R Michel1, F Berger2, J Ravelonarivo3, P Dussart4, M Dia5, M Nacher6, S Rogier7, D Moua4, F D Sarr5, O M Diop5, A A Sall5, L Baril8. 1. Institut Pasteur in Dakar, Dakar, Senegal; Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France; Ecole du Val-de-Grâce, Paris, France. Electronic address: r.michel4@wanadoo.fr. 2. Centre d'Epidémiologie et de Santé Publique des Armées, Marseille, France; Institut Pasteur in French Guiana, Cayenne, France. 3. Institut Pasteur in Dakar, Dakar, Senegal; Institut Pasteur de Madagascar, Madagascar. 4. Institut Pasteur in French Guiana, Cayenne, France. 5. Institut Pasteur in Dakar, Dakar, Senegal. 6. Centre d'Investigation Clinique, Epidémiologie Clinique Antilles Guyane (CIC EC CIE802), Centre Hospitalier de Cayenne, Cayenne, French Guiana. 7. Institut Pasteur de Madagascar, Madagascar. 8. Institut Pasteur in Dakar, Dakar, Senegal; Global Epidemiology, GSK Vaccines, Wavre, Belgium.
Abstract
BACKGROUND: The use of 2 live attenuated vaccines (LAV) is recommended to be simultaneous or after an interval of at least four weeks between injections. The primary objective of this study was to compare the humoral response to yellow fever (YF) and measles vaccines among children vaccinated against these two diseases, either simultaneously or separated by an interval of 7-28 days. SUBJECTS AND METHODS: A prospective, multicenter observational study was conducted among children aged 9-15 months. The primary endpoint was the occurrence of positive yellow fever antibodies after YF vaccine by estimating the titers of neutralizing antibodies from venous blood samples. Children vaccinated against YF 7-28 days after receiving the vaccine against measles (test group) were compared with children vaccinated the same day against these two diseases (referent group). RESULTS: Analysis was performed on 284 children. Of them, fifty-four belonged to the test group. Measles serology was positive in 91.7% of children. Neutralizing antibodies against YF were detected in 90.7% of the test group and 92.9 of the referent group (p=0.6). In addition, quantitative analysis of the immune response did not show a lower response to YF vaccination when it took place 1-28 days after measles vaccination. DISCUSSION: In 1965, Petralli showed a lower response to the smallpox vaccine when injected 4-20 days after measles vaccination. Since then, recommendations are to observe an interval of four weeks between LAV not injected on the same day. Other published studies failed to show a significant difference in the immune response to a LAV injected 1-28 days after another LAV. These results suggest that the usual recommendations for immunization with two LAV may not be correct. CONCLUSION: In low income countries, the current policy should be re-evaluated. This re-evaluation should also be applied to travelers to yellow fever endemic countries.
BACKGROUND: The use of 2 live attenuated vaccines (LAV) is recommended to be simultaneous or after an interval of at least four weeks between injections. The primary objective of this study was to compare the humoral response to yellow fever (YF) and measles vaccines among children vaccinated against these two diseases, either simultaneously or separated by an interval of 7-28 days. SUBJECTS AND METHODS: A prospective, multicenter observational study was conducted among children aged 9-15 months. The primary endpoint was the occurrence of positive yellow fever antibodies after YF vaccine by estimating the titers of neutralizing antibodies from venous blood samples. Children vaccinated against YF 7-28 days after receiving the vaccine against measles (test group) were compared with children vaccinated the same day against these two diseases (referent group). RESULTS: Analysis was performed on 284 children. Of them, fifty-four belonged to the test group. Measles serology was positive in 91.7% of children. Neutralizing antibodies against YF were detected in 90.7% of the test group and 92.9 of the referent group (p=0.6). In addition, quantitative analysis of the immune response did not show a lower response to YF vaccination when it took place 1-28 days after measles vaccination. DISCUSSION: In 1965, Petralli showed a lower response to the smallpox vaccine when injected 4-20 days after measles vaccination. Since then, recommendations are to observe an interval of four weeks between LAV not injected on the same day. Other published studies failed to show a significant difference in the immune response to a LAV injected 1-28 days after another LAV. These results suggest that the usual recommendations for immunization with two LAV may not be correct. CONCLUSION: In low income countries, the current policy should be re-evaluated. This re-evaluation should also be applied to travelers to yellow fever endemic countries.
Authors: Alexandra C Willcox; Matthew H Collins; Ramesh Jadi; Corinna Keeler; Jonathan B Parr; Dieudonné Mumba; Melchior Kashamuka; Antoinette Tshefu; Aravinda M de Silva; Steven R Meshnick Journal: Am J Trop Med Hyg Date: 2018-07-05 Impact factor: 2.345
Authors: Panchali Roy Chowdhury; Christian Meier; Hewad Laraway; Yuxiao Tang; Abraham Hodgson; Samba O Sow; Godwin C Enwere; Brian D Plikaytis; Prasad S Kulkarni; Marie-Pierre Preziosi; Matthias Niedrig Journal: Clin Infect Dis Date: 2015-11-15 Impact factor: 9.079