Active and passive surveillance of yellow fever vaccine 17D or 17DD-associated serious adverse events: Systematic review

Thomas, Roger E.; Lorenzetti, Diane; Spragins, Wendy; Jackson, Dave; Williamson, Tyler

doi:10.1016/j.vaccine.2011.04.055

Cited by 50 publications

(28 citation statements)

References 57 publications

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“…While precise measurements of the incidence of YEL-AVD in large populations are limited by the lack of adequate prospective data, several retrospective reviews have addressed the rate of this life-threatening condition [62,65,68,80,81,83]. The CDC identified a total of 72 cases from 437 million doses administered from 1990–2010, for an estimated rate of 0.16 cases of YEL-AVD per million doses administered [11].…”

Section: Yellow Fever Vaccine-associated Viscerotropic Disease (Yementioning

confidence: 99%

Questions regarding the safety and duration of immunity following live yellow fever vaccination

Amanna

Slifka

2016

Expert Review of Vaccines

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Introduction The World Health Organization (WHO) and other health agencies have concluded that yellow fever booster vaccination is unnecessary since a single dose of vaccine confers lifelong immunity. Areas Covered We reviewed the clinical studies cited by health authorities in their investigation of both the safety profile and duration of immunity for the YFV-17D vaccine and examined the position that booster vaccination is no longer needed. We found that antiviral immunity may be lost in 1-in-3 to 1-in-5 individuals within 5 to 10 years after a single vaccination and that children may be at greater risk for primary vaccine failure. The safety profile of YFV-17D was compared to other licensed vaccines including oral polio vaccine (OPV) and the rotavirus vaccine, RotaShield, which have subsequently been withdrawn from the US and world market, respectively. Expert Commentary Based on these results and recent epidemiological data on vaccine failures (particularly evident at >10 years after vaccination), we believe that current recommendations to no longer administer YFV-17D booster vaccination be carefully re-evaluated, and that further development of safer vaccine approaches should be considered.

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Section: Yellow Fever Vaccine-associated Viscerotropic Disease (Yementioning

confidence: 99%

Questions regarding the safety and duration of immunity following live yellow fever vaccination

Amanna

Slifka

2016

Expert Review of Vaccines

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“…33 However, certain host factors have been associated with a reduced immunologic response or safety concerns following vaccination. [40][41][42] We explored available evidence for the following persons: infants and children, HIV-infected persons, pregnant women, and severely malnourished persons.…”

Section: Americanmentioning

confidence: 99%

Efficacy and Duration of Immunity after Yellow Fever Vaccination: Systematic Review on the Need for a Booster Every 10 Years

Gotuzzo¹,

Yactayo²,

Córdova³

2013

The American Society of Tropical Medicine and Hygiene

203

172

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Abstract. Current regulations stipulate a yellow fever (YF) booster every 10 years. We conducted a systematic review of the protective efficacy and duration of immunity of YF vaccine in residents of disease-endemic areas and in travelers to assess the need for a booster in these two settings and in selected populations (human immunodeficiency virus-infected persons, infants, children, pregnant women, and severely malnourished persons). Thirty-six studies and 22 reports were included. We identified 12 studies of immunogenicity, 8 of duration of immunity, 8 of vaccine response in infants and children, 7 of human-immunodeficiency virus-infected persons, 2 of pregnant women, and 1 of severely malnourished children. Based on currently available data, a single dose of YF vaccine is highly immunogenic and confers sustained life-long protective immunity against YF. Therefore, a booster dose of YF vaccine is not needed. Special considerations for selected populations are detailed.

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“…It is ironic that the risk of SAEs may be highest in young females, while the risk (occupational) of wild-type YF infection is highest in young males. Thomas et al recently summarized the reporting rates of SAEs across all published studies in which surveillance for these events was undertaken, and determined that the rate of YEL-AVD would not exceed one in 720,000 vaccinations (0.14/100,000) [61]. However, the data used were overwhelmingly (98%) represented by a single study in a mass vaccination campaign in a west African city (Abidjan) [62].…”

Section: How To Weigh Risks and Benefits Of Yf Vaccine?mentioning

confidence: 99%

Review of the risks and benefits of yellow fever vaccination including some new analyses

Monath

2012

Expert Review of Vaccines

126

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The live, attenuated yellow fever (YF) 17D vaccine provides highly effective and durable immunity and is widely used for travelers to and residents of endemic areas of South America and Africa. Neurotropic and viscerotropic serious adverse events associated with these vaccines occur rarely, but YF 17D vaccine-associated viscerotropic disease (YEL-AVD) is notable for its lethality. There appear to be two distinct patterns of risk for YEL-AVD: the first in younger persons, particularly women, with defects in innate immunity, in whom the case-fatality rate is higher; and the second in elderly persons, particularly men with age-related immune senescence and a lower case-fatality rate. From 1990 to the present, the number of cases (n = 31) and deaths (n = 12) from YEL-AVD in travelers has exceeded the reports of YF (n = 6) acquired by natural infection, raising the question whether the risk of vaccination exceeds the benefit in travelers. To provide some guidance on this point, the rate of vaccine-related injury is compared with the rate of naturally acquired disease in a new analysis that estimates the immunologically susceptible denominator population in YF endemic and epidemic areas. For many years, the risk of vaccine-related illness and death was similar to the risk of illness and death from natural infection with YF in South America. Africa posed a substantially higher estimated risk of wild-type YF than vaccine-related injury. Multiple factors should be considered in making decisions about YF vaccination, including specific destination, season of the year, local evidence for YF transmission, likelihood of exposure to vector mosquitoes and individual risk factors for YEL-AVD, with the goal of increasing vaccine coverage for travel to high-risk areas and reducing unnecessary vaccination. Prospects for future, safer vaccines are also described.

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Active and passive surveillance of yellow fever vaccine 17D or 17DD-associated serious adverse events: Systematic review

Cited by 50 publications

References 57 publications

Questions regarding the safety and duration of immunity following live yellow fever vaccination

Questions regarding the safety and duration of immunity following live yellow fever vaccination

Efficacy and Duration of Immunity after Yellow Fever Vaccination: Systematic Review on the Need for a Booster Every 10 Years

Review of the risks and benefits of yellow fever vaccination including some new analyses

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