Yellow fever vaccine-associated viscerotropic disease and death in Spain

Robert Koch Institut, Berlín, Berlin, Germany
Journal of Clinical Virology (Impact Factor: 3.02). 07/2006; 36(2):156-8. DOI: 10.1016/j.jcv.2006.02.005
Source: PubMed


Yellow fever vaccine-associated viscerotropic disease (YEL-AVD) is a recently described severe adverse event after yellow fever vaccination, and some cases have been reported in different countries [Anonymous. Effects of yellow fever and vaccination. Lancet 2001;358(9296):1907-9]. Herein we describe a YEL-AVD case in a young woman, who died after vaccination with 17D-204 strain. Clinical, serological and immunochemical analysis as well as virus detection, quantification, sequence analysis and cytokine release, were performed. Further investigations on yellow fever vaccine adverse events, and carefully analysis of the immune response elicited are important tasks for the future.

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    • "The presence of virus titers as high as 6.2 × 10 9 genome equivalents/g in individuals with YEL-AVD increases the possibility of transmission Chimeric YF/West Nile vaccine studied in horses; no evidence for shedding but vaccines intended for other species may need studies. Limited persistence and bio-distribution in monkeys after vaccination with Chimerivax-WN [35] [38] [73] [74] "
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    ABSTRACT: The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety of live, recombinant viral vaccines incorporating genes from heterologous viruses inserted into the backbone of another virus (so-called "chimeric virus vaccines"). Many viral vector vaccines are in advanced clinical trials. The first such vaccine to be approved for marketing (to date in Australia, Thailand, Malaysia, and the Philippines) is a vaccine against the flavivirus, Japanese encephalitis (JE), which employs a licensed vaccine (yellow fever 17D) as a vector. In this vaccine, two envelope proteins (prM-E) of YF 17D virus were exchanged for the corresponding genes of JE virus, with additional attenuating mutations incorporated into the JE gene inserts. Similar vaccines have been constructed by inserting prM-E genes of dengue and West Nile into YF 17D virus and are in late stage clinical studies. The dengue vaccine is, however, more complex in that it requires a mixture of four live vectors each expressing one of the four dengue serotypes. This vaccine has been evaluated in multiple clinical trials. No significant safety concerns have been found. The Phase 3 trials met their endpoints in terms of overall reduction of confirmed dengue fever, and, most importantly a significant reduction in severe dengue and hospitalization due to dengue. However, based on results that have been published so far, efficacy in preventing serotype 2 infection is less than that for the other three serotypes. In the development of these chimeric vaccines, an important series of comparative studies of safety and efficacy were made using the parental YF 17D vaccine virus as a benchmark. In this paper, we use a standardized template describing the key characteristics of the novel flavivirus vaccine vectors, in comparison to the parental YF 17D vaccine. The template facilitates scientific discourse among key stakeholders by increasing the transparency and comparability of information. The Brighton Collaboration V3SWG template may also be useful as a guide to the evaluation of other recombinant viral vector vaccines. Copyright © 2014. Published by Elsevier Ltd.
    Full-text · Article · Oct 2014 · Vaccine
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    • "YFV RNA has been detected in serum, plasma, blood, and tissues like liver, kidney and heart. The reported incidence in European, Australian and New Zealand or US travelers for YEL-AVD has been approximately 0.07 and 0.4 per 100,000 doses of vaccine administered, respectively, and case fatality ratio varying from very low even up to 65% [5] [6] [7] [8] [9] [10]. The YEL-AND manifestations include fever, headache, focal neurological findings, mental status changes and seizures caused by central nervous system tropisms of the vaccine virus itself. "
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    ABSTRACT: Yellow fever (YF) vaccine is considered safe but vaccine-associated complications have also been encountered. We report neurological symptoms after YF-vaccination in a previously healthy Finnish male. Other concomitant infections or causes for the symptoms could not be identified.
    Full-text · Article · Sep 2014 · Journal of Clinical Virology
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    • "These two 17D subgroups are nested in a polytomy with the vaccine strain Stamaril ® (France), an isolate from a YEL-AVD from Spain after vaccination with Stamaril ® [16] and the Chinese vaccine strain YFV 17D-Tiantan. Regarding the historical genealogy of 17D-passaging (Fig. 2), YFV 17D-Tiantan was separated from the other strains at passage 229 and has with 13 nucleotide differences, Table 1 Sequence differences between all available YFV vaccine strains. "
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    ABSTRACT: In recent years the safety of the yellow fever live vaccine 17D came under scrutiny. The focus was on serious adverse events after vaccinations that resemble a wild type infection with yellow fever and whose reasons are still not known. Also the exact mechanism of attenuation of the vaccine remains unknown to this day. In this context, the standards of safety and surveillance in vaccine production and administration have been discussed. Therein embodied was the demand for improved documentation of the derivation of the seed virus used for yellow fever vaccine production. So far, there was just a historical genealogy available that is based on source area and passage level. However, there is a need for a documentation based on molecular information to get better insights into the mechanisms of pathology. In this work we sequenced the whole genome of different passages of the YFV-17D strain used by Crucell Switzerland AG for vaccine production. Using all other publically available 17D full genome sequences we compared the sequence variance of all vaccine strains and oppose a phylogenetic tree based on full genome sequences to the historical genealogy.
    Full-text · Article · Dec 2011 · Vaccine
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