Yellow fever vaccine safety in immunocompromised individuals: a systematic review and meta-analysis

dc.contributor.authorLagos, Letícia Wigg de Araújo
dc.contributor.authorAbreu, Ariane de Jesus Lopes de
dc.contributor.authorCaetano, Rosângela
dc.contributor.authorBraga, José Ueleres
dc.date.accessioned2024-12-03T20:16:56Z
dc.date.available2024-12-03T20:16:56Z
dc.date.issued2023
dc.description.abstractBackground: Yellow fever (YF) is an arbovirus with variable severity, including severe forms with high mor- tality. The vaccination is the most effective measure to protect against the disease. Non-serious and serious adverse events have been described in immunocompromised individuals, but previous studies have failed to demonstrate this association. This systematic review assessed the risk of adverse events after YF vaccination in immunocompromised individuals compared with its use in non-immunocompromised individuals. Methods: A search was conducted in the MEDLINE, LILACS, EMBASE, SCOPUS, DARE, Toxiline, Web of Science and grey literature databases for publications until February 2021. Randomized and quasi-randomized clinical trials and observational studies that included immunocompromised participants (individuals with HIV infection, organ transplants, with cancer, who used immunosuppressive drugs for rheumatologic diseases and those on immunosuppressive therapy for other diseases) were selected. The methodological quality of observational or non-randomized studies was assessed by the ROBINS-I tool. Two meta-analyses were performed, proportion and risk factor analyses, to identify the summary measure of relative risk (RR) in the studies that had variables suitable for combination. Results: Twenty-five studies were included, most with risk of bias classified as critical. Thirteen studies had enough data to carry out the proposed meta-analyses. Seven studies without a comparator group had their results aggregated in the proportion meta-analysis, identifying an 8.5% [95% confidence interval (CI) 0.07–21.8] risk of immunocompromised individuals presenting adverse events after vaccination. Six cohort studies were combined, with an RR of 1.00 (95% CI 0.78–1.29). Subgroup analysis was performed according to the aetiology of immunosuppression and was also unable to identify an increased risk of adverse events following vaccination. Conclusions: It is not possible to affirm that immunocompromised individuals, regardless of aetiology, have a higher risk of adverse events after receiving the YF vaccine.
dc.identifier.citationWigg de Araújo Lagos L, de Jesus Lopes de Abreu A, Caetano R, Braga JU. Yellow fever vaccine safety in immunocompromised individuals: a systematic review and meta-analysis. J Travel Med. 2023 Apr 5;30(2):taac095. doi: 10.1093/jtm/taac095.
dc.identifier.otherDOI: 10.1093/jtm/taac095
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/650
dc.language.isoen
dc.publisherJournal of Travel Medicine
dc.subjectimmunocompromiseden
dc.subjectsystematic reviewen
dc.subjectadverse eventsen
dc.subjectyellow fever vaccineen
dc.subjectYellow feveren
dc.titleYellow fever vaccine safety in immunocompromised individuals: a systematic review and meta-analysis
dc.typeArticle
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