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ACIP postpones vote on yellow fever vaccine booster dose
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The Advisory Committee on Immunization Practices has postponed voting on recommendations for booster doses of the yellow fever vaccine.
There are many questions concerning the timing of the booster vaccine for the patients and the lack of high-quality evidence for many of the recommendations being made. ACIP also seeks clarification on the specific groups for which a booster dose is recommended.
One concern is the recommendation for booster doses for patients who received their first vaccine when they were younger than 1 year. The committee members said this might be an arbitrary cutoff age because there is a lack of data supporting this recommendation. They requested data review and input from pediatric infectious disease experts and suggested that due to the lack of data, a cutoff of age 5 years or younger may be more appropriate, as children may not have responded to the vaccine as well.
“We have incredible data that children younger than 3 years don’t respond as well as older individuals,” Janet Englund, MD, professor of pediatric infectious diseases at the University of Washington and Seattle Children’s Hospital, said during the meeting. “When they come to be 40 or 50 years old, there is no vaccine we have that lasts that long.”
Janet Englund
WHO changed its recommendations for the yellow fever vaccine and no longer recommends a booster dose. The International Health Regulations have not changed, and booster doses are still recommended for travel to countries where yellow fever vaccine is required for entry.
The working group recommendation was to no longer recommend booster doses, except for certain groups of individuals, as the available evidence suggests that one vaccine confers lifelong protection. Booster doses are recommended for certain people at risk for exposure to the yellow fever virus: those who last received a vaccine 10 or more years ago and are planning long stays in endemic areas or frequent travel to highly endemic areas; those who received the vaccine more than 10 years ago and were pregnant, younger than 1 year or had HIV infection at first vaccination; and laboratory workers who work with the virus who have no evidence of yellow fever neutralizing antibody titers or who last received the vaccine 10 or more years ago and have no available data on neutralizing antibody titers.