title: Defining risk groups to yellow fever vaccine-associated viscerotropic disease in the absence of denominator data.
abstract: Several risk groups are known for the rare but serious, frequently fatal, viscerotropic reactions following live yellow fever virus vaccine (YEL-AVD). Establishing additional risk groups is hampered by ignorance of the numbers of vaccinees in factor-specific risk groups thus preventing their use as denominators in odds ratios (ORs). Here, we use an equation to calculate ORs using the prevalence of the factor-specific risk group in the population who remain well. The 95% confidence limits and P values can also be calculated. Moreover, if the estimate of the prevalence is imprecise, discrimination analysis can indicate the prevalence at which the confidence interval results in an OR of ∼1 revealing if the prevalence might be higher without yielding a non-significant result. These methods confirm some potential risk groups for YEL-AVD and cast doubt on another. They should prove useful in situations in which factor-specific risk group denominator data are not available.
authors.affiliation: Department of Microbiology and Immunology, New York Medical College, Valhalla, New York; Laboratory of Populations, The Rockefeller University, New York, New York and Columbia University, New York, New York; St. Giles Laboratory of Human Genetics of Infectious Diseases, The Rockefeller University, New York, New York; Department of Medicine, Georgetown University, Washington, DC.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Seligman
authors.forename: Joel E
authors.initials: JE
authors.lastname: Cohen
authors.forename: Yuval
authors.initials: Y
authors.lastname: Itan
authors.forename: Jean-Laurent
authors.initials: JL
authors.lastname: Casanova
authors.forename: John C
authors.initials: JC
authors.lastname: Pezzullo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D014611:Vaccination / Q000706:statistics & numerical data; D014613:Vaccines, Attenuated / Q000627:therapeutic use; D015004:Yellow Fever / Q000453:epidemiology* / Q000517:prevention & control*; D022341:Yellow Fever Vaccine / Q000627:therapeutic use*; D015005:Yellow fever virus; D055815:Young Adult
chemical_list: D014613:Vaccines, Attenuated; D022341:Yellow Fever Vaccine