[CIS PIDD] [cis-pidd] Yellow fever vaccine

[dmvascon at usp.br]

Dear friends 

Here in Brazil there are some regions presenting endemic yellow fever, therefore when one individual intend to travel to one of these regions is oriented to take the YF vaccine. 
YF vaccine in Brazil is derived from 17DD substrain, which is passaged 81 times more in culture. 
Five CVID patients I follow live in endemic regions and had taken YF shots inadvertently in vaccination campaigns, without any severe reaction. One of these families have a TACI mutation (mother and daughter with CVID and one grandson with IgA deficiency). 
Moreover, one patient with IL-12 Rbeta1 deficiency also took one YF shot without adverse reaction. 
Nevertheless, approximately 10 years ago 4 patients died in Brazil after receiving one dose of YF vaccine. Due to this event, we standardized an antigen directly derived from YF vaccine to perform lymphoproliferation tests, as a fifth patient (sister of one of the died patients) presented a disseminated viscerotropic disease but eventually recovered. 
Unfortunately this young woman didn't come for evaluation so we don't know how she (and her sister) presented disseminated disease due to YF vaccine (that was tested in necropsy samples from died patients and no mutation was found in its genome). 

So, I think that it is possible to test for immune response (lymphoproliferation, cytokine synthesis etc.) induced by YF Ag, as well as other third party Ags to assess for competence of the cellular immunity of the patient before vaccinating such patients. 

If you would like for more details of the YF vaccine Ag please contact me. 

Best regards, 

Dewton de Moraes Vasconcelos 
University of São Paulo School of Medicine 

----- Mensagem original -----


De: "Michael Blaese" <mblaese at comcast.net> 
Para: "CIS-PIDD" <cis-pidd at lists.clinimmsoc.org> 
Enviadas: Terça-feira, 11 de Dezembro de 2012 0:24:27 
Assunto: [cis-pidd] Yellow fever vaccine 


Dear colleagues, 


IDF has received the following inquiry from a caregiver for a patient with CVID. 

QUESTION: My daughter may be exposed to a person who is taking typhoid fever pills and a yellow fever shot for a trip to India. Is it necessary to avoid the person or how much contact with the person can be made safely? 


Is there a risk of horizontal spread of yellow fever vaccine from a recently immunized individual to a patient with CVID? The CDC recommendation is to not allow recently vaccinated individuals to donate blood for 2 weeks, but I have not been able to find information on the potential risk of horizontal spread from ordinary contact. Does anyone have experience with the direct immunization of a CVID patient with the yellow fever vaccine causing significant problems for the patient? 


Any information you can provide would be greatly appreciated. Maybe someone from a yellow fever endemic area might have direct experience with this question that just does not come up very often in the northern U.S. 


Thanks 


R Michael Blaese, MD 
Immune Deficiency Foundation 
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