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Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study.
Front Immunol. 2020; 11:1382.FI

Abstract

Yellow Fever (YF) vaccination is suggested to induce a large number of adverse events (AE) and suboptimal responses in patients with autoimmune diseases (AID); however, there have been no studies on 17DD-YF primary vaccination performance in patients with AID. This prospective non-interventional study conducted between March and July, 2017 assessed the safety and immunogenicity of planned 17DD-YF primary vaccination in patients with AID. Adult patients with AID (both sexes) were enrolled, along with healthy controls, at a single hospital (Vitória, Brazil). Included patients were referred for planned vaccination by a rheumatologist; in remission, or with low disease activity; and had low level immunosuppression or the attending physician advised interruption of immunosuppression for safety reasons. The occurrence of AE, neutralizing antibody kinetics, seropositivity rates, and 17DD-YF viremia were evaluated at various time points (day 0 (D0), D3, D4, D5, D6, D14, and D28). Individuals evaluated (n = 278), including patients with rheumatoid arthritis (RA; 79), spondyloarthritis (SpA; 59), systemic sclerosis (8), systemic lupus erythematosus (SLE; 27), primary Sjögren's syndrome (SS; 54), and healthy controls (HC; 51). Only mild AE were reported. The frequency of local and systemic AE in patients with AID and HC did not differ significantly (8 vs. 10% and 21 vs. 32%; p = 1.00 and 0.18, respectively). Patients with AID presented late seroconversion profiles according to kinetic timelines of the plaque reduction neutralization test (PRNT). PRNT-determined virus titers (copies/mL) [181 (95% confidence interval (CI), 144-228) vs. 440 (95% CI, 291-665), p = 0.004] and seropositivity rate (78 vs. 96%, p = 0.01) were lower in patients with AID after 28 days, particularly those with SpA (73%) and SLE (73%), relative to HC. The YF viremia peak (RNAnemia) was 5-6 days after vaccination in all groups. In conclusion, consistent seroconversion rates were observed in patients with AID and our findings support that planned 17DD-YF primary vaccination is safe and immunogenic in patients with AID.

Authors+Show Affiliations

Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil. Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil.Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil.Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil.Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil.Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Divisão de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes, Universidade Federal do Espírito Santo (UFES), Vitória, Brazil.Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, Brazil.Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, Brazil.Escola de Ciências da Saúde da Santa Casa de Misericórdia, Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Sociedade de Reumatologia do Espírito Santo (SORES), Vitória, Brazil.Centro de Referências para Imunobiológicos Especiais (CRIE) da Secretaria de Saúde do Estado do Espírito Santo, Vitória, Brazil.Departamento de Vigilância das Doenças Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil.Faculdade de Ciências da Saúde de Barretos-FACISB, Barretos, Brazil.Divisão de Reumatologia do Hospital Universitário de Brasília, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil.Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32765496

Citation

Valim, Valéria, et al. "Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: a Prospective Non-interventional Study." Frontiers in Immunology, vol. 11, 2020, p. 1382.
Valim V, Machado KLLL, Miyamoto ST, et al. Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study. Front Immunol. 2020;11:1382.
Valim, V., Machado, K. L. L. L., Miyamoto, S. T., Pinto, A. D., Rocha, P. C. M., Serrano, E. V., Dinis, V. G., Gouvêa, S. A., Dias, J. G. F., Campi-Azevedo, A. C., Teixeira-Carvalho, A., Peruhype-Magalhães, V., da Costa-Rocha, I. A., de Lima, S. M. B., Miranda, E. H., Trindade, G. F., Maia, M. L. S., Gavi, M. B. R. O., da Silva, L. B., ... Martins-Filho, O. A. (2020). Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study. Frontiers in Immunology, 11, 1382. https://doi.org/10.3389/fimmu.2020.01382
Valim V, et al. Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: a Prospective Non-interventional Study. Front Immunol. 2020;11:1382. PubMed PMID: 32765496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study. AU - Valim,Valéria, AU - Machado,Ketty Lysie Libardi Lira, AU - Miyamoto,Samira Tatiyama, AU - Pinto,Arthur Dalmaso, AU - Rocha,Priscila Costa Martins, AU - Serrano,Erica Vieira, AU - Dinis,Valquiria Garcia, AU - Gouvêa,Sônia Alves, AU - Dias,João Gabriel Fragoso, AU - Campi-Azevedo,Ana Carolina, AU - Teixeira-Carvalho,Andréa, AU - Peruhype-Magalhães,Vanessa, AU - da Costa-Rocha,Ismael Artur, AU - de Lima,Sheila Maria Barbosa, AU - Miranda,Emily Hime, AU - Trindade,Gisela Freitas, AU - Maia,Maria de Lourdes de Sousa, AU - Gavi,Maria Bernadete Renoldi de Oliveira, AU - da Silva,Lidia Balarini, AU - Duque,Ruben Horst, AU - Gianordoli,Ana Paula Espíndula, AU - Casagrande,Thays Zanon, AU - Oliveira,Karine Gadioli, AU - Moura,Bruna Costa da Mata, AU - Nicole-Batista,Fernanda, AU - Rodrigues,Luiza Correa, AU - Clemente,Thalles Brandão, AU - Magalhães,Enan Sales, AU - Bissoli,Maria de Fatima, AU - Gouvea,Maria da Penha Gomes, AU - Pinto-Neto,Lauro Ferreira da Silva, AU - Costa,Carolina Zorzanelli, AU - Giovelli,Raquel Altoé, AU - Brandão,Leticia Resende, AU - Polito,Elizandra Tomazela Laurenti, AU - Koehlert,Ingrid de Oliveira, AU - Borjaille,Brunela Passos, AU - Pereira,Daniela Bergamim, AU - Dias,Laiza Hombre, AU - Merlo,Daniela Linhares, AU - Genelhu,Luiz Fellipe Favoreto, AU - Pretti,Flavia Zon, AU - Giacomin,Maryella Dos Santos, AU - Burian,Ana Paula Neves, AU - Fantinato,Francieli Fontana Sutile Tardetti, AU - Pileggi,Gecilmara Salviato, AU - da Mota,Lícia Maria Henrique, AU - Martins-Filho,Olindo Assis, Y1 - 2020/07/17/ PY - 2020/03/08/received PY - 2020/05/29/accepted PY - 2020/8/9/entrez PY - 2020/8/9/pubmed PY - 2020/8/9/medline KW - autoimmune diseases KW - pharmacokinetics KW - seroconversion KW - viremia KW - yellow fever vaccine SP - 1382 EP - 1382 JF - Frontiers in immunology JO - Front Immunol VL - 11 N2 - Yellow Fever (YF) vaccination is suggested to induce a large number of adverse events (AE) and suboptimal responses in patients with autoimmune diseases (AID); however, there have been no studies on 17DD-YF primary vaccination performance in patients with AID. This prospective non-interventional study conducted between March and July, 2017 assessed the safety and immunogenicity of planned 17DD-YF primary vaccination in patients with AID. Adult patients with AID (both sexes) were enrolled, along with healthy controls, at a single hospital (Vitória, Brazil). Included patients were referred for planned vaccination by a rheumatologist; in remission, or with low disease activity; and had low level immunosuppression or the attending physician advised interruption of immunosuppression for safety reasons. The occurrence of AE, neutralizing antibody kinetics, seropositivity rates, and 17DD-YF viremia were evaluated at various time points (day 0 (D0), D3, D4, D5, D6, D14, and D28). Individuals evaluated (n = 278), including patients with rheumatoid arthritis (RA; 79), spondyloarthritis (SpA; 59), systemic sclerosis (8), systemic lupus erythematosus (SLE; 27), primary Sjögren's syndrome (SS; 54), and healthy controls (HC; 51). Only mild AE were reported. The frequency of local and systemic AE in patients with AID and HC did not differ significantly (8 vs. 10% and 21 vs. 32%; p = 1.00 and 0.18, respectively). Patients with AID presented late seroconversion profiles according to kinetic timelines of the plaque reduction neutralization test (PRNT). PRNT-determined virus titers (copies/mL) [181 (95% confidence interval (CI), 144-228) vs. 440 (95% CI, 291-665), p = 0.004] and seropositivity rate (78 vs. 96%, p = 0.01) were lower in patients with AID after 28 days, particularly those with SpA (73%) and SLE (73%), relative to HC. The YF viremia peak (RNAnemia) was 5-6 days after vaccination in all groups. In conclusion, consistent seroconversion rates were observed in patients with AID and our findings support that planned 17DD-YF primary vaccination is safe and immunogenic in patients with AID. SN - 1664-3224 UR - https://www.unboundmedicine.com/medline/citation/32765496/Planned_Yellow_Fever_Primary_Vaccination_Is_Safe_and_Immunogenic_in_Patients_With_Autoimmune_Diseases:_A_Prospective_Non_interventional_Study_ L2 - https://doi.org/10.3389/fimmu.2020.01382 DB - PRIME DP - Unbound Medicine ER -