An Inactivated Cell-Culture Vaccine against Yellow FeverArchived
A double-blind, placebo-controlled, dose-escalation, phase 1 study was performed in 60 healthy subjects between 18 and 49 years of age. The two-dose regimen induced the development of neutralizing antibodies in high percentages of the subjects (from 88% to 100% of subjects depending on antigen content)”.
Monath TP, Fowler E, Johnson CT, Balser J, Merribeth JM, Sisti M, and Trent DW. N Engl J Med 2011; 364:1326-1333April 7, 2011
Description: A double-blind, placebo-controlled, dose-escalation, phase 1 study was performed in 60 healthy subjects between 18 and 49 years of age. The two-dose regimen induced the development of neutralizing antibodies in high percentages of the subjects (from 88% to 100% of subjects depending on antigen content)”. The vaccination was associated with modest local reaction and didn’t show significant increase in the frequency of systemic adverse events compared to placebo.
Public Health Significance: The commonly used highly immunogenic live attenuated vaccine (17D) is distributed approx. 20 million times per annum worldwide. However, this vaccine may cause serious viscerotropic and neurotropic adverse events. Since 1973, 59 cases of viscerotropic disease have been reported after vaccination. 64% of these cases had a lethal outcome. Though the elderly seem to be at a higher risk of developing severe viscerotropic adverse events these are described in all age groups. Using a killed yellow fever vaccine that avoids the risk of severe or deadly adverse events could be an alternative for travellers, and the risk – benefit analysis between the live attenuated and the killed yellow fever vaccine seems to favour the latter for this group. However, it is most likely that the persistence of protection lasts much longer for the life vaccine. Therefore, the life attenuated yellow fever will probably remain the product of choice for inhabitants of yellow fever endemic areas.