mmunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic disease

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Tonacio, Adriana Coracini ^[1] ; Pedrosa, Tatiana do Nascimento ^[2] ; Borba, Eduardo Ferreira ^[2] ; Aikawa, Nadia Emi ^[2] ; Pasoto, Sandra Gofinet ^[2] ; Rente Ferreira Filho, Julio Cesar ^[2] ; Sampaio Barros, Marilia Mantovani ^[2] ; Leon, Elaine Pires ^[2] ; Ferreira Spina Lombardi, Suzete Cleusa ^[3] ; Mendrone Junior, Alfredo ^[3] ; Azevedo, Adriana de Souza ^[4] ; Schwarcz, Waleska Dias ^[4] ; Fuller, Ricardo ^[2] ; Neves Yuki, Emily Figueiredo ^[2] ; Ugolini Lopes, Michelle Remiao ^[2] ; Rodrigues Pereira, Rosa Maria ^[2] ; Sampaio Barros, Percival Degrava ^[2] ; Oliveira de Andrade, Danieli Castro ^[2] ; de Medeiros-Ribeiro, Ana Cristina ^[2] ; Bertacini de Moraes, Julio Cesar ^[2] ; Shinjo, Samuel Katsuyuki ^[2] ; Miossi, Renata ^[2] ; da Silva Duarte, Alberto Jose ^[5] ; Lopes, Marta Heloisa ^[1] ; Kallas, Esper Georges ^[1] ; Almeida da Silva, Clovis Artur ^[2] ; Bonfa, Eloisa ^[2]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Dept Infect & Parasit Dis, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Rheumatol Div, Sao Paulo - Brazil

^[3] Fundacao Prosangue, Div Pesquisa & Ensino, Lab Seguranca Transfus, Hemoctr Sao Paulo, Sao Paulo - Brazil

^[4] Fundacao Oswaldo Cruz Fdn, Inst Technol Immunobiol, FIOCRUZ, Biomanguinhos, Rio De Janeiro - Brazil

^[5] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Clin Lab Div, Dept Pathol, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: PLoS Neglected Tropical Diseases; v. 15, n. 11 NOV 2021.
• Citações Web of Science: 1

Resumo

Background Brazil faced a yellow fever(YF) outbreak in 2016-2018 and vaccination was considered for autoimmune rheumatic disease patients(ARD) with low immunosuppression due to YF high mortality. Objective This study aimed to evaluate, prospectively for the first time, the short-term immunogenicity of the fractional YF vaccine(YFV) immunization in ARD patients with low immunossupression. Methods and Results A total of 318 participants(159 ARD and 159 age- and sex-matched healthy controls) were vaccinated with the fractional-dose(one fifth) of 17DD-YFV. All subjects were evaluated at entry(D0), D5, D10, and D30 post-vaccination for clinical/laboratory and disease activity parameters for ARD patients. Post-vaccination seroconversion rate(83.7%vs.96.6%, p = 0.0006) and geometric mean titers(GMT) of neutralizing antibodies{[}1143.7 (95%CI 1012.3-1292.2) vs.731 (95%CI 593.6-900.2), p< 0.001] were significantly lower in ARD compared to controls. A lower positivity rate of viremia was also identified for ARD patients compared to controls at D5 (53%vs.70%, p = 0.005) and the levels persisted in D10 for patients and reduced for controls(51%vs.19%, p = 0.0001). The viremia was the only variable associated with seroconvertion. No serious adverse events were reported. ARD disease activity parameters remained stable at D30(p>0.05). Conclusion Fractional-dose 17DD-YF vaccine in ARD patients resulted in a high rate of seroconversion rate(> 80%) but lower than controls, with a longer but less intense viremia. This vaccine was immunogenic, safe and did not induce flares in ARD under low immunosuppression and may be indicated in YF outbreak situations and for patients who live or travel to endemic areas. (AU)

• Processo FAPESP: 10/10749-0 - Vacina anti-influenza H1N1/2009 em pacientes com doenças reumáticas autoimunes
• Beneficiário: Eloisa Silva Dutra de Oliveira Bonfá
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 17/14352-7 - Avaliação da relevância dos níveis sanguíneos de drogas utilizadas em doenças autoimunes reumatológicas no acompanhamento da segurança, eficácia e aderência à terapêutica
• Beneficiário: Tatiana Do Nascimento Pedrosa
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 18/16162-3 - Campanha de vacinação de 2018 para febre amarela e influenza: segurança e imunogenicidade em pacientes com doenças autoimunes reumatológicas
• Beneficiário: Eduardo Ferreira Borba Neto
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 17/11516-9 - Avaliação da relevância dos níveis sanguíneos de drogas utilizadas em doenças autoimunes reumatológicas no acompanhamento da segurança, eficácia e aderência à terapêutica
• Beneficiário: Julio Cesar Rente Ferreira Filho
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado