Immunogenicity and safety of fractional doses of yellow fever vaccines: a randomised, double-blind, non-inferiority trial

Juan-Giner, Aitana; Kimathi, Derick; Grantz, Kyra H.; Hamaluba, Mainga; Kazooba, Patrick; Njuguna, Patricia; Fall, Gamou; Dia, Moussa; Bob, Ndeye Sakha; Monath, Thomas P.; Barrett, Alan D.T.; Hombach, Joachim; Mulogo, Edgar; Ampeire, Immaculate; Karanja, Henry; Nyehangane, Dan; Mwanga-Amumpaire, Juliet; Cummings, Derek A. T.; Bejon, Philip; Warimwe, George M.; Grais, Rebecca F.

doi:10.1016/s0140-6736(20)32520-4

Cited by 40 publications

(47 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[103][104][105] Third, the study performed in research centers in Uganda and in Kenya, with healthy female and male volunteers (18-59y), compared standard and fractional doses (1/5 th of the standard dose) administrated subcutaneously. 106 The Dutch study showed that seroconversion (defined as serum dilution at which 80% viral neutralization occurred) induced by an intradermal 1/5 th reduced dose and by the standard dose did not differ between 2 weeks and 1 year after vaccination. 102 A follow-up study reported that participants had nAbs at protective levels more than 10 years after fractional dose vaccination, 99 The Brazilian study showed that seroconversion (determined by a 50% viral plaque reduction by anti-YFV nAbs) was equivalent in participants vaccinated with 1/46 dilution (587 IU) or standard dose.…”

Section: Immunogenicity Of Yf-17d Fractional Dosesmentioning

confidence: 98%

“…Seroconversion rates and nAb titers remained high up to 1 year after YF-17D vaccination for both fractional and standard doses. 106 Based on these data, the WHO recommended that dose sparing should contain at least 1ʹ000 IU. 100 The number of vaccinated individuals in the described studies is too low to assess the rate of serious adverse events upon vaccination with fractional dose of YF-17D.…”

Section: Immunogenicity Of Yf-17d Fractional Dosesmentioning

confidence: 99%

See 1 more Smart Citation

Yellow fever virus vaccination: an emblematic model to elucidate robust human immune responses

Bovay

Marraco

Speiser

2021

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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.

show abstract

Section: Immunogenicity Of Yf-17d Fractional Dosesmentioning

confidence: 98%

Section: Immunogenicity Of Yf-17d Fractional Dosesmentioning

confidence: 99%

Yellow fever virus vaccination: an emblematic model to elucidate robust human immune responses

Bovay

Marraco

Speiser

2021

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

show abstract

“…It should be emphasized that the two vaccines used in domestic markets are not inferior to those prequalified they just have not applied to the WHO for prequalification to be used internationally. None of the substrains appear to diverge in attenuation phenotype, and multiple non-inferiority trials have shown each substrain to be adequate for protection against YF [ 4 , 33 , 34 , 35 ].…”

Section: Live-attenuated 17d Vaccinementioning

confidence: 99%

The Present and Future of Yellow Fever Vaccines

Barrett

2021

Pharmaceuticals

View full text Add to dashboard Cite

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.

show abstract

“…Adverse vaccine events have been reported and associated with viscerotropic disease, which presents signs and symptoms that are not distinguished from the natural infection, and neurological disease [ 130 , 131 , 132 , 133 , 134 , 135 ].…”

Section: Viruses Commonly Associated With Cns Infection In Brazilmentioning

confidence: 99%

Viral and Prion Infections Associated with Central Nervous System Syndromes in Brazil

Sousa

Santos

Paula

et al. 2021

Viruses

View full text Add to dashboard Cite

Virus-induced infections of the central nervous system (CNS) are among the most serious problems in public health and can be associated with high rates of morbidity and mortality, mainly in low- and middle-income countries, where these manifestations have been neglected. Typically, herpes simplex virus 1 and 2, varicella-zoster, and enterovirus are responsible for a high number of cases in immunocompetent hosts, whereas other herpesviruses (for example, cytomegalovirus) are the most common in immunocompromised individuals. Arboviruses have also been associated with outbreaks with a high burden of neurological disorders, such as the Zika virus epidemic in Brazil. There is a current lack of understanding in Brazil about the most common viruses involved in CNS infections. In this review, we briefly summarize the most recent studies and findings associated with the CNS, in addition to epidemiological data that provide extensive information on the circulation and diversity of the most common neuro-invasive viruses in Brazil. We also highlight important aspects of the prion-associated diseases. This review provides readers with better knowledge of virus-associated CNS infections. A deeper understanding of these infections will support the improvement of the current surveillance strategies to allow the timely monitoring of the emergence/re-emergence of neurotropic viruses.

show abstract

Immunogenicity and safety of fractional doses of yellow fever vaccines: a randomised, double-blind, non-inferiority trial

Cited by 40 publications

References 21 publications

Yellow fever virus vaccination: an emblematic model to elucidate robust human immune responses

Yellow fever virus vaccination: an emblematic model to elucidate robust human immune responses

The Present and Future of Yellow Fever Vaccines

Viral and Prion Infections Associated with Central Nervous System Syndromes in Brazil

Contact Info

Product

Resources

About