Yellow fever vaccination: Is one dose always enough?

Patel, Dipti; Simons, Hilary

doi:10.1016/j.tmaid.2013.08.007

Cited by 26 publications

(19 citation statements)

References 21 publications

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“…The YFV vaccine is highly immunogenic, and both the WHO and the U.S. Centers for Disease Control and Prevention recently concluded that a single dose of the vaccine is sufficient for lifelong immunity in most populations, although this statement is not universally accepted. [42][43][44][45][46][47][48] There is some evidence that children are less likely to seroconvert than adults; however, the rates of seroconversion in children are nevertheless consistently reported to be above 80%. 44,[49][50][51] Duration of immunity in children receiving the YFV vaccine must also be considered in addition to early convalescent seroconversion; but unfortunately, data to that point are notably deficient in the literature over the past half century.…”

Section: Discussionmentioning

confidence: 99%

Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo

Willcox

Collins

Jadi

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Flaviviruses such as Zika, dengue, and yellow fever cause epidemics throughout the tropics and account for substantial global morbidity and mortality. Although malaria and other vector-borne diseases have long been appreciated in Africa, flavivirus epidemiology is incompletely understood. Despite the existence of an effective vaccine, yellow fever continues to cause outbreaks and deaths, including at least 42 fatalities in the Democratic Republic of the Congo (DRC) in 2016. Here, we leveraged biospecimens collected as part of the nationally representative 2013-2014 Demographic and Health Survey in the DRC to examine serological evidence of flavivirus infection or vaccination in children aged 6 months to 5 years. Even in this young stratum of the Congolese population, we find evidence of infection by dengue and Zika viruses based on results from enzyme-linked immunosorbent assay and neutralization assay. Surprisingly, there was remarkable discordance between reported yellow fever vaccination status and results of serological assays. The estimated seroprevalences of neutralizing antibodies against each virus are yellow fever, 6.0% (95% confidence interval [CI] = 4.6-7.5%); dengue, 0.4% (0.1-0.9%); and Zika, 0.1% (0.0-0.5%). These results merit targeted, prospective studies to assess effectiveness of yellow fever vaccination programs, determine flavivirus seroprevalence across a broader age range, and investigate how these emerging diseases contribute to the burden of acute febrile illness in the DRC.

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Section: Discussionmentioning

confidence: 99%

Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo

Willcox

Collins

Jadi

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…Similarly, the US Advisory Committee on Immunization Practices (ACIP) has voted that a single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers 38 . It should be noted that the decision to discontinue to YFV booster vaccinations has been the subject of some discussion 37, 39, 40 .…”

Section: Discussionmentioning

confidence: 99%

Adaptive immune responses to booster vaccination against yellow fever virus are much reduced compared to those after primary vaccination

Kongsgaard

Bassi

Rasmussen

et al. 2017

Sci Rep

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Outbreaks of Yellow Fever occur regularly in endemic areas of Africa and South America frequently leading to mass vaccination campaigns straining the availability of the attenuated Yellow Fever vaccine, YF-17D. The WHO has recently decided to discontinue regular booster-vaccinations since a single vaccination is deemed to confer life-long immune protection. Here, we have examined humoral (neutralizing antibody) and cellular (CD8 and CD4 T cell) immune responses in primary and booster vaccinees (the latter spanning 8 to 36 years after primary vaccination). After primary vaccination, we observed strong cellular immune responses with T cell activation peaking ≈2 weeks and subsiding to background levels ≈ 4 weeks post-vaccination. The number of antigen-specific CD8+ T cells declined over the following years. In >90% of vaccinees, in vitro expandable T cells could still be detected >10 years post-vaccination. Although most vaccinees responded to a booster vaccination, both the humoral and cellular immune responses observed following booster vaccination were strikingly reduced compared to primary responses. This suggests that pre-existing immunity efficiently controls booster inoculums of YF-17D. In a situation with epidemic outbreaks, one could argue that a more efficient use of a limited supply of the vaccine would be to focus on primary vaccinations.

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“…The 17D vaccine has been used in the YF control programs in endemic areas as well as in travelers, and the vaccine elicits long-term immunity (Gotuzzo et al, 2013; Ishikawa et al, 2014; Patel and Simons, 2013). Rare adverse effects including YEL-AND and YEL-AVD have been reported (Breugelmans et al, 2013; Ishikawa et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Although genetically distinct, all three substrains are immunogenic and efficacious, with amino acid substitutions likely responsible for attenuation (dos Santos et al, 1995; Jennings et al, 1993; Lang et al, 1999). A single dose of vaccine confers life-long protective immunity; therefore, a booster dose is not needed in most cases (Gotuzzo et al, 2013; Patel and Simons, 2013). …”

Section: Introductionmentioning

confidence: 99%

Plasmid DNA initiates replication of yellow fever vaccine in vitro and elicits virus-specific immune response in mice

et al. 2014

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Yellow fever (YF) causes an acute hemorrhagic fever disease in tropical Africa and Latin America. To develop a novel experimental YF vaccine, we applied iDNA infectious clone technology. The iDNA represents plasmid that encodes the full-length RNA genome of 17D vaccine downstream from a cytomegalovirus (CMV) promoter. The vaccine was designed to transcribe the full-length viral RNA and to launch 17D vaccine virus in vitro and in vivo. Transfection with 10ng of iDNA plasmid was sufficient to start replication of vaccine virus in vitro. Safety of the parental 17D and iDNA-derived 17D viruses was confirmed in AG129 mice deficient in receptors for IFN-α/β/γ. Finally, direct vaccination of BALB/c mice with a single 20µg dose of iDNA plasmid resulted in seroconversion and elicitation of virus-specific neutralizing antibodies in animals. We conclude that iDNA immunization approach combines characteristics of DNA and attenuated vaccines and represents a promising vaccination strategy for YF.

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Yellow fever vaccination: Is one dose always enough?

Cited by 26 publications

References 21 publications

Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo

Seroepidemiology of Dengue, Zika, and Yellow Fever Viruses among Children in the Democratic Republic of the Congo

Adaptive immune responses to booster vaccination against yellow fever virus are much reduced compared to those after primary vaccination

Plasmid DNA initiates replication of yellow fever vaccine in vitro and elicits virus-specific immune response in mice

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