Open AccessImmunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases
Author(s) -
Adriana Coracini Tonácio,
Tatiana do Nascimento Pedrosa,
Eduardo F. Borba,
Nádia Emi Aikawa,
Sandra Gofinet Pasoto,
Júlio César Rente Ferreira Filho,
Marília Mantovani Sampaio Barros,
Elaine Pires Leon,
Suzete Cleusa Ferreira Spina Lombardi,
Alfredo Mendrone,
Adriana de Souza Azevedo,
Waleska Dias Schwarcz,
Ricardo Fuller,
Emily Figueiredo Neves Yuki,
Maria Helena Baena de Moraes Lopes,
Rosa Maria Rodrigues Pereira,
Percival Degrava Sampaio Barros,
Danieli Castro Oliveira de Andrade,
Ana Cristina Medeiros-Ribeiro,
Júlio César Bertacini de Moraes,
Samuel Katsuyuki Shinjo,
Renata Miossi,
Alberto José da Silva Duarte,
Marta Heloísa Lopes,
Esper G. Kallás,
Clóvis A. Silva,
Eloísa Bonfá
Publication year - 2021
Publication title -
plos neglected tropical diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.99
H-Index - 135
eISSN - 1935-2735
pISSN - 1935-2727
DOI - 10.1371/journal.pntd.0010002
Subject(s) - medicine , viremia , seroconversion , vaccination , immunogenicity , yellow fever vaccine , yellow fever , immunology , immunosuppression , titer , dengue fever , adverse effect , gastroenterology , antibody , virus
Background Brazil faced a yellow fever(YF) outbreak in 2016–2018 and vaccination was considered for autoimmune rheumatic disease patients(ARD) with low immunosuppression due to YF high mortality. Objective This study aimed to evaluate, prospectively for the first time, the short-term immunogenicity of the fractional YF vaccine(YFV) immunization in ARD patients with low immunossupression. Methods and Results A total of 318 participants(159 ARD and 159 age- and sex-matched healthy controls) were vaccinated with the fractional-dose(one fifth) of 17DD-YFV. All subjects were evaluated at entry(D0), D5, D10, and D30 post-vaccination for clinical/laboratory and disease activity parameters for ARD patients. Post-vaccination seroconversion rate(83.7%vs.96.6%, p = 0.0006) and geometric mean titers(GMT) of neutralizing antibodies[1143.7 (95%CI 1012.3–1292.2) vs.731 (95%CI 593.6–900.2), p 0.05). Conclusion Fractional-dose 17DD-YF vaccine in ARD patients resulted in a high rate of seroconversion rate(>80%) but lower than controls, with a longer but less intense viremia. This vaccine was immunogenic, safe and did not induce flares in ARD under low immunosuppression and may be indicated in YF outbreak situations and for patients who live or travel to endemic areas. Trial registration This clinical trial was registered with Clinicaltrials.gov ( #NCT03430388 ).