Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study

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 stu...

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Published in:	Frontiers in immunology Vol. 11; p. 1382
Main Authors:	Valim, Valéria, Machado, Ketty Lysie Libardi Lira, Miyamoto, Samira Tatiyama, Pinto, Arthur Dalmaso, Rocha, Priscila Costa Martins, Serrano, Erica Vieira, Dinis, Valquiria Garcia, Gouvêa, Sônia Alves, Dias, João Gabriel Fragoso, Campi-Azevedo, Ana Carolina, Teixeira-Carvalho, Andréa, Peruhype-Magalhães, Vanessa, da Costa-Rocha, Ismael Artur, de Lima, Sheila Maria Barbosa, Miranda, Emily Hime, Trindade, Gisela Freitas, Maia, Maria de Lourdes de Sousa, Gavi, Maria Bernadete Renoldi de Oliveira, da Silva, Lidia Balarini, Duque, Ruben Horst, Gianordoli, Ana Paula Espíndula, Casagrande, Thays Zanon, Oliveira, Karine Gadioli, Moura, Bruna Costa da Mata, Nicole-Batista, Fernanda, Rodrigues, Luiza Correa, Clemente, Thalles Brandão, Magalhães, Enan Sales, Bissoli, Maria de Fatima, Gouvea, Maria da Penha Gomes, Pinto-Neto, Lauro Ferreira da Silva, Costa, Carolina Zorzanelli, Giovelli, Raquel Altoé, Brandão, Leticia Resende, Polito, Elizandra Tomazela Laurenti, Koehlert, Ingrid de Oliveira, Borjaille, Brunela Passos, Pereira, Daniela Bergamim, Dias, Laiza Hombre, Merlo, Daniela Linhares, Genelhu, Luiz Fellipe Favoreto, Pretti, Flavia Zon, Giacomin, Maryella Dos Santos, Burian, Ana Paula Neves, Fantinato, Francieli Fontana Sutile Tardetti, Pileggi, Gecilmara Salviato, da Mota, Lícia Maria Henrique, Martins-Filho, Olindo Assis
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 17-07-2020
Subjects:	Adolescent Adult Aged Aged, 80 and over Antibodies, Neutralizing - blood Antibodies, Neutralizing - immunology Antibodies, Viral - blood Antibodies, Viral - immunology autoimmune diseases Autoimmune Diseases - complications Brazil Female Humans Immunology Male Middle Aged pharmacokinetics Prospective Studies seroconversion viremia Yellow Fever - prevention & control yellow fever vaccine Yellow Fever Vaccine - immunology Yellow Fever Vaccine - therapeutic use Young Adult Brazil autoimmune diseases pharmacokinetics yellow fever vaccine seroconversion viremia
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Summary:	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 ( = 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%; = 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), = 0.004] and seropositivity rate (78 vs. 96%, = 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.
Bibliography:	Reviewed by: Roger E. Thomas, University of Calgary, Canada; Anna Helena Roukens, Leiden University Medical Center, Netherlands These authors have contributed equally to this work This article was submitted to Vaccines and Molecular Therapeutics, a section of the journal Frontiers in Immunology Edited by: Daniel O'Connor, University of Oxford, United Kingdom
ISSN:	1664-3224 1664-3224
DOI:	10.3389/fimmu.2020.01382