Long-Term Protection After Fractional-Dose Yellow Fever Vaccination: Follow-up Study of a Randomized, Controlled, Noninferiority Trial.
Ann Intern Med
; 169(11): 761-765, 2018 12 04.
Article
en En
| MEDLINE
| ID: mdl-30476963
ABSTRACT
Background:
Outbreaks of yellow fever and a frequently depleted vaccine stock increase demand for a dose-sparing strategy. A fractional dose of 17D yellow fever virus (17D-YFV) vaccine has been shown to be noninferior to the standard dose in inducing seroprotection.Objective:
To evaluate whether fractional-dose vaccination can confer long-term immunity.Design:
10-year follow-up of a subgroup of a randomized, controlled, noninferiority trial. (Dutch Trial Register NTR7094 [current study] and ISRCTN46326316 [original study]).Setting:
The Netherlands.Participants:
Seventy-five of 155 participants in the original trial provided a blood sample for this study. These 75 participants had received primary vaccination with 17D-YFV vaccine 10 years before. Forty received a 0.1-mL fractional dose intradermally, and 35 received the standard 0.5-mL dose subcutaneously. Measurements Virus-neutralizing antibody responses were measured by a plaque reduction neutralization test.Results:
Thirty-nine of 40 (98% [95% CI, 89% to 100%]) participants had protective levels of yellow fever-neutralizing antibodies more than 10 years after receiving a fractional dose of 17D-YFV vaccine compared with 34 of 35 (97% [CI, 87% to 100%]) in the standard-dose group.Limitation:
Only 48% of participants from the original trial participated in this study.Conclusion:
Intradermal administration of a one-fifth dose of yellow fever vaccine induced a protective immune response that lasted for 10 years after vaccination. Persons receiving a fractional dose of yellow fever vaccine do not require a booster vaccination for long-term protection against yellow fever. Primary Funding Source Leiden University Medical Center and the International Society of Travel Medicine.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fiebre Amarilla
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Vacunación
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Vacuna contra la Fiebre Amarilla
Tipo de estudio:
Clinical_trials
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Observational_studies
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Prognostic_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Ann Intern Med
Año:
2018
Tipo del documento:
Article