title: 17D yellow fever vaccine elicits comparable long-term immune responses in healthy individuals and immune-compromised patients.
abstract: The 17D live attenuated yellow fever (YF) vaccine is contra-indicated in immune-compromised individuals and may elicit a suboptimal immunologic response. The aim of this study is to assess whether long-term immune responses against the YF vaccine are impaired in immune-compromised patients.
  
  
  
  Fifteen patients using different immunosuppressive drugs and 30 healthy individuals vaccinated 0-22 years ago were included. The serological response was measured using the plaque reduction neutralization test (PRNT). CD8(+) and CD4(+) T-cell responses were measured following proliferation and re-stimulation with YFV peptide pools. Phenotypic characteristics and cytokine responses of CD8(+) T-cells were determined using class I tetramers.
  
  
  
  The geometric mean titre of neutralizing antibodies was not different between the groups (p = 0.77). The presence of YFV-specific CD4(+) and CD8(+) T-cell did not differ between patients and healthy individuals (15/15, 100.0% vs. 29/30, 96.7%, p = 0.475). Time since vaccination correlated negatively with the number of YFV-specific CD8(+) T-cells (r = -0.66, p = 0.0045). Percentages of early-differentiated memory cells increased (r = 0.67, p = 0.017) over time.
  
  
  
  These results imply that YF vaccination is effective despite certain immunosuppressive drug regimens. An early-differentiated memory-like phenotype persisted, which is associated with effective expansion upon re-encounter with antigen, suggesting a potent memory T-cell pool remains.
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: rosannewieten@icloud.com.
authors.forename: R W
authors.initials: RW
authors.lastname: Wieten
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Goorhuis
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: E F F
authors.initials: EFF
authors.lastname: Jonker
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: de Bree
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: de Visser
authors.affiliation: Institute for Tropical Diseases, Harbour Hospital, Rotterdam, the Netherlands.
authors.forename: P J J
authors.initials: PJJ
authors.lastname: van Genderen
authors.affiliation: Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: E B M
authors.initials: EBM
authors.lastname: Remmerswaal
authors.affiliation: Renal Transplant Unit, Division of Internal Medicine, Academic Medical Center, the Netherlands.
authors.forename: I J M
authors.initials: IJM
authors.lastname: Ten Berge
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: L G
authors.initials: LG
authors.lastname: Visser
authors.affiliation: Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Grobusch
authors.affiliation: Department of Experimental Immunology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: E M M
authors.initials: EMM
authors.lastname: van Leeuwen
mesh_terms: D000328:Adult; D000368:Aged; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D013997:Time Factors; D014611:Vaccination; D022341:Yellow Fever Vaccine / Q000008:administration & dosage / Q000276:immunology*; D015005:Yellow fever virus / Q000276:immunology*; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D016207:Cytokines; D022341:Yellow Fever Vaccine
keywords: 17D yellow fever; Immune-compromised; Vaccination