AUTHOR=Valim Valéria , Machado Ketty Lysie Libardi Lira , Miyamoto Samira Tatiyama , Pinto Arthur Dalmaso , Rocha Priscila Costa Martins , Serrano Erica Vieira , Dinis Valquiria Garcia , Gouvêa Sônia Alves , Dias João Gabriel Fragoso , Campi-Azevedo Ana Carolina , Teixeira-Carvalho Andréa , Peruhype-Magalhães Vanessa , Costa-Rocha Ismael Artur da , Lima Sheila Maria Barbosa de , Miranda Emily Hime , Trindade Gisela Freitas , Maia Maria de Lourdes de Sousa , Gavi Maria Bernadete Renoldi de Oliveira , Silva Lidia Balarini da , Duque Ruben Horst , Gianordoli Ana Paula Espíndula , Casagrande Thays Zanon , Oliveira Karine Gadioli , Moura Bruna Costa da Mata , Nicole-Batista Fernanda , Rodrigues Luiza Correa , Clemente Thalles Brandão , Magalhães Enan Sales , Bissoli Maria de Fatima , Gouvea Maria da Penha Gomes , Pinto-Neto Lauro Ferreira da Silva , Costa Carolina Zorzanelli , Giovelli Raquel Altoé , Brandão Leticia Resende , Polito Elizandra Tomazela Laurenti , Koehlert Ingrid de Oliveira , Borjaille Brunela Passos , Pereira Daniela Bergamim , Dias Laiza Hombre , Merlo Daniela Linhares , Genelhu Luiz Fellipe Favoreto , Pretti Flavia Zon , Giacomin Maryella dos Santos , Burian Ana Paula Neves , Fantinato Francieli Fontana Sutile Tardetti , Pileggi Gecilmara Salviato , Mota Lícia Maria Henrique da , Martins-Filho Olindo Assis 

TITLE=Planned Yellow Fever Primary Vaccination Is Safe and Immunogenic in Patients With Autoimmune Diseases: A Prospective Non-interventional Study

JOURNAL=Frontiers in Immunology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.01382

DOI=10.3389/fimmu.2020.01382

ISSN=1664-3224

ABSTRACT=<p>Yellow Fever (YF) vaccination is suggested to induce a large number of adverse events (AE) and suboptimal responses in patients with autoimmune diseases (AID); however, there have been no studies on 17DD-YF primary vaccination performance in patients with AID. This prospective non-interventional study conducted between March and July, 2017 assessed the safety and immunogenicity of planned 17DD-YF primary vaccination in patients with AID. Adult patients with AID (both sexes) were enrolled, along with healthy controls, at a single hospital (Vitória, Brazil). Included patients were referred for planned vaccination by a rheumatologist; in remission, or with low disease activity; and had low level immunosuppression or the attending physician advised interruption of immunosuppression for safety reasons. The occurrence of AE, neutralizing antibody kinetics, seropositivity rates, and 17DD-YF viremia were evaluated at various time points (day 0 (D0), D3, D4, D5, D6, D14, and D28). Individuals evaluated (<italic>n</italic> = 278), including patients with rheumatoid arthritis (RA; 79), spondyloarthritis (SpA; 59), systemic sclerosis (8), systemic lupus erythematosus (SLE; 27), primary Sjögren's syndrome (SS; 54), and healthy controls (HC; 51). Only mild AE were reported. The frequency of local and systemic AE in patients with AID and HC did not differ significantly (8 vs. 10% and 21 vs. 32%; <italic>p</italic> = 1.00 and 0.18, respectively). Patients with AID presented late seroconversion profiles according to kinetic timelines of the plaque reduction neutralization test (PRNT). PRNT-determined virus titers (copies/mL) [181 (95% confidence interval (CI), 144–228) vs. 440 (95% CI, 291–665), <italic>p</italic> = 0.004] and seropositivity rate (78 vs. 96%, <italic>p</italic> = 0.01) were lower in patients with AID after 28 days, particularly those with SpA (73%) and SLE (73%), relative to HC. The YF viremia peak (RNAnemia) was 5–6 days after vaccination in all groups. In conclusion, consistent seroconversion rates were observed in patients with AID and our findings support that planned 17DD-YF primary vaccination is safe and immunogenic in patients with AID.</p>