Yellow fever (YF) vaccination does not increase dengue severity: A retrospective study based on 11,448 dengue notifications in a YF and dengue endemic region

Author(s)

Luppe, Marina Jolli ^[1] ; Verro, Alice Tobal ^{[1, 2]} ; Barbosa, Alana S. ^[1] ; Nogueira, Mauricio L. ^[3] ; Undurraga, Eduardo A. ^[4] ; da Silva, Natal S. ^{[1, 2, 3]}

Affiliation

^[1] Uniao Fac Grandes Lagos, Fac Med, Rua Dr Eduardo Nielsem, 960 Jardim Novo Aeroporto, BR-15030070 Sao Jose Do Rio Preto, SP - Brazil

^[2] Uniao Fac Grandes Lagos, Fac Med, Lab Modelagens Matemat & Estat Med, Rua Dr Eduardo Nielsem, 960 Jardim Novo Aeroporto, BR-15030070 Sao Jose Do Rio Preto, SP - Brazil

^[3] Fac Med Sao Jose do Rio Preto, Lab Pesquisa Virol, Av Brigadeiro Faria Lima 5416, BR-15090000 Sao Jose Do Rio Preto, SP - Brazil

^[4] Pontificia Univ Catolica Chile, Escuela Gobierno, Vicuna Mackenna 4860, Santiago 4860, Region Metropol - Chile

• Document type: Journal article
• Source: TRAVEL MEDICINE AND INFECTIOUS DISEASE; v. 30, p. 25-31, JUL-AUG 2019.
• Web of Science Citations: 1

Abstract

Background: We study the association between prior yellow fever immunization and clinical outcomes of dengue infections in individuals of varying sexes and ages. Serological interactions between dengue virus and other flaviviruses could drive antibody dependent enhancement, which is associated with disease severity in dengue infections. This effect may influence disease severity in individuals subsequently affected by related flaviviruses, such as dengue. We compare the severity of dengue episodes between patients vaccinated and non-vaccinated against yellow fever. Methods: We evaluated the severity of 11,448 lab-confirmed dengue cases reported in Sao Jose do Rio Preto, Brazil, in 7370 YF vaccinated patients compared to 4043 unvaccinated patients. We regressed dengue severity against YF vaccine status and a number of demographic, clinical, and laboratory variables as controls. We also evaluated the association between YF vaccination status and the clinical and laboratory symptoms of dengue patients. Results: We did not find any evidence of increased risk for severe dengue in patients vaccinated against YF (odds ratio = 1.00; 95% confidence interval = 0.87-1.14). Most of the variables analyzed did not have a statistically significant association with YF vaccination status. Conclusions: We found no evidence that YF vaccination in dengue-endemic areas increases the risk of severe dengue fever. (AU)

• FAPESP's process: 13/21719-3 - Epidemiological study of dengue (serotypes1-4) in a cohort of São José do Rio Preto, São Paulo, Brazil, during 2014-2018
• Grantee: Maurício Lacerda Nogueira
• Support Opportunities: Research Projects - Thematic Grants