Long-term immunogenicity after yellow fever vaccination in immunosuppressed and healthy individuals.

Burkhard, J; Ciurea, A; Gabay, C; Hasler, P; Müller, R; Niedrig, M; Fehr, J; Villiger, P; Visser, L G; de Visser, A W; Walker, U A; Hatz, C; Bühler, S (2020). Long-term immunogenicity after yellow fever vaccination in immunosuppressed and healthy individuals. Vaccine, 38(19), pp. 3610-3617. Elsevier 10.1016/j.vaccine.2019.12.042

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BACKGROUND

The live-attenuated yellow fever vaccine (YFV) is generally contraindicated in immunosuppressed patients. Our aim was to investigate if immunosuppressive therapy impairs the long-term protection against yellow fever virus in patients who had received YFV prior to the start of their immunosuppressive therapy.

METHODS

Our study examined 35 healthy individuals and 40 immunosuppressed patients with autoimmune diseases or organ transplants. All individuals had received YFV prior to the onset of their immunosuppression. We analysed the long-term influence of the immunosuppressive therapy on the YFV protective immunity by measuring neutralising antibodies (NA) with the Plaque Reduction Neutralisation Test (PRNT). We assessed risk factors for a negative PRNT result (titre below 1: 10) and their influence on the magnitude of the NA.

RESULTS

A median time interval of 21.1 years (interquartile range 14.4-31.3 years) after the YFV in all patients, a total of 35 immunosuppressed patients (88%) were seropositive (PRNT ≥ 1:10) compared to 31 patients (89%) in the control group. The geometric mean titres of NA did not differ between the groups. The duration of an underlying rheumatic disease was the only risk factor found for a lower magnitude of NA. An insufficient level of NA was found in nine subjects (12%) who had received a single dose of YFV (in one subject, the number of YFV doses was unknown).

CONCLUSION

The use of an immunosuppressive drug started after the administration of the YFV did not affect long-term persistence of NA. A second dose of YFV may be necessary to secure long-term immunity.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology

UniBE Contributor:

Villiger, Peter Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0264-410X

Publisher:

Elsevier

Language:

English

Submitter:

Marlise Bühler Zimmermann

Date Deposited:

24 Dec 2020 11:31

Last Modified:

05 Dec 2022 15:43

Publisher DOI:

10.1016/j.vaccine.2019.12.042

PubMed ID:

31911033

Uncontrolled Keywords:

Immunosuppression Long-term immune response Neutralising antibodies Travel medicine Yellow fever vaccination

BORIS DOI:

10.48350/150010

URI:

https://boris.unibe.ch/id/eprint/150010

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