Fractional-dose yellow fever vaccination: an expert review

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
Anna H E Roukens ◽  
Leo G Visser
Keyword(s):  
Yellow Fever ◽  
Yellow Fever Virus ◽  
World Health ◽  
Yellow Fever Vaccine ◽  
Short Term ◽  
Protective Response ◽  
Fractional Dose ◽  
Dose Sparing ◽  
Yellow Fever Vaccination

Abstract Rationale for review: The global yellow fever vaccine supply is insufficient to provide full-dose vaccination to millions threatened by outbreaks. Given the excess of live-attenuated 17D yellow fever virus in the current single dose vials, dose sparing would increase available vaccine doses manifold. Fractional-dose yellow fever vaccination is now accepted as an emergency solution, as short-term protection has been confirmed in an outbreak situation in the Democratic Republic of Congo, but broader application of this dose-sparing strategy is still not recommended. In this review, important knowledge gaps that hamper this application such as long-term protection after fractional-dose vaccination, safety, comparability across different genetic backgrounds and different World Health Organization-licensed yellow fever vaccines and immunogenicity in infants are addressed. Main findings: Recently, published results on long-term protection after fractional-dose vaccination in healthy young volunteers indicate that if a person mounts a protective response shortly after vaccination, the protective response will persist for 10 years and possibly longer. It also appears that fractional-dose vaccination does not elicit more serious adverse events than standard dose vaccination. Short-term immunogenicity studies are currently underway in specific populations (infants, human immunodeficiency virus (HIV)-infected persons and healthy adults living in Uganda and Kenya), of which the results will become available in 2021–22. Conclusions: Available results on long-lasting immunogenicity of fractional-dose yellow fever vaccination are encouraging, although confirmation is required in larger populations including young children living in yellow fever endemic areas.

scholarly journals Prescrição da Vacina Contra a Febre Amarela: Experiência do Centro de Vacinação Internacional do Agrupamento de Centros de Saúde Loures-Odivela

2018 ◽  
Vol 31 (12) ◽  
pp. 724
Author(s):  
Clarisse Martinho ◽  
David Lopes ◽  
Luciana Bastos ◽  
Hugo Esteves
Keyword(s):  
Yellow Fever ◽  
Yellow Fever Virus ◽  
Health Centre ◽  
Travel Medicine ◽  
Sub Saharan Africa ◽  
World Health ◽  
Yellow Fever Vaccine ◽  
Travel Destination ◽  
Vector Borne ◽  
Sub Saharan

Introduction: Yellow fever is a vector-borne disease in sub-Saharan Africa and tropical South America regions which is preventable by an effective and safe vaccine. In some cases, it may cause serious adverse effects and should therefore be prescribed only to individuals at risk of exposure to the yellow fever virus or those traveling to countries requiring proof of vaccination. The aim of this study was to analyze the prescriptions of yellow fever vaccine, based on travel destination and type of referring consultation, according to the international recommendations of the World Health Organization.Material and Methods: The database of the International Vaccination Centre of the International Vaccination Centre of the Loures-Odivelas Health Centre Group was used to analyze data concerning the year of 2016. Travelers who were prescribed and administered the yellow fever vaccine were grouped based on travel destination and type of referring consultation (travelers’ medical consultations or non-specialist consultations).Results: A total of 517 yellow fever vaccines were administered, with the highest proportion in female (53%) and in individuals aged 40 - 49 years (20.7%). One hundred and thirteen (22.6%) of the 499 individuals with known-destinations were travelling to non-endemic/non-epidemic countries and a greater proportion of those were prescribed in non-specialist consultations (27.3%) than in travel medicine consultations (8.8%).Discussion/Conclusion: The highest percentage of yellow fever vaccines that were administered to individuals travelling to non-endemic/non-epidemic countries were prescribed in non-specialist consultations.

scholarly journals Long-Term Protection After Fractional-Dose Yellow Fever Vaccination

2019 ◽  
Vol 171 (2) ◽  
pp. 145 ◽  
Author(s):  
Annelies Wilder-Smith ◽  
Alan Barrett ◽  
Kirsten Vannice ◽  
Joachim Hombach
Keyword(s):  
Yellow Fever ◽  
Fractional Dose ◽  
Yellow Fever Vaccination

Long-Term Protection After Fractional-Dose Yellow Fever Vaccination

2018 ◽  
Vol 169 (11) ◽  
pp. 761 ◽  
Author(s):  
Anna H.E. Roukens ◽  
Karlijn van Halem ◽  
Adriëtte W. de Visser ◽  
Leo G. Visser
Keyword(s):  
Yellow Fever ◽  
Fractional Dose ◽  
Yellow Fever Vaccination

Multiple sclerosis: Is there a risk of worsening after yellow fever vaccination?

2021 ◽  
pp. 135245852110063
Author(s):  
Caroline Papeix ◽  
Julie Mazoyer ◽  
Elisabeth Maillart ◽  
Caroline Bensa ◽  
Anne-Laure Dubessy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cohort Study ◽  
Yellow Fever ◽  
Yellow Fever Vaccine ◽  
Relapsing Remitting ◽  
Annualized Relapse Rate ◽  
National Cohort ◽  
First Relapse ◽  
Yellow Fever Vaccination ◽  
Relapsing Remitting Multiple Sclerosis

Background: Yellow fever vaccine (YFV) is not advised for multiple sclerosis (MS) patients because of the potential risk of post-vaccine relapses. Objective: To assess the risk of relapsing-remitting multiple sclerosis (RR-MS) worsening after YFV. Methods: Non-interventional observational retrospective, exposed/non-exposed cohort study nested in the French national cohort including MS. Results: 128 RR-MS were included. The 1-year annualized relapse rate (ARR) following YFV did not differ between exposed: 0.219 (0.420) and non-exposed subjects: 0.208 (0.521) ( p = 0.92). Time to first relapse was not different between groups (adjusted hazard ratio (HR) = 1.33; 95% confidence interval (CI) = 0.53–3.30, p = 0.54). Conclusion: These results suggest that YFV does not worsen the course of RR-MS.

scholarly journals Yellow Fever Outbreak in Eastern Senegal, 2020–2021

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1475
Author(s):  
Moussa Moïse Diagne ◽  
Marie Henriette Dior Ndione ◽  
Alioune Gaye ◽  
Mamadou Aliou Barry ◽  
Diawo Diallo ◽  
...  
Keyword(s):  
Yellow Fever ◽  
Yellow Fever Virus ◽  
Mosquito Species ◽  
Virus Transmission ◽  
Genomic Analysis ◽  
Hemorrhagic Fever ◽  
Fever Virus ◽  
World Health ◽  
Effective Vaccine ◽  
Ministry Of Health

Yellow fever virus remains a major threat in low resource countries in South America and Africa despite the existence of an effective vaccine. In Senegal and particularly in the eastern part of the country, periodic sylvatic circulation has been demonstrated with varying degrees of impact on populations in perpetual renewal. We report an outbreak that occurred from October 2020 to February 2021 in eastern Senegal, notified and managed through the synergistic effort yellow fever national surveillance implemented by the Senegalese Ministry of Health in collaboration with the World Health Organization, the countrywide 4S network set up by the Ministry of Health, the Institut Pasteur de Dakar, and the surveillance of arboviruses and hemorrhagic fever viruses in human and vector populations implemented since mid 2020 in eastern Senegal. Virological analyses highlighted the implication of sylvatic mosquito species in virus transmission. Genomic analysis showed a close relationship between the circulating strain in eastern Senegal, 2020, and another one from the West African lineage previously detected and sequenced two years ago from an unvaccinated Dutch traveler who visited the Gambia and Senegal before developing signs after returning to Europe. Moreover, genome analysis identified a 6-nucleotide deletion in the variable domain of the 3′UTR with potential impact on the biology of the viral strain that merits further investigations. Integrated surveillance of yellow fever virus but also of other arboviruses of public health interest is crucial in an ecosystem such as eastern Senegal.

Response to Austriaco on Vaccine Passports

2021 ◽  
Vol 46 (4) ◽  
pp. 4-4
Author(s):  
Joseph Meaney ◽  
Keyword(s):  
World Health Organization ◽  
Cell Lines ◽  
Yellow Fever ◽  
International Travel ◽  
World Health ◽  
Yellow Fever Vaccine ◽  
Work Activities ◽  
The World ◽  
Health Organization

This essay clarifies the author’s objections to COVID-19 vaccine credentials voiced in “The Ethics of COVID-19 Vaccine Passports.” The author’s objections centered on discriminatory practices based on vaccine status for domestic social and work activities, but he agrees with the World Health Organization that these credentials should not be required for international travel. In addition, there is a significant ethical different between currently available COVID-19 vaccines and the yellow fever vaccine because the former are produced or tested using abortion-derived cell lines. The yellow fever vaccine is much less ethically problematic. This situation could change with the approval of new COVID-19 vaccines without links to abortion-derived cell lines.

scholarly journals Cutaneous lesions caused by the yellow fever vaccine – have you ever seen them?

2018 ◽  
Vol 64 (6) ◽  
pp. 498-500 ◽  
Author(s):  
Michelle Larissa Zini Lise ◽  
Michael Laurence Zini Lise
Keyword(s):  
Side Effects ◽  
South America ◽  
Skin Rash ◽  
Yellow Fever ◽  
Yellow Fever Virus ◽  
Fever Virus ◽  
Yellow Fever Vaccine ◽  
Cutaneous Lesions ◽  
Tropical Regions

SUMMARY The Yellow Fever virus was isolated in 1927 and the disease is considered endemic and epidemic in tropical regions of South America and Africa, with thousands of new cases reported annually. Several side effects of the vaccine have already been reported. Although reports of skin rash secondary to the vaccine range from 0 to 15%, no image or detailed description of the lesions were found in the literature. Here we describe a rash on a toddler vaccinated to travel.

scholarly journals Randomized, double-blinded, controlled non-inferiority trials evaluating the immunogenicity and safety of fractional doses of Yellow Fever vaccines in Kenya and Uganda

2019 ◽  
Vol 4 ◽  
pp. 182 ◽  
Author(s):  
Derick Kimathi ◽  
Aitana Juan ◽  
Philip Bejon ◽  
Rebecca F. Grais ◽  
George M. Warimwe ◽  
...  
Keyword(s):  
Immune Response ◽  
Randomized Controlled Trials ◽  
Yellow Fever ◽  
Vaccine Dose ◽  
World Health ◽  
Yellow Fever Vaccine ◽  
Controlled Trials ◽  
Post Vaccination ◽  
Randomized Controlled ◽  
Link Type

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 (PRNT50) 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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