PMID- 17012867
OWN - NLM
STAT- MEDLINE
DCOM- 20070112
LR  - 20220310
IS  - 1554-8600 (Print)
IS  - 1554-8600 (Linking)
VI  - 1
IP  - 5
DP  - 2005 Sep-Oct
TI  - Yellow fever 17D vaccine safety and immunogenicity in the elderly.
PG  - 207-14
AB  - The incidence of serious and severe multisystem adverse events (AEs) following 
      yellow fever (YF) 17D vaccine is higher in persons of advanced age. One 
      hypothesis for the occurrence of these AEs in the elderly is immunological 
      senescence and a reduced ability to clear the vaccine virus infection. We 
      determined age-specific rates of serious and nonserious AEs in two large clinical 
      trials of two YF 17D vaccines from different manufacturers. In addition, we 
      analyzed AEs reported in a large general practice data base in the United 
      Kingdom. Neutralizing antibody responses were compared in young and elderly 
      subjects. In the clinical trials, involving a total of 4,532 subjects, there were 
      no neurological and viscerotropic AEs; interestingly, the incidence of common 
      injection site and systemic AEs was significantly lower in elderly than in 
      younger subjects. The neutralizing antibody categorical and quantitative 
      responses were equivalent across younger and elderly subjects. In contrast, the 
      larger retrospective analysis of 43,555 persons receiving YF 17D in the UK 
      general practice database revealed a higher incidence of significant neurologic 
      and multisystem AEs with advancing age. The age-specific reporting rate ratio 
      (RRR) was approximately twice that in the 25-44 year-old reference group for 
      subjects in the 45-64 year age group (RRR 1.82; 95% CI 0.88,3.77) and 3-fold 
      higher for the 65-74 year-old age group (RRR 2.82; 95% CI 0.81, 9.81). These 
      results are consistent with previous reports on YF vaccine safety in the US 
      (Martin M, et al. Emerg Infect Dis 2001;6:945-51; Khromova et al., Vaccine 
      2005;23:3256-63). In elderly persons, YF 17D vaccine is associated with a higher 
      frequency of significant AEs in the elderly but a lower incidence of common 
      nonserious side-effects. The neutralizing antibody response, which is the 
      mediator of protective immunity to YF, is not diminished in healthy, elderly 
      persons.
FAU - Monath, Thomas P
AU  - Monath TP
AD  - Acambis, Cambridge, Massachusetts 02139, USA. tom.monath@acambis.com
FAU - Cetron, Martin S
AU  - Cetron MS
FAU - McCarthy, Karen
AU  - McCarthy K
FAU - Nichols, Richard
AU  - Nichols R
FAU - Archambault, W Tad
AU  - Archambault WT
FAU - Weld, Leisa
AU  - Weld L
FAU - Bedford, Philip
AU  - Bedford P
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20050902
PL  - United States
TA  - Hum Vaccin
JT  - Human vaccines
JID - 101265291
RN  - 0 (Antibodies, Viral)
RN  - 0 (Antigens, Viral)
RN  - 0 (Yellow Fever Vaccine)
SB  - IM
MH  - Adaptation, Physiological/immunology
MH  - Adolescent
MH  - Adult
MH  - Adverse Drug Reaction Reporting Systems/statistics & numerical data
MH  - Age Factors
MH  - Aged
MH  - Aging/*immunology
MH  - Antibodies, Viral/biosynthesis/blood
MH  - Antigens, Viral/biosynthesis/blood
MH  - Double-Blind Method
MH  - Drug Hypersensitivity/etiology/immunology
MH  - Humans
MH  - Immunocompetence/*immunology
MH  - Immunologic Memory/immunology
MH  - Middle Aged
MH  - Neutralization Tests/methods/statistics & numerical data
MH  - Retrospective Studies
MH  - United Kingdom
MH  - Yellow Fever Vaccine/administration & dosage/adverse effects/*immunology
EDAT- 2006/10/03 09:00
MHDA- 2007/01/16 09:00
CRDT- 2006/10/03 09:00
PHST- 2006/10/03 09:00 [pubmed]
PHST- 2007/01/16 09:00 [medline]
PHST- 2006/10/03 09:00 [entrez]
AID - 2221 [pii]
AID - 10.4161/hv.1.5.2221 [doi]
PST - ppublish
SO  - Hum Vaccin. 2005 Sep-Oct;1(5):207-14. doi: 10.4161/hv.1.5.2221. Epub 2005 Sep 2.