Adverse events following yellow fever immunization: Report and analysis of 67 neurological cases in Brazil

Serious adverse events associated with yellow fever vaccine

“…Rates during a campaign in 2009 in RS (Rio Grande do Sul State) with enhanced passive surveillance were much higher than with the routine passive surveillance in the rest of Brazil. 21 The overall rate of neurotropic disease per 100,000 doses in RS was 1.03, higher than expected. In RS the highest risk was for the age group from 5 to 9 years, but again confidence intervals for RRR were wide.…”

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

“…However, this number may be heavily skewed since 432 million doses (94%) were distributed in endemic countries. When the analysis is specifically limited to endemic countries ([64,65,75,76] and the endemic subpopulation in [63]) there are 0.38 cases of YEL-AND per million doses (165 cases from approximately 432 million vaccinations). After correcting for the number of administered military doses in [68], analysis from this study and the three other references cited by the CDC [11] in non-endemic regions ([62,68,77], and the non-endemic subpopulation in [63]), together totaled 43 cases of YEL-AND among approximately 22.5 million vaccinations (1.9 YEL-AND per million doses).…”

“…Of the 24 cases of YEL-AND identified by Cottin et al , only 1 occurred outside of their traveler vaccine subpopulation, which equates to 1 case per 259.8 million vaccinations (0.004 YEL-AND per million doses) [63]. In 2014, 63 cases of YEL-AND were reported in Brazil among 31.4 million immunizations (2.0 YEL-AND per million vaccinations) [75]. However, when limiting their analysis to only the state of Rio Grande do Sul in 2009, where training of healthcare staff and surveillance were specifically intensified due to a vaccination campaign, the YEL-AND rate jumped to 10.8 cases per million.…”

Controvérsias sobre a ampliação das áreas com vacinação de rotina contra a febre amarela no Brasil

“…Since the vaccine has been contraindicated in infants less than 6 months of age, the neurological manifestations have become even rarer, generally with favorable evolution and without sequelae. In Brazil, from 2007 to 2012, the overall rate of adverse neurological events after primary yellow fever vaccination (sub-strain 17DD) was 0.20 per 100,000 doses administered, with a higher rate in the 5 to 9 year age bracket and a lower rate in children 1 to 4 years of age (0.83 and 0.09 cases per 100,000 doses administered, respectively) 25 . In the United States, in 2007-2013, the overall rate of these events was 0.8 per 100,000, with a peak in the 60-69-year age bracket (2.5 per 100,000) 24 .…”