Yellow fever vaccine: worthy friend or stealthy foe?

ABSTRACT

Recognition that the live yellow fever vaccine may rarely be associated with viscerotropic disease (YEL-AVD) has diminished its safety status. However, the vaccine remains the principal tool for limiting the occurrence of yellow fever, making large portions of Africa and South America more habitable. The subject has previously been exhaustively reviewed. Novel concepts in the current report include the description of a systematic method for deciding whom to vaccinate, recommendations for obtaining data helpful in making that decision, and suggestions for additional study. The vaccine is indeed a worthy friend, but its adverse reactions need to be recognized.

KEYWORDS:

• Yellow fever
• vaccine
• yellow fever vaccine-associated viscerotropic disease
• YEL-AVD

Acknowledgments

The authors thank Yuval Itan for assistance in producing the figures, to Molly Crosby for suggestions on the history of yellow fever particularly the Memphis outbreak of 1878, Joel Cohen for advice on making decisions when the numbers are small, and Tom Monath for supplying the CDC listing as of 2011 of YEL-AVD cases originally compiled by Mark Gershman.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Supplementary materia

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