseases, CDC, Fort Collins, CO (J.L., O.K., J.E.S.)
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Wilder-Smith A, Barrett A, Vannice K, Hombach J. Long-Term Protection After Fractional-Dose Yellow Fever Vaccination. Ann Intern Med 2019; 171:145-146. [PMID: 31307078 DOI: 10.7326/l19-0196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Annelies Wilder-Smith
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany, and London School of Hygiene and Tropical Medicine, London, United Kingdom (A.W.)
| | - Alan Barrett
- University of Texas Medical Branch, Galveston, Texas (A.B.)
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da Costa-Rocha IA, Campi-Azevedo AC, Peruhype-Magalhães V, Coelho-dos-Reis JG, Fradico JRB, Souza-Lopes T, Reis LR, Freire LC, Costa-Pereira C, Mambrini JVDM, Maia MDLDS, de Lima SMB, de Noronha TG, Xavier JR, Camacho LAB, de Albuquerque EM, Farias RHG, de Castro TDM, Homma A, Romano APM, Domingues CM, Martins RDM, Teixeira-Carvalho A, Martins-Filho OA. Duration of Humoral and Cellular Immunity 8 Years After Administration of Reduced Doses of the 17DD-Yellow Fever Vaccine. Front Immunol 2019; 10:1211. [PMID: 31293563 PMCID: PMC6598206 DOI: 10.3389/fimmu.2019.01211] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/13/2019] [Indexed: 11/13/2022] Open
Abstract
The present study aims to determine whether 17DD-YF-specific humoral and cellular immunological memory is maintained 8-years after primary vaccination with subdoses (10,447IU;3,013IU;587IU;158IU;31IU). For this purpose, this follow-up study was carried out in a subset of volunteers (n = 98) originally enrolled in the dose-response study in 2009 and 46 non-vaccinated controls. Our results demonstrated that vaccinees, who had seroconverted following primary vaccination and had not been revaccinated, present similar neutralizing antibodies levels and YF-specific cellular memory, particularly CMCD4 and EMCD8 as compared to the reference full dose (27,476IU). Although, PRNT seropositivity rates were similar across subgroups (94, 82, 83, 94, 80, and 91%, correspondingly), only doses above 587IU elicited similar iterative proportion of seropositivity rates, calculated as a progressive decrease on seropositivity rates along time (89, 80, 80, and 91%, respectively) as compared to 158IU and 31IU (68 and 46%, respectively). Noteworthy were the strong positive correlations ("EMCD4,EMCD8" and "TNFCD8,IFNCD8") observed in most subdoses, except for 31IU. Major similarities underscored the preserved antibody titers and the outstanding levels of EMCD8, relevant correlates of protection for YF-specific immunity. These findings provide evidences to support the regular use of dose sparing strategy for YF vaccine in adults.
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Affiliation(s)
- Ismael Artur da Costa-Rocha
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Ana Carolina Campi-Azevedo
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Vanessa Peruhype-Magalhães
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Jordana Grazziela Coelho-dos-Reis
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
- Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Thalles Souza-Lopes
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Laise Rodrigues Reis
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Larissa Chaves Freire
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Christiane Costa-Pereira
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Juliana Vaz de Melo Mambrini
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | | | - Sheila Maria Barbosa de Lima
- Laboratório de Tecnologia Virológica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Janaina Reis Xavier
- Assessoria Clínica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | - Luiz Antonio Bastos Camacho
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde - Escola Nacional de Saúde Pública – FIOCRUZ, Rio de Janeiro, Brazil
| | | | | | - Thalita da Matta de Castro
- Assessoria Clínica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | - Akira Homma
- Assessoria Clínica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Carla Magda Domingues
- Departamento de Vigilância das Doenças Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
| | - Reinaldo de Menezes Martins
- Assessoria Clínica, Instituto de Tecnologia em Imunobiológicos Bio-Manguinhos – FIOCRUZ, Rio de Janeiro, Brazil
| | - Andréa Teixeira-Carvalho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz – FIOCRUZ-Minas, Belo Horizonte, Brazil
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Rhodes SJ, Knight GM, Kirschner DE, White RG, Evans TG. Dose finding for new vaccines: The role for immunostimulation/immunodynamic modelling. J Theor Biol 2019; 465:51-55. [PMID: 30639297 PMCID: PMC6860008 DOI: 10.1016/j.jtbi.2019.01.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/12/2018] [Accepted: 01/09/2019] [Indexed: 12/17/2022]
Abstract
Current methods to optimize vaccine dose are purely empirically based, whereas in the drug development field, dosing determinations use far more advanced quantitative methodology to accelerate decision-making. Applying these established methods in the field of vaccine development may reduce the currently large clinical trial sample sizes, long time frames, high costs, and ultimately have a better potential to save lives. We propose the field of immunostimulation/immunodynamic (IS/ID) modelling, which aims to translate mathematical frameworks used for drug dosing towards optimizing vaccine dose decision-making. Analogous to Pharmacokinetic/Pharmacodynamic (PK/PD) modelling, the mathematical description of drug distribution (PK) and effect (PD) in host, IS/ID modelling approaches apply mathematical models to describe the underlying mechanisms by which the immune response is stimulated by vaccination (IS) and the resulting measured immune response dynamics (ID). To move IS/ID modelling forward, existing datasets and further data on vaccine allometry and dose-dependent dynamics need to be generated and collate, requiring a collaborative environment with input from academia, industry, regulators, governmental and non-governmental agencies to share modelling expertise, and connect modellers to vaccine data.
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Affiliation(s)
- Sophie J Rhodes
- TB Modelling Group, CMMID, TB Centre, London School of Hygiene and Tropical Medicine, UK.
| | - Gwenan M Knight
- TB Modelling Group, CMMID, TB Centre, London School of Hygiene and Tropical Medicine, UK
| | | | - Richard G White
- TB Modelling Group, CMMID, TB Centre, London School of Hygiene and Tropical Medicine, UK
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Schaumburg F, De Pijper CA, Grobusch MP. Intradermal travel vaccinations-when less means more. Travel Med Infect Dis 2019; 28:3-5. [PMID: 30878310 DOI: 10.1016/j.tmaid.2019.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Frieder Schaumburg
- Institute of Medical Microbiology, University Hospital Münster, Domagkstraße 10, 48149, Münster, Germany.
| | - Cornelis A De Pijper
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Infection & Immunity, Amsterdam Public Health, Meibergdreef 9, 1100, DD, Amsterdam, Netherlands
| | - Martin P Grobusch
- Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Infection & Immunity, Amsterdam Public Health, Meibergdreef 9, 1100, DD, Amsterdam, Netherlands
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Espinal MA, Andrus JK, Jauregui B, Waterman SH, Morens DM, Santos JI, Horstick O, Francis LA, Olson D. Emerging and Reemerging Aedes-Transmitted Arbovirus Infections in the Region of the Americas: Implications for Health Policy. Am J Public Health 2019; 109:387-392. [PMID: 30676796 PMCID: PMC6366516 DOI: 10.2105/ajph.2018.304849] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2018] [Indexed: 12/26/2022]
Abstract
The increasing geographical spread and disease incidence of arboviral infections are among the greatest public health concerns in the Americas. The region has observed an increasing trend in dengue incidence in the last decades, evolving from low to hyperendemicity. Yellow fever incidence has also intensified in this period, expanding from sylvatic-restricted activity to urban outbreaks. Chikungunya started spreading pandemically in 2005 at an unprecedented pace, reaching the Americas in 2013. The following year, Zika also emerged in the region with an explosive outbreak, carrying devastating congenital abnormalities and neurologic disorders and becoming one of the greatest global health crises in years. The inadequate arbovirus surveillance in the region and the lack of serologic tests to differentiate among viruses poses substantial challenges. The evidence for vector control interventions remains weak. Clinical management remains the mainstay of arboviral disease control. Currently, only yellow fever and dengue vaccines are licensed in the Americas, with several candidate vaccines in clinical trials. The Global Arbovirus Group of Experts provides in this article an overview of progress, challenges, and recommendations on arboviral prevention and control for countries of the Americas.
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Affiliation(s)
- Marcos A Espinal
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Jon K Andrus
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Barbara Jauregui
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Stephen Hull Waterman
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - David Michael Morens
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Jose Ignacio Santos
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Olaf Horstick
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Lorraine Ayana Francis
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
| | - Daniel Olson
- Marcos A. Espinal is with Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization/World Health Organization, Washington, DC. Jon K. Andrus is with the Department of Global Health, George Washington University Milken Institute of Public Health, Washington, DC, and the Division of Vaccines and Immunization, Center for Global Health, University of Colorado, Boulder. Barbara Jauregui is with the Department of Global Health, Milken Institute of Public Health, George Washington University. Stephen Hull Waterman is with the Dengue Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico. David Michael Morens is with the Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. Jose Ignacio Santos is with the Experimental Medicine Research Unit, Medical School, National Autonomous University of Mexico, Mexico City, Mexico. Olaf Horstick is with the Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany. Lorraine Ayana Francis is with Communicable Diseases & Emergency Response, Caribbean Public Health Agency, Port-of-Spain, Trinidad. Daniel Olson is with the Pediatric Infectious Disease Department, University of Colorado School of Medicine, and Epidemiology Department, Colorado School of Public Health, Aurora
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Roukens AHE, van Halem K, de Visser AW, Visser LG. Long-Term Protection After Fractional-Dose Yellow Fever Vaccination: Follow-up Study of a Randomized, Controlled, Noninferiority Trial. Ann Intern Med 2018; 169:761-765. [PMID: 30476963 DOI: 10.7326/m18-1529] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Outbreaks of yellow fever and a frequently depleted vaccine stock increase demand for a dose-sparing strategy. A fractional dose of 17D yellow fever virus (17D-YFV) vaccine has been shown to be noninferior to the standard dose in inducing seroprotection. OBJECTIVE To evaluate whether fractional-dose vaccination can confer long-term immunity. DESIGN 10-year follow-up of a subgroup of a randomized, controlled, noninferiority trial. (Dutch Trial Register: NTR7094 [current study] and ISRCTN46326316 [original study]). SETTING The Netherlands. PARTICIPANTS Seventy-five of 155 participants in the original trial provided a blood sample for this study. These 75 participants had received primary vaccination with 17D-YFV vaccine 10 years before. Forty received a 0.1-mL fractional dose intradermally, and 35 received the standard 0.5-mL dose subcutaneously. MEASUREMENTS Virus-neutralizing antibody responses were measured by a plaque reduction neutralization test. RESULTS Thirty-nine of 40 (98% [95% CI, 89% to 100%]) participants had protective levels of yellow fever-neutralizing antibodies more than 10 years after receiving a fractional dose of 17D-YFV vaccine compared with 34 of 35 (97% [CI, 87% to 100%]) in the standard-dose group. LIMITATION Only 48% of participants from the original trial participated in this study. CONCLUSION Intradermal administration of a one-fifth dose of yellow fever vaccine induced a protective immune response that lasted for 10 years after vaccination. Persons receiving a fractional dose of yellow fever vaccine do not require a booster vaccination for long-term protection against yellow fever. PRIMARY FUNDING SOURCE Leiden University Medical Center and the International Society of Travel Medicine.
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Affiliation(s)
- Anna H E Roukens
- Leiden University Medical Center, Leiden, and Maasstad Hospital, Rotterdam, the Netherlands (A.H.R.)
| | - Karlijn van Halem
- Leiden University Medical Center, Leiden, the Netherlands (K.V., A.W.D., L.G.V.)
| | - Adriëtte W de Visser
- Leiden University Medical Center, Leiden, the Netherlands (K.V., A.W.D., L.G.V.)
| | - Leo G Visser
- Leiden University Medical Center, Leiden, the Netherlands (K.V., A.W.D., L.G.V.)
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Handel A, Li Y, McKay B, Pawelek KA, Zarnitsyna V, Antia R. Exploring the impact of inoculum dose on host immunity and morbidity to inform model-based vaccine design. PLoS Comput Biol 2018; 14:e1006505. [PMID: 30273336 PMCID: PMC6181424 DOI: 10.1371/journal.pcbi.1006505] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/11/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022] Open
Abstract
Vaccination is an effective method to protect against infectious diseases. An important consideration in any vaccine formulation is the inoculum dose, i.e., amount of antigen or live attenuated pathogen that is used. Higher levels generally lead to better stimulation of the immune response but might cause more severe side effects and allow for less population coverage in the presence of vaccine shortages. Determining the optimal amount of inoculum dose is an important component of rational vaccine design. A combination of mathematical models with experimental data can help determine the impact of the inoculum dose. We illustrate the concept of using data and models to inform inoculum dose determination for vaccines, wby fitting a mathematical model to data from influenza A virus (IAV) infection of mice and human parainfluenza virus (HPIV) infection of cotton rats at different inoculum doses. We use the model to map inoculum dose to the level of immune protection and morbidity and to explore how such a framework might be used to determine an optimal inoculum dose. We show how a framework that combines mathematical models with experimental data can be used to study the impact of inoculum dose on important outcomes such as immune protection and morbidity. Our findings illustrate that the impact of inoculum dose on immune protection and morbidity can depend on the specific pathogen and that both protection and morbidity do not necessarily increase monotonically with increasing inoculum dose. Once vaccine design goals are specified with required levels of protection and acceptable levels of morbidity, our proposed framework can help in the rational design of vaccines and determination of the optimal amount of inoculum. An important component of vaccines is the amount of pathogen inoculum, dead or alive, that is included in the vaccine. This inoculum dose, sometimes also referred to as antigen dose, needs to be large enough to induce good protective immunity. However, one usually also wants to keep the dose low to reduce costs, maximize the number of vaccine doses available, and minimize potential vaccine side effects. The inoculum dose is currently chosen based on limited data from clinical trials. In this study, we set up a framework that combines data with mathematical models to illustrate how such a combination could lead to better and more efficient determination of an optimal inoculum dose for vaccines.
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Affiliation(s)
- Andreas Handel
- Department of Epidemiology and Biostatistics and Health Informatics Institute and Center for the Ecology of Infectious Diseases, University of Georgia, Athens, Georgia, United States of America
- * E-mail:
| | - Yan Li
- Institute of Bioinformatics, University of Georgia, Athens, Georgia, United States of America
| | - Brian McKay
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, Georgia, United States of America
| | - Kasia A. Pawelek
- Department of Mathematics and Computational Science, University of South Carolina Beaufort, Bluffton, South Carolina, United States of America
| | - Veronika Zarnitsyna
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Rustom Antia
- Department of Biology, Emory University, Atlanta, Georgia, United States of America
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Klitting R, Fischer C, Drexler JF, Gould EA, Roiz D, Paupy C, de Lamballerie X. What Does the Future Hold for Yellow Fever Virus? (II). Genes (Basel) 2018; 9:E425. [PMID: 30134625 PMCID: PMC6162518 DOI: 10.3390/genes9090425] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 02/06/2023] Open
Abstract
As revealed by the recent resurgence of yellow fever virus (YFV) activity in the tropical regions of Africa and South America, YFV control measures need urgent rethinking. Over the last decade, most reported outbreaks occurred in, or eventually reached, areas with low vaccination coverage but that are suitable for virus transmission, with an unprecedented risk of expansion to densely populated territories in Africa, South America and Asia. As reflected in the World Health Organization's initiative launched in 2017, it is high time to strengthen epidemiological surveillance to monitor accurately viral dissemination, and redefine vaccination recommendation areas. Vector-control and immunisation measures need to be adapted and vaccine manufacturing must be reconciled with an increasing demand. We will have to face more yellow fever (YF) cases in the upcoming years. Hence, improving disease management through the development of efficient treatments will prove most beneficial. Undoubtedly, these developments will require in-depth descriptions of YFV biology at molecular, physiological and ecological levels. This second section of a two-part review describes the current state of knowledge and gaps regarding the molecular biology of YFV, along with an overview of the tools that can be used to manage the disease at the individual, local and global levels.
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Affiliation(s)
- Raphaëlle Klitting
- Unité des Virus Émergents (UVE: Aix-Marseille Univ⁻IRD 190⁻Inserm 1207⁻IHU Méditerranée Infection), 13385 Marseille CEDEX 05, France.
| | - Carlo Fischer
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, 10117 Berlin, Germany.
- German Center for Infection Research (DZIF), 38124 Braunschweig, Germany.
| | - Jan F Drexler
- Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Virology, 10117 Berlin, Germany.
- German Center for Infection Research (DZIF), 38124 Braunschweig, Germany.
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, Sechenov University, 119991 Moscow, Russia.
| | - Ernest A Gould
- Unité des Virus Émergents (UVE: Aix-Marseille Univ⁻IRD 190⁻Inserm 1207⁻IHU Méditerranée Infection), 13385 Marseille CEDEX 05, France.
| | - David Roiz
- UMR Maladies Infectieuses et Vecteurs: Écologie, Génétique Évolution et Contrôle (MIVEGEC: IRD, CNRS, Univ. Montpellier), 34394 Montpellier, France.
| | - Christophe Paupy
- UMR Maladies Infectieuses et Vecteurs: Écologie, Génétique Évolution et Contrôle (MIVEGEC: IRD, CNRS, Univ. Montpellier), 34394 Montpellier, France.
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ⁻IRD 190⁻Inserm 1207⁻IHU Méditerranée Infection), 13385 Marseille CEDEX 05, France.
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Vannice K, Wilder-Smith A, Hombach J. Fractional-Dose Yellow Fever Vaccination - Advancing the Evidence Base. N Engl J Med 2018; 379:603-605. [PMID: 29995585 DOI: 10.1056/nejmp1803433] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Kirsten Vannice
- From the Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva (K.V., J.H.); the London School of Hygiene and Tropical Medicine, London (A.W.-S.); and the Institute of Public Health, University of Heidelberg, Heidelberg, Germany (A.W.-S.)
| | - Annelies Wilder-Smith
- From the Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva (K.V., J.H.); the London School of Hygiene and Tropical Medicine, London (A.W.-S.); and the Institute of Public Health, University of Heidelberg, Heidelberg, Germany (A.W.-S.)
| | - Joachim Hombach
- From the Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva (K.V., J.H.); the London School of Hygiene and Tropical Medicine, London (A.W.-S.); and the Institute of Public Health, University of Heidelberg, Heidelberg, Germany (A.W.-S.)
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41
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Yellow fever in the diagnostics laboratory. Emerg Microbes Infect 2018; 7:129. [PMID: 30002363 PMCID: PMC6043483 DOI: 10.1038/s41426-018-0128-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 05/30/2018] [Accepted: 06/03/2018] [Indexed: 12/15/2022]
Abstract
Yellow fever (YF) remains a public health issue in endemic areas despite the availability of a safe and effective vaccine. In 2015–2016, urban outbreaks of YF were declared in Angola and the Democratic Republic of Congo, and a sylvatic outbreak has been ongoing in Brazil since December 2016. Of great concern is the risk of urban transmission cycles taking hold in Brazil and the possible spread to countries with susceptible populations and competent vectors. Vaccination remains the cornerstone of an outbreak response, but a low vaccine stockpile has forced a sparing-dose strategy, which has thus far been implemented in affected African countries and now in Brazil. Accurate laboratory confirmation of cases is critical for efficient outbreak control. A dearth of validated commercial assays for YF, however, and the shortcomings of serological methods make it challenging to implement YF diagnostics outside of reference laboratories. We examine the advantages and drawbacks of existing assays to identify the barriers to timely and efficient laboratory diagnosis. We stress the need to develop new diagnostic tools to meet current challenges in the fight against YF.
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de Menezes Martins R, Maia MDLS, de Lima SMB, de Noronha TG, Xavier JR, Camacho LAB, de Albuquerque EM, Farias RHG, da Matta de Castro T, Homma A. Duration of post-vaccination immunity to yellow fever in volunteers eight years after a dose-response study. Vaccine 2018; 36:4112-4117. [PMID: 29784469 PMCID: PMC6026294 DOI: 10.1016/j.vaccine.2018.05.041] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/04/2018] [Accepted: 05/07/2018] [Indexed: 11/19/2022]
Abstract
In 2009, Bio-Manguinhos conducted a dose-response study with the yellow fever vaccine, administering the vaccine in the usual mean dose of 27,476 IU (full dose, reference) and in tapered doses (10,447 IU, 3013 IU, 587 IU, 158 IU, and 31 IU) by the usual subcutaneous route and usual volume (0.5 mL). Tapered doses were obtained by dilution in the manufacturer's laboratory, and the test batches presented industrial quality. Doses down to 587 IU showed similar immunogenicity to the full dose (27,476, reference), while the 158 IU and 31 IU doses displayed lower immunogenicity. Seropositivity was maintained at 10 months, except in the group that received the 31 IU dose. The current study aims to determine whether yellow fever seropositivity was maintained eight years after YF vaccination in non-revaccinated individuals. According to the current study's results, seropositivity was maintained in 85% of 318 participants and was similar across groups. The findings support the use of the yellow fever vaccine in fractional doses during outbreaks, but each fractional dose should have at least 587 IU. This study also supports the minimum dose required by WHO, 1000 IU. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov NCT 03338231.
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43
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Naveca FG, Pontes GS, Chang AYH, Silva GAVD, Nascimento VAD, Monteiro DCDS, Silva MSD, Abdalla LF, Santos JHA, Almeida TAPD, Mejía MDCC, Mesquita TGRD, Encarnação HVDS, Gomes MDS, Amaral LR, Campi-Azevedo AC, Coelho-Dos-Reis JG, Antonelli LRDV, Teixeira-Carvalho A, Martins-Filho OA, Ramasawmy R. Analysis of the immunological biomarker profile during acute Zika virus infection reveals the overexpression of CXCL10, a chemokine linked to neuronal damage. Mem Inst Oswaldo Cruz 2018; 113:e170542. [PMID: 29768624 PMCID: PMC5961926 DOI: 10.1590/0074-02760170542] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/14/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Infection with Zika virus (ZIKV) manifests in a broad spectrum of disease ranging from mild illness to severe neurological complications and little is known about Zika immunopathogenesis. OBJECTIVES To define the immunologic biomarkers that correlate with acute ZIKV infection. METHODS We characterized the levels of circulating cytokines, chemokines, and growth factors in 54 infected patients of both genders at five different time points after symptom onset using microbeads multiplex immunoassay; comparison to 100 age-matched controls was performed for statistical analysis and data mining. FINDINGS ZIKV-infected patients present a striking systemic inflammatory response with high levels of pro-inflammatory mediators. Despite the strong inflammatory pattern, IL-1Ra and IL-4 are also induced during the acute infection. Interestingly, the inflammatory cytokines IL-1β, IL-13, IL-17, TNF-α, and IFN-γ; chemokines CXCL8, CCL2, CCL5; and the growth factor G-CSF, displayed a bimodal distribution accompanying viremia. While this is the first manuscript to document bimodal distributions of viremia in ZIKV infection, this has been documented in other viral infections, with a primary viremia peak during mild systemic disease and a secondary peak associated with distribution of the virus to organs and tissues. MAIN CONCLUSIONS Biomarker network analysis demonstrated distinct dynamics in concurrence with the bimodal viremia profiles at different time points during ZIKV infection. Such a robust cytokine and chemokine response has been associated with blood-brain barrier permeability and neuroinvasiveness in other flaviviral infections. High-dimensional data analysis further identified CXCL10, a chemokine involved in foetal neuron apoptosis and Guillain-Barré syndrome, as the most promising biomarker of acute ZIKV infection for potential clinical application.
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Affiliation(s)
- Felipe Gomes Naveca
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil
| | | | | | - George Allan Villarouco da Silva
- Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil
| | - Valdinete Alves do Nascimento
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | | | - Marineide Souza da Silva
- Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil
| | - Lígia Fernandes Abdalla
- Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | | | - Tatiana Amaral Pires de Almeida
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Matilde Del Carmen Contreras Mejía
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | | | | | | | | | | | | | | | | | | | - Rajendranath Ramasawmy
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil.,Universidade Nilton Lins, Manaus, AM, Brasil
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Gamma-interferon exerts a critical early restriction on replication and dissemination of yellow fever virus vaccine strain 17D-204. NPJ Vaccines 2018; 3:5. [PMID: 29387474 PMCID: PMC5780476 DOI: 10.1038/s41541-017-0039-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/27/2017] [Accepted: 11/30/2017] [Indexed: 11/11/2022] Open
Abstract
Live attenuated viruses are historically among the most effective viral vaccines. Development of a safe vaccine requires the virus to be less virulent, a phenotype that is historically arrived by empirical evaluation often leaving the mechanisms of attenuation unknown. The yellow fever virus 17D live attenuated vaccine strain has been developed as a delivery vector for heterologous antigens; however, the mechanisms of attenuation remain elusive. The successful and safe progress of 17D as a vaccine vector and the development of live attenuated vaccines (LAVs) to related flaviviruses requires an understanding of the molecular mechanisms leading to attenuation. Using subcutaneous infection of interferon-deficient mouse models of wild type yellow fever virus (WT YFV) pathogenesis and 17D-mediated immunity, we found that, in the absence of type I IFN (IFN-α/β), type II interferon (IFN-γ) restricted 17D replication, but not that of WT YFV, by 1–2 days post-infection. In this context, IFN-γ responses protected 17D-infected animals from mortality, largely restricted the virus to lymphoid organs, and eliminated viscerotropic disease signs such as steatosis in the liver and inflammatory cell infiltration into the spleen. However, WT YFV caused a disseminated infection, gross liver pathology, and rapid death of the animals. In vitro, IFN-γ treatment of myeloid cells suppressed the replication of 17D significantly more than that of WT YFV, suggesting a direct differential effect on 17D virus replication. Together these data indicate that an important mechanism of 17D attenuation in vivo is increased sensitivity to IFN-γ stimulated responses elicited early after infection. The interferon gamma protein may play a key role in preventing yellow fever vaccine 17D from causing virus-like disease in recipients. The highly effective 17D vaccine is a less virulent form of the virus, but can induce severe disease in rare cases. A research group from the University of Pittsburgh, led by William Klimstra, investigated the impact of the vaccine on mice, as the mechanism by which hosts defend against its disease-causing potential is not fully understood. They found that interferon gamma restricted the replication and spread of the attenuated virus (the vaccine) but not its natural form. This study helps to inform efforts to improve the safety of the 17D vaccine, as well as the other vaccines that use it as a template for prophylaxis against other pathogens.
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Bassi PB, de Araújo FF, Garcia GC, Vinícius da Silva M, Oliveira CJF, Bittar ER, de Souza Gomes M, Rodrigues do Amaral L, Costa E Silva MF, Nascentes GAN, Rodrigues Junior V, Martins-Filho OA, Araújo MSS, Bittar JFF. Parasitological and immunological evaluation of cattle experimentally infected with Trypanosoma vivax. Exp Parasitol 2018; 185:98-106. [PMID: 29309784 DOI: 10.1016/j.exppara.2018.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 12/19/2017] [Accepted: 01/05/2018] [Indexed: 11/28/2022]
Abstract
Trypanosoma vivax infection causes relevant economical impact due to high morbidity and mortality leading to negative impact on local livestock. Despite parasitological and serological methods are used for the diagnosis of T. vivax infection, gaps regarding sensitivity and specificity of these methods still represent a challenge. The present study aimed to compare the kinetics of parasitological and serological parameters in cattle experimentally infected with T. vivax along with immunophenotypic analysis of whole blood leukocytes. Based on the parasitemia profile the analysis were performed in three distinct periods, referred as pre-patent, patent and post-treatment. Distinct kinetics of anti-T. vivax IgM and IgG were observed during the pre-patent, patent and post-treatment periods. Increased levels of WC1+ γδ T-cells were observed throughout the infection with strong correlations with other biomarkers observed during post-treatment period. Our findings demonstrated that there is a important participation of Monocytes:CD14+; NK-cells:CD335+ and WC1+ γδ T-cells that coincide with the peak of parasitemia and also with the adaptive immunity, specially CD4+ T-cells in T. vivax infection. The knowledge of the immune response is important not only for understanding the biology of the parasite in the host, but for the design of new treatment strategies for trypanosome infections.
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Affiliation(s)
- Paula Boeira Bassi
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil.
| | - Fernanda Fortes de Araújo
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil; Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou - Fundação Oswaldo Cruz. Avenida Augusto de Lima nº 1715, 30190-009, Barro Preto, Belo Horizonte, MG, Brazil.
| | - Guilherme Caetano Garcia
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil.
| | - Marcos Vinícius da Silva
- Laboratorio de Imunologia, Instituto de Ciencias Biológicas e Natural, Universidade Federal do Triângulo Mineiro, Uberaba, 38015-050, MG, Brazil.
| | - Carlo José Freire Oliveira
- Laboratorio de Imunologia, Instituto de Ciencias Biológicas e Natural, Universidade Federal do Triângulo Mineiro, Uberaba, 38015-050, MG, Brazil.
| | - Eustáquio Resende Bittar
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil.
| | - Matheus de Souza Gomes
- Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, INGEB/FACOM, Campus Patos de Minas, 38700-900, Patos de Minas, MG, Brazil.
| | - Laurence Rodrigues do Amaral
- Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, INGEB/FACOM, Campus Patos de Minas, 38700-900, Patos de Minas, MG, Brazil.
| | - Matheus Fernandes Costa E Silva
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil; Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou - Fundação Oswaldo Cruz. Avenida Augusto de Lima nº 1715, 30190-009, Barro Preto, Belo Horizonte, MG, Brazil.
| | - Gabriel Antônio Nogueira Nascentes
- Laboratório de Microbiologia e Imunologia, Instituto Federal de Educação, Ciência e Tecnologia do Triângulo Mineiro, Campus Uberaba, 38064-790, Uberaba, MG, Brazil.
| | - Virmondes Rodrigues Junior
- Laboratorio de Imunologia, Instituto de Ciencias Biológicas e Natural, Universidade Federal do Triângulo Mineiro, Uberaba, 38015-050, MG, Brazil.
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou - Fundação Oswaldo Cruz. Avenida Augusto de Lima nº 1715, 30190-009, Barro Preto, Belo Horizonte, MG, Brazil.
| | - Márcio Sobreira Silva Araújo
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil; Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou - Fundação Oswaldo Cruz. Avenida Augusto de Lima nº 1715, 30190-009, Barro Preto, Belo Horizonte, MG, Brazil.
| | - Joely Ferreira Figueiredo Bittar
- Universidade de Uberaba (UNIUBE), Medicina Veterinária, Mestrado em Sanidade e Produção Animal nos Trópicos - Avenida Nenê Sabino 1697/1698, 38055-500, Uberaba, MG, Brazil.
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Tottey S, Shoji Y, Jones RM, Chichester JA, Green BJ, Musiychuk K, Si H, Manceva SD, Rhee A, Shamloul M, Norikane J, Guimarães RC, Caride E, Silva ANMR, Simões M, Neves PCC, Marchevsky R, Freire MS, Streatfield SJ, Yusibov V. Plant-Produced Subunit Vaccine Candidates against Yellow Fever Induce Virus Neutralizing Antibodies and Confer Protection against Viral Challenge in Animal Models. Am J Trop Med Hyg 2017; 98:420-431. [PMID: 29231157 DOI: 10.4269/ajtmh.16-0293] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Yellow fever (YF) is a viral disease transmitted by mosquitoes and endemic mostly in South America and Africa with 20-50% fatality. All current licensed YF vaccines, including YF-Vax® (Sanofi-Pasteur, Lyon, France) and 17DD-YFV (Bio-Manguinhos, Rio de Janeiro, Brazil), are based on live attenuated virus produced in hens' eggs and have been widely used. The YF vaccines are considered safe and highly effective. However, a recent increase in demand for YF vaccines and reports of rare cases of YF vaccine-associated fatal adverse events have provoked interest in developing a safer YF vaccine that can be easily scaled up to meet this increased global demand. To this point, we have engineered the YF virus envelope protein (YFE) and transiently expressed it in Nicotiana benthamiana as a stand-alone protein (YFE) or as fusion to the bacterial enzyme lichenase (YFE-LicKM). Immunogenicity and challenge studies in mice demonstrated that both YFE and YFE-LicKM elicited virus neutralizing (VN) antibodies and protected over 70% of mice from lethal challenge infection. Furthermore, these two YFE-based vaccine candidates induced VN antibody responses with high serum avidity in nonhuman primates and these VN antibody responses were further enhanced after challenge infection with the 17DD strain of YF virus. These results demonstrate partial protective efficacy in mice of YFE-based subunit vaccines expressed in N. benthamiana. However, their efficacy is inferior to that of the live attenuated 17DD vaccine, indicating that formulation development, such as incorporating a more suitable adjuvant, may be required for product development.
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Affiliation(s)
- Stephen Tottey
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | - Yoko Shoji
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | - R Mark Jones
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | | | - Brian J Green
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | | | - Huaxin Si
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | | | - Amy Rhee
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | - Moneim Shamloul
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | - Joey Norikane
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
| | - Rosane C Guimarães
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Elena Caride
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Andrea N M R Silva
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Marisol Simões
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Patricia C C Neves
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Renato Marchevsky
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | - Marcos S Freire
- Instituto de Tecnologia em Imunobiológicos, Bio-Manguinhos, Fiocruz, Rio de Janeiro, Brazil
| | | | - Vidadi Yusibov
- Fraunhofer USA Center for Molecular Biotechnology, Newark, Delaware
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Ferreira CDC, Campi-Azevedo AC, Peruhype-Magalhāes V, Costa-Pereira C, Albuquerque CPD, Muniz LF, Yokoy de Souza T, Oliveira ACV, Martins-Filho OA, da Mota LMH. The 17D-204 and 17DD yellow fever vaccines: an overview of major similarities and subtle differences. Expert Rev Vaccines 2017; 17:79-90. [PMID: 29172832 DOI: 10.1080/14760584.2018.1406800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The yellow fever vaccine is a live attenuated virus vaccine that is considered one of the most efficient vaccines produced to date. The original 17D strain generated the substrains 17D-204 and 17DD, which are used for the current production of vaccines against yellow fever. The 17D-204 and 17DD substrains present subtle differences in their nucleotide compositions, which can potentially lead to variations in immunogenicity and reactogenicity. We will address the main changes in the immune responses induced by the 17D-204 and 17DD yellow fever vaccines and report similarities and differences between these vaccines in cellular and humoral immunity . This is a relevant issue in view of the re-emergence of yellow fever in Uganda in 2016 and in Brazil in the beginning of 2017. AREAS COVERED This article will be divided into 8 sections that will analyze the innate immune response, adaptive immune response, humoral response, production of cytokines, immunity in children, immunity in the elderly, gene expression and adverse reactions. EXPERT COMMENTARY The 17D-204 and 17DD yellow fever vaccines present similar immunogenicity, with strong activation of the cellular and humoral immune responses. Additionally, both vaccines have similar adverse effects, which are mostly mild and thus are considered safe.
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Affiliation(s)
| | | | | | | | | | - Luciana Feitosa Muniz
- a Department of Rheumatology , University Hospital of Brasilia, University of Brasilia , Brasilia , Brazil
| | - Talita Yokoy de Souza
- a Department of Rheumatology , University Hospital of Brasilia, University of Brasilia , Brasilia , Brazil
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Barrett AD. Yellow fever live attenuated vaccine: A very successful live attenuated vaccine but still we have problems controlling the disease. Vaccine 2017; 35:5951-5955. [DOI: 10.1016/j.vaccine.2017.03.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/18/2017] [Accepted: 03/08/2017] [Indexed: 02/08/2023]
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WHO position on the use of fractional doses – June 2017, addendum to vaccines and vaccination against yellow fever WHO: Position paper – June 2013. Vaccine 2017; 35:5751-5752. [DOI: 10.1016/j.vaccine.2017.06.087] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 06/29/2017] [Indexed: 11/18/2022]
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50
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Abstract
Recognition that the live yellow fever vaccine may rarely be associated with viscerotropic disease (YEL-AVD) has diminished its safety status. However, the vaccine remains the principal tool for limiting the occurrence of yellow fever, making large portions of Africa and South America more habitable. The subject has previously been exhaustively reviewed. Novel concepts in the current report include the description of a systematic method for deciding whom to vaccinate, recommendations for obtaining data helpful in making that decision, and suggestions for additional study. The vaccine is indeed a worthy friend, but its adverse reactions need to be recognized.
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Affiliation(s)
- Stephen J Seligman
- a Department of Microbiology and Immunology , New York Medical College , Valhalla , NY , USA.,b St. Giles Laboratory of Human Genetics of Infectious Diseases , The Rockefeller University , New York , NY , USA
| | - Jean-Laurent Casanova
- b St. Giles Laboratory of Human Genetics of Infectious Diseases , The Rockefeller University , New York , NY , USA.,c Howard Hughes Medical Institute , The Rockefeller University , New York , NY , USA
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