Yellow fever vaccination in Brazil: Short-term safety and immunogenicity in juvenile autoimmune rheumatic diseases

Nádia Emi Aikawa; Verena Andrade Balbi; Eduardo Ferreira Borba; Adriana Coracini Tonacio; Adriana Maluf Elias Sallum; Lucia Maria Arruda Campos; Kátia Tomie Kozu; Margarete Borges Vendramini; Nicole Fontoura; Adriana de Souza Azevedo; Waleska Dias Schwarcz; Ana Marli Christovam Sartori; Leila Antonangelo; Clovis Artur Silva; Eloisa Bonfá

doi:10.1016/j.jvacx.2021.100131

Yellow fever vaccination in Brazil: Short-term safety and immunogenicity in juvenile autoimmune rheumatic diseases

Vaccine X. 2021 Dec 10:10:100131. doi: 10.1016/j.jvacx.2021.100131. eCollection 2022 Apr.

Authors

Nádia Emi Aikawa^{1

2}, Verena Andrade Balbi¹, Eduardo Ferreira Borba², Adriana Coracini Tonacio³, Adriana Maluf Elias Sallum¹, Lucia Maria Arruda Campos¹, Kátia Tomie Kozu¹, Margarete Borges Vendramini², Nicole Fontoura², Adriana de Souza Azevedo⁴, Waleska Dias Schwarcz⁴, Ana Marli Christovam Sartori³, Leila Antonangelo⁵, Clovis Artur Silva^{1

2}, Eloisa Bonfá²

Affiliations

¹ Pediatric Rheumatology Unit, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil.
² Division of Rheumatology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil.
³ Division of Infectology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil.
⁴ Institute of Technology in Immunobiologicals, Bio-Manguinhos, Fundação Oswaldo Cruz Foundation, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
⁵ Central Laboratory, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil.

Abstract

Yellow fever vaccine (YFV) is a live attenuated vaccine usually contraindicated for juvenile autoimmune rheumatic disease (JARD) patients. During the recent epidemic in Sao Paulo-Brazil, YFV was indicated for patients under low immunosuppression. Thirty JARD patients with inactive diseases undergoing low immunosuppression and 30 healthy controls (HC) were vaccinated with a fractional dose 17DD YFV (∼5495 IU) and evaluated 30 days later. JARD patients and controls had comparable median age (12.4 vs. 12 years, p = 0.250). Disease parameters remained stable 30 days after 17DD YFV (p > 0.05) and only mild adverse events were reported in both groups (p > 0.05). JARD and HC had similar seroprotection [93% vs. 100%;p = 0.49], seroconversion rates [96% vs. 100%;p = 0.489], and GMT [1249 vs.1293;p = 0.821]. Both groups had similar white-blood-cells kinetics with transient decreases in lymphocytes at D5 and neutrophils at D10, followed by full recovery at D30 (P < 0.05). In conclusion, 17DD YFV was safe and immunogenic in JARD. This study may contribute to recommendations for patients living/travelling to endemic areas.

Keywords: Immunogenicity; Juvenile autoimmune rheumatic disease; Leukocytes; Safety; Vaccine; Yellow fever.