Is a dose of 17D vaccine in the current context of Yellow Fever enough?

Estofolete, Cássia Fernanda; Nogueira, Maurício Lacerda

doi:10.1016/j.bjm.2018.02.003

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…Since 2013, WHO has recommended a single dose of yellow fever vaccine for life-long immunity, and the amended International Health Regulations (2005) no longer require revaccination every 10 years 5, 16. Although it followed evidence of long-term immunogenicity,17, 18 this policy change has been controversial 19, 20, 21, 22. The one-dose recommendation bypasses the question of the duration of protective immunity elicited in infants, the target population of immunisation programmes in endemic countries 6 .…”

Section: Discussionmentioning

confidence: 99%

Long-term immunity against yellow fever in children vaccinated during infancy: a longitudinal cohort study

Domingo

Fraissinet

Ansah

et al. 2019

The Lancet Infectious Diseases

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SummaryBackgroundA 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.MethodsWe 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.FindingsWe 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.InterpretationRapid 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.FundingWellcome Trust.

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Section: Discussionmentioning

confidence: 99%

Long-term immunity against yellow fever in children vaccinated during infancy: a longitudinal cohort study

Domingo

Fraissinet

Ansah

et al. 2019

The Lancet Infectious Diseases

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“…In addition, strategies to control the Ae aegypti vector, which contribute to preventing viral spread and the resurgence of YFV, have little emphasis on the continent [57]. However, after emergency situations it is necessary to re-vaccinate the population with the full dose; the long-term protection provided by fractional doses in varied populations and epidemiological contexts is unknown [58]. In this sense, the study by Costa-Rocha and colleagues which evaluated the duration of humoral and cellular immunity after administration of reduced doses of the 17DD-Yellow Fever vaccine provided evidence to support the regular use of dose sparing strategies for YF vaccine in adults [59].…”

Section: Challenges and Lessons Learnedmentioning

confidence: 99%

“…These recent findings suggest that in YF endemic areas, at least an additional dose of the vaccine should be administered after the first immunization, in order to avoid the reduction in neutralizing antibodies titers below the protective levels [60][61][62]. During the recent epidemic in Brazil, the priority was to vaccinate the largest portion of the population possible; however, it is recommended that after this emergency period the population receives a full dose of 17DD vaccine, reinforcing the idea that at least two doses are necessary [58,60,62,65].…”

Section: Challenges and Lessons Learnedmentioning

confidence: 99%

Re-Emergence of Yellow Fever in Brazil during 2016–2019: Challenges, Lessons Learned, and Perspectives

Figueiredo

Stoffella-Dutra

Costa

et al. 2020

Viruses

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Yellow fever (YF) is a re-emerging viral zoonosis caused by the Yellow Fever virus (YFV), affecting humans and non-human primates (NHP). YF is endemic in South America and Africa, being considered a burden for public health worldwide despite the availability of an effective vaccine. Acute infectious disease can progress to severe hemorrhagic conditions and has high rates of morbidity and mortality in endemic countries. In 2016, Brazil started experiencing one of the most significant YF epidemics in its history, with lots of deaths being reported in regions that were previously considered free of the disease. Here, we reviewed the historical aspects of YF in Brazil, the epidemiology of the disease, the challenges that remain in Brazil’s public health context, the main lessons learned from the recent outbreaks, and our perspective for facing future YF epidemics.

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“…A further challenge to maintaining long-term population immunity is the World Health Organization’s recommendation that individuals receive a single lifetime dose of the vaccine. The emerging consensus points instead to the need for a second dose to boost waning immunity and mitigate the demonstrated risk of re-infection in YF-vaccinated individuals (Campi-Azevedo et al, 2019b, 2019a; Estofolete and Nogueira, 2018; Vasconcelos, 2018).…”

Section: Discussionmentioning

confidence: 99%

Genotype-specific Features Reduce the Susceptibility of South American Yellow Fever Virus Strains to Vaccine-Induced Antibodies

Haslwanter

Lasso

Wec

et al. 2021

Preprint

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SummaryThe resurgence of yellow fever in South America has prompted mitigation through vaccination against the etiologic agent, yellow fever virus (YFV). Current vaccines are based on a virulent African isolate, and their capacity to induce neutralizing antibodies against the vaccine strain is widely used as a surrogate for protection. However, the sensitivity of genetically distinct South American strains to vaccine-induced antibodies is unknown. Here, we show that antiviral potency of the polyclonal antibody response in both U.S. and Brazilian vaccinees is attenuated against an emergent Brazilian strain. This reduction was attributable to genetic changes at two sites in the central domain II of the glycoprotein E, including the acquisition of an N–linked glycosylation site, which are unique to and shared among most South American YFV strains. Our findings call for a reevaluation of current approaches to YFV immunological surveillance in South America and suggest approaches for designing updated vaccines.

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Is a dose of 17D vaccine in the current context of Yellow Fever enough?

Cited by 7 publications

References 14 publications

Long-term immunity against yellow fever in children vaccinated during infancy: a longitudinal cohort study

Long-term immunity against yellow fever in children vaccinated during infancy: a longitudinal cohort study

Re-Emergence of Yellow Fever in Brazil during 2016–2019: Challenges, Lessons Learned, and Perspectives

Genotype-specific Features Reduce the Susceptibility of South American Yellow Fever Virus Strains to Vaccine-Induced Antibodies

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