Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study

Valim, Valéria; Machado, Ketty Lysie Libardi Lira; Miyamoto, Samira Tatiyama; Pinto, Arthur Dalmaso; Rocha, Priscila Costa Martins; Serrano, Érica Vieira; Dinis, Valquíria Garcia; Gouvêa, Sônia Alves; Dias, João Gabriel Fragoso; Campi-Azevedo, Ana Carolina; Teixeira-Carvalho, Andréa; Peruhype-Magalhães, Vanessa; Costa-Rocha, Ismael Artur da; Lima, Sheila Maria Barbosa de; Miranda, Emily Hime; Trindade, Gisela Freitas; Maia, Maria de Lourdes de Sousa; Gavi, Maria Bernadete Renoldi de Oliveira; Silva, Lídia Balarini da; Duque, Ruben Horst; Gianórdoli, Ana Paula Espíndula; Casagrande, Thays Zanon; Oliveira, Karine Gadioli; Moura, Bruna Costa da Mata; Nicole-Batista, Fernanda; Rodrigues, Lívia Carla de Melo; Clemente, T.B.; Magalhães, E.S.; Bissoli, Maria de Fatima; Gouvea, Maria da Penha Gomes; Pinto-Neto, Lauro Ferreira da Silva; Costa, Carolina Zorzanelli; Giovelli, Raquel Altoé; Brandão, Letícia Resende; Polito, Elizandra; Koehlert, Ingrid De Oliveira; Borjaille, Brunela P.; Pereira, Daniela; Dias, Laiza Hombre; Merlo, Daniela; Genelhu, Luiz Fellipe Favoreto; Pretti, F; Giacomin, Maryella Dos Santos; Burian, Ana Paula Neves; Fantinato, Francieli Fontana Sutile Tardetti; Pileggi, Gecilmara Salviato; Mota, Lícia Maria Henrique da; Martins‐Filho, Olindo Assis

doi:10.3389/fimmu.2020.01382

Cited by 26 publications

(20 citation statements)

References 40 publications

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“…The viremia peak was 5-6 days after vaccination in all groups but was lower in patients with AID. 97 Overall, these results highlight the importance of evaluating the immunogenicity of the YF-17D vaccine in specific populations and how the prior immune status influences the immune response to YF-17D vaccination. In addition, these studies pinpoint to important immune parameters at baseline or linked to immune status that interfere or hinder with the induction of optimal immune responses.…”

Section: Immunocompromised and Autoimmune Disease Patientsmentioning

confidence: 81%

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

Bovay

Marraco

Speiser

2021

Human Vaccines & Immunotherapeutics

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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.

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Section: Immunocompromised and Autoimmune Disease Patientsmentioning

confidence: 81%

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

Bovay

Marraco

Speiser

2021

Human Vaccines & Immunotherapeutics

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“…The 17DD-YF vaccine induces a safe and effective protective immunity in healthy vaccinees leading to high levels of protection in healthy adults (95–98%) resultant of robust humoral and cellular immunity 7 , 15 – 19 . Recent evidences have shown that planned primary 17DD-YF vaccination is safe and immunogenic but lower seropositivity rate is overall observed in AID patients upon planned 17DD-YF primary vaccination 14 .…”

Section: Discussionmentioning

confidence: 99%

“…Based on this guideline, our group has previously developed a prospective non-interventional study to assess the safety and immunogenicity of planned 17DD-YF primary vaccination in AID patients 14 . Consistent seroconversion rates (78%) were observed in AID patients, supporting the safety and immunogenicity of planned 17DD-YF primary vaccination for AID patients.…”

Section: Introductionmentioning

confidence: 99%

Serum biomarker profile orchestrating the seroconversion status of patients with autoimmune diseases upon planned primary 17DD Yellow fever vaccination

Costa-Rocha

Machado

Campi-Azevedo

et al. 2021

Sci Rep

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The present study aimed to investigate whether the serum biomarkers of immune response orchestrate the seroconversion status in patients with autoimmune diseases (AID) upon planned primary 17DD-YF vaccination. For this purpose a total of 161 individuals were enrolled in a prospective study, including patients with Rheumatoid Arthritis (RA = 38), Spondyloarthritis (SpA = 51), Systemic Lupus Erythematosus (SLE = 21) and Sjögren’s Syndrome (SS = 30) along with a group of healthy controls (HC = 21). Analysis of plaque reduction neutralization test (PRNT) titers and seropositivity rates along with the 17DD-YF viremia and serum biomarkers were carried out at distinct time points (D0/D3–4/D5–6/D7/D14–28). The results demonstrated an overall lower PRNT titer and seropositivity rate (170 vs. 448; 77 vs. 95%) in AID as compared to HC, especially in SpA and SLE subgroups. No significant differences were observed in the viremia levels amongst groups. In general, a more prominent serum biomarker response was observed in AID as compared to HC, throughout the timeline kinetics. Remarkably, AID/PRNT(−) exhibited higher levels of several biomarkers at baseline as compared to AID/PRNT+. Moreover, while AID/PRNT(+) exhibited earlier increase in serum biomarkers at D3–4/D5–6, the AID/PRNT(−) displayed higher response at later time points (D7/D14–D28). Of note, a synchronic increase of IFN-γ at the peak of viremia (D5–6) was observed in HC and AID/PRNT(+) groups, whereas a later asynchronous IFN-γ response was reported for AID/PRNT(−) at D7. The biomarker profile tends to deflate at post-vaccination timeline, highlighting a putative immunomodulatory effect of live attenuated 17DD-YF vaccine in AID/PRNT(+), but not in AID/PRNT(−). Altogether these data suggested that inflammatory status prior vaccination, low IFN-γ at viremia peak and the occurrence of asynchronous biomarker storm after 17DD-YF vaccination may orchestrate the lack of neutralizing antibody response γ.

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“… 50 YF vaccination of patients with low-active autoimmune diseases was safe after the withdrawal of immunomodulating therapy, but it led to a lower seropositivity rate (78% versus 96%) at day 28 after vaccination. 51 …”

Section: Discussionmentioning

confidence: 99%

A clinician’s perspective on yellow fever vaccine-associated neurotropic disease

Lecomte

Lochard

Verbeke

et al. 2020

Journal of Travel Medicine

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Yellow fever (YF) causes high fever, liver dysfunction, renal failure, hypercoagulopathy and platelet dysfunction and can lead to shock and death with a case-fatality ratio of 20 to 50%. Yellow fever vaccination results in long-lasting protective immunity. Serious adverse events, such as yellow fever vaccine-associated neurotropic disease (YEL-AND) are rare. We present a case of a 56-year-old Caucasian man with fever, headache, cognitive problems at the emergency department. He received a primary yellow fever vaccination 4 weeks prior to symptom onset. Cerebrospinal fluid tested positive for YF virus by RT-PCR and confirmed diagnosis of YEL-AND. The patient recovered with symptomatic treatment. We reviewed published clinical reports on YEL-AND indexed for MEDLINE. We identified and analyzed 53 case reports. Forty-five patients were male and eight were female. Twenty-nine cases met criteria for definite YEL-AND and twenty-four for suspected YEL-AND according to Yellow Fever Vaccine Safety Working Group. We applied the Brighton Collaboration diagnostic criteria to assess the diagnostic accuracy of the clinical diagnoses and found meningoencephalitis in 38 reported YEL-AND cases, Guillain Barré Syndrome (GBS) in 7, Acute Disseminated Encephalomyelitis (ADEM) in 6 and myelitis in 5. Thirty-five patients recovered or improved; however, not all cases had a complete follow-up. The prognosis of YEL-AND presenting with GBS, ADEM or myelitis was poor. Fourteen patients received therapy (corticosteroids, intravenous immunoglobulins and/or plasmapheresis). In conclusion, Yellow fever vaccine-associated neurotropic disease is a very rare but serious adverse event after yellow fever vaccination. We described a case of YEL-AND and propose a standardized clinical workup of this condition based on a review of the literature. Centralized registration of complications of yellow fever vaccination is encouraged.

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Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study

Cited by 26 publications

References 40 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

Serum biomarker profile orchestrating the seroconversion status of patients with autoimmune diseases upon planned primary 17DD Yellow fever vaccination

A clinician’s perspective on yellow fever vaccine-associated neurotropic disease

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