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Original Abstract of the Article

Major Research Findings

Yellow fever vaccine is generally considered safe and effective. However, in recent years, rare cases of serious side effects have been reported. 11 reports a case of a 23-year-old woman who developed severe viscerotropic disease and encephalitis after receiving the yellow fever vaccine. This patient had decreased expression of Fc-gamma receptors (CD16, CD32, and CD64) in monocytes, along with increased levels of NK T cells, activated T cells (CD4(+) and CD8(+) cells), and B lymphocytes. 25 is a retrospective study on the safety of yellow fever vaccine in patients with diabetes mellitus, and no side effects were reported in diabetic patients. 8 is a randomized, double-blind, controlled trial that evaluated whether coadministration of the yellow fever (YF) virus vaccine with human immunoglobulin (Ig) that contained YF virus-neutralizing antibodies would reduce post-vaccination viremia without compromising immunogenicity and thus, potentially mitigate YF vaccine-associated adverse events. In this study, no difference was found in the proportion of vaccinated participants who developed viremia, seroconversion, cluster of differentiation (CD)-8(+) and CD4(+) T-cell responses, and cytokine responses between the two groups. 13 reports on adverse events following yellow fever preventive vaccination campaigns in eight African countries from 2007 to 2010. The paper reports that serious, but rare adverse events following immunization (AEFI) have been reported with yellow fever (YF) 17D vaccine, including severe allergic reactions, YF vaccine-associated neurologic disease (YEL-AND), and YF vaccine-associated viscerotropic disease (YEL-AVD). The frequency with which YEL-AND and YEL-AVD occur in YF endemic countries is mostly unknown. Serious side effects are rare, but the risk may be higher, especially in the elderly and immunocompromised individuals. 3 reports on adverse events following yellow fever immunization in Brazil. This paper analyzed 67 neurological cases found from 2007 to 2012. The highest rate of neurological adverse events was found in the age group from 5 to 9 years. However, these adverse events generally have a good prognosis and should not contraindicate the use of yellow fever vaccine in the face of the risk of infection by yellow fever virus. 4 investigated risk groups for yellow fever vaccine-associated viscerotropic disease (YEL-AVD). This paper identified elderly males, women between the ages of 19 and 34, people with a variety of autoimmune diseases, individuals who have been thymectomized because of thymoma, and infants and children ≤11 years old as risk groups for YEL-AVD. YEL-AVD does not negate the fact that yellow fever vaccine is safe and effective, but it is important to understand the risks and take appropriate precautions.

Reasons for Side Effects

Side effects of the yellow fever vaccine may be caused by allergic reactions to vaccine components, infection by the vaccine virus, or abnormal immune reactions. 18 is a study that investigated serious adverse events associated with the yellow fever vaccine. This paper suggests that the cause of serious adverse events is largely unknown and may be related to individual host factors. Additionally, side effects of the yellow fever vaccine may vary depending on factors such as age and immune status. 2 is a study that investigated the risk of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) in the elderly. This study suggested that the elderly may be at increased risk of YEL-AVD. However, this paper concluded that further research is needed on the risk of YEL-AVD in the elderly.

Common Side Effects

Pain at the injection site

Pain and swelling at the injection site may occur after receiving the yellow fever vaccine. 19 is a study that investigated the occurrence of side effects in people who received the yellow fever vaccine in Brazil. This study found no significant difference in side effects between those who received the normal dose and those who received a 25-fold concentrated dose of the vaccine.

Fever

Fever may occur after receiving the yellow fever vaccine. 1 is a study that investigated the safety and efficacy of yellow fever vaccine in infants aged 7 to 8 months. This study reported fever as the most significant immediate and delayed side effect. 12 children (15.6%) experienced fever within 48 hours of vaccination, while 10 children (12.9%) experienced fever within 10 days of vaccination. Other side effects such as pain at the injection site and vomiting were also reported.

Fatigue

Fatigue and headache may occur after receiving the yellow fever vaccine. 27 is a double-blind randomized clinical trial that evaluated the immunogenicity and safety of the 17DD yellow fever vaccine (17DD-YFV) in Brazil. This study investigated the dose-response relationship of the vaccine and found that low-dose 17DD-YFV was as immunogenic and safe as the current formulation. However, this study did not mention fatigue as a side effect.

Allergic reactions

Allergic reactions may occur after receiving the yellow fever vaccine. 11 reports a case of a 23-year-old woman who developed severe viscerotropic disease and encephalitis after receiving the yellow fever vaccine. This patient had potential allergic reactions. However, this study did not mention specific symptoms of allergic reactions.

Neurological side effects

Rarely, neurological side effects such as encephalitis and paralysis may occur after receiving the yellow fever vaccine. 28 reports on two fatal cases of hemorrhagic fever associated with yellow fever 17DD substrain vaccine in Brazil. This study suggests that the yellow fever vaccine may cause serious neurological side effects. Yellow fever vaccine-associated neurologic disease (YEL-AND) is more likely to occur in children and older adults. 16 is a paper that explains immunization against yellow fever. This paper points out that neurological side effects from the yellow fever vaccine are rare, but tend to be more frequent in older adults. However, this paper does not mention specific symptoms of side effects. Neurological side effects may occur weeks to months after vaccination. 3 reports on adverse events following yellow fever immunization in Brazil. This paper analyzed 67 neurological cases found from 2007 to 2012. The highest rate of neurological adverse events was found in the age group from 5 to 9 years. However, these adverse events generally have a good prognosis and should not contraindicate the use of yellow fever vaccine in the face of the risk of infection by yellow fever virus.

Viscerotropic Disease

Rarely, viscerotropic disease, which affects the internal organs such as the liver and kidneys, may occur after receiving the yellow fever vaccine. Yellow fever vaccine-associated viscerotropic disease (YEL-AVD) is serious and can often be fatal. 4 investigated risk groups for yellow fever vaccine-associated viscerotropic disease (YEL-AVD). This paper identified elderly males, women between the ages of 19 and 34, people with a variety of autoimmune diseases, individuals who have been thymectomized because of thymoma, and infants and children ≤11 years old as risk groups for YEL-AVD.

Other

Other symptoms such as nausea, vomiting, abdominal pain, muscle aches, joint pain, and swollen lymph nodes may occur after receiving the yellow fever vaccine. 29 reports a case of a rare local vesicular reaction to the yellow fever vaccine. This paper reports that the patient developed vesicular lesions resulting in bullae and circumferential hyperpigmentation.

Countermeasures for Side Effects

Pain at the injection site

Cold compresses and analgesics can be used for pain at the injection site. Massaging the injection site may also be effective.

Fever

Antipyretics can be taken for fever. It is also important to stay hydrated. If fever persists, see a doctor.

Fatigue

It is important to get enough rest for fatigue. Light exercise may also be effective. If fatigue persists, see a doctor.

Allergic reactions

If you have an allergic reaction, seek medical attention immediately. Serious allergic reactions can be life-threatening.

Neurological side effects

If you suspect neurological side effects, seek medical attention immediately. Serious neurological side effects can lead to permanent disabilities.

Viscerotropic disease

If you suspect viscerotropic disease, seek medical attention immediately. Viscerotropic disease can be life-threatening if left untreated.

Comparison of Studies

Commonalities of Studies

Multiple studies have shown that the yellow fever vaccine is generally safe and effective. However, serious side effects can occur, albeit rarely. The risk of serious side effects may be higher, especially in the elderly and immunocompromised individuals.

Differences in Studies

Multiple studies have shown that side effects of the yellow fever vaccine may vary depending on factors such as age and immune status. For example, 2 suggests that the elderly may be at increased risk of yellow fever vaccine-associated viscerotropic disease (YEL-AVD). On the other hand, 25 reported no side effects of yellow fever vaccine in patients with diabetes mellitus.

Precautions for Real-Life Application

The yellow fever vaccine is recommended for travelers to areas where yellow fever is prevalent and for those who work in these areas. When considering yellow fever vaccination, it is important to consult with a doctor to assess your health status and risks. If you experience side effects after receiving the yellow fever vaccine, see a doctor immediately.

Limitations of Current Research

Research on side effects of the yellow fever vaccine is still insufficient. Further research is needed, especially on the incidence and mechanisms of side effects in the elderly and immunocompromised patients. In addition, future research is needed on countermeasures to reduce side effects of the yellow fever vaccine.

Future Research Directions

Research on side effects of the yellow fever vaccine needs to focus on the following points:

  • Incidence and mechanisms of side effects in the elderly and immunocompromised patients
  • Countermeasures to reduce side effects of the yellow fever vaccine
  • Development of safer and more effective yellow fever vaccines

Conclusion

The yellow fever vaccine is generally considered safe and effective. However, serious side effects can occur, albeit rarely. The risk of serious side effects may be higher, especially in the elderly and immunocompromised individuals. When considering yellow fever vaccination, it is important to consult with a doctor to assess your health status and risks. If you experience side effects after receiving the yellow fever vaccine, see a doctor immediately.


Literature analysis of 30 papers
Positive Content
25
Neutral Content
1
Negative Content
4
Article Type
3
0
1
8
28

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Author: BühlerSilja, JaegerVeronika Katharina, EperonGilles, FurrerHansjakob, FuxChristoph A, JansenStephanie, NeumayrAndreas, RochatLaurence, SchmidSabine, Schmidt-ChanasitJonas, StaehelinCornelia, de VisserAdriëtte W, VisserLeonardus G, NiedrigMatthias, HatzChristoph


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Author: RibeiroAna Freitas, TenganCiléa, SatoHelena Keico, SpinolaRoberta, MascherettiMelissa, FrançaAna Cecilia Costa, Port-CarvalhoMarcio, PereiraMariza, SouzaRenato Pereira de, AmakuMarcos, BurattiniMarcelo Nascimento, CoutinhoFrancisco Antonio Bezerra, LopezLuis Fernandez, MassadEduardo


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Author: Mad'arRastislav, BenesováDagmar, BrandejskáDana, CermákováMiriam, DvorkováAlena, GazárkováOlga, JakubalováSilvana, KochováIlona, LastovickováJana, NebázniváDagmar, OrolinováMarta, PolomisKarel, RehkaVáclav, SattranováLudmila, SchejbalováMiriam, SlámováAlena, SkalleováDeanna, SevcíkováHana, TkadlecováHana, TmejováMarta, TrmalJosef, TurkováDagmar


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Author: MartinsReinaldo M, MaiaMaria de Lourdes S, FariasRoberto Henrique G, CamachoLuiz Antonio B, FreireMarcos S, GallerRicardo, YamamuraAnna Maya Yoshida, AlmeidaLuiz Fernando C, LimaSheila Maria B, NogueiraRita Maria R, SáGloria Regina S, HokamaDarcy A, de CarvalhoRicardo, FreireRicardo Aguiar V, Pereira FilhoEdson, LealMaria da Luz Fernandes, HommaAkira


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Author: VasconcelosP F, LunaE J, GallerR, SilvaL J, CoimbraT L, BarrosV L, MonathT P, RodiguesS G, LavalC, CostaZ G, VilelaM F, SantosC L, PapaiordanouP M, AlvesV A, AndradeL D, SatoH K, RosaE S, FroguasG B, LacavaE, AlmeidaL M, CruzA C, RoccoI M, SantosR T, OlivaO F, PapaiordanouC M,


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