The Safety of Yellow Fever Vaccine 17D or 17DD in Children, Pregnant Women, HIV+ Individuals, and Older Persons: Systematic Review

Roger E. Thomas Department of Family Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Independent Research Consultant, Calgary, Alberta, Canada

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Diane L. Lorenzetti Department of Family Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Independent Research Consultant, Calgary, Alberta, Canada

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Wendy Spragins Department of Family Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Independent Research Consultant, Calgary, Alberta, Canada

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Dave Jackson Department of Family Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Independent Research Consultant, Calgary, Alberta, Canada

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Tyler Williamson Department of Family Medicine, Faculty of Medicine, University of Calgary, Alberta, Canada; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada; Independent Research Consultant, Calgary, Alberta, Canada

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Yellow fever vaccine provides long-lasting immunity. Rare serious adverse events after vaccination include neurologic or viscerotropic syndromes or anaphylaxis. We conducted a systematic review of adverse events associated with yellow fever vaccination in vulnerable populations. Nine electronic bibliographic databases and reference lists of included articles were searched. Electronic databases identified 2,415 abstracts for review, and 32 abstracts were included in this review. We identified nine studies of adverse events in infants and children, eight studies of adverse events in pregnant women, nine studies of adverse events in human immunodeficiency virus-positive patients, five studies of adverse events in persons 60 years and older, and one study of adverse events in individuals taking immunosuppressive medications. Two case studies of maternal–neonate transmission resulted in serious adverse events, and the five passive surveillance databases identified very small numbers of cases of yellow fever vaccine-associated viscerotropic disease, yellow fever vaccine-associated neurotropic disease, and anaphylaxis in persons ≥ 60 years. No other serious adverse events were identified in the other studies of vulnerable groups.

Author Notes

*Address correspondence to Roger E. Thomas, Department of Family Medicine, University of Calgary, G012, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1. E-mail: rthomas@ucalgary.ca

Financial support: The systematic review was funded by The Global Alliance for Vaccines and Immunization (GAVI).

Authors’ addresses: Roger E. Thomas, Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada, E-mail: rthomas@ucalgary.ca. Diane L. Lorenzetti and Tyler Williamson, Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada, E-mails: dllorenz@ucalgary.ca and tswillia@ucalgary.ca. Wendy Spragins and Dave Jackson, Independent Research Consultants, Calgary, Alberta, Canada, E-mails: spragins@ucalgary.ca and djackson@ucalgary.ca.

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