In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 15, No. 11 ( 2021-11-29), p. e0010002-
Abstract:
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 〈 0.001] were significantly lower in ARD compared to controls. A lower positivity rate of viremia was also identified for ARD patients compared to controls at D5 (53%vs.70%, p = 0.005) and the levels persisted in D10 for patients and reduced for controls(51%vs.19%, p = 0.0001). The viremia was the only variable associated with seroconvertion. No serious adverse events were reported. ARD disease activity parameters remained stable at D30(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 ).
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0010002
DOI:
10.1371/journal.pntd.0010002.g001
DOI:
10.1371/journal.pntd.0010002.g002
DOI:
10.1371/journal.pntd.0010002.g003
DOI:
10.1371/journal.pntd.0010002.g004
DOI:
10.1371/journal.pntd.0010002.t001
DOI:
10.1371/journal.pntd.0010002.t002
DOI:
10.1371/journal.pntd.0010002.t003
DOI:
10.1371/journal.pntd.0010002.t004
DOI:
10.1371/journal.pntd.0010002.t005
DOI:
10.1371/journal.pntd.0010002.s001
DOI:
10.1371/journal.pntd.0010002.s002
DOI:
10.1371/journal.pntd.0010002.s003
DOI:
10.1371/journal.pntd.0010002.s004
DOI:
10.1371/journal.pntd.0010002.s005
DOI:
10.1371/journal.pntd.0010002.s006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2429704-5
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