{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:20:15Z","timestamp":1787224815867,"version":"build-2736575974"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Yellow fever (YF) is an arbovirus with variable severity, including severe forms with high mortality. The vaccination is the most effective measure to protect against the disease. Non-serious and serious adverse events have been described in immunocompromised individuals, but previous studies have failed to demonstrate this association. This systematic review assessed the risk of adverse events after YF vaccination in immunocompromised individuals compared with its use in non-immunocompromised individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A search was conducted in the MEDLINE, LILACS, EMBASE, SCOPUS, DARE, Toxiline, Web of Science and grey literature databases for publications until February 2021. Randomized and quasi-randomized clinical trials and observational studies that included immunocompromised participants (individuals with HIV infection, organ transplants, with cancer, who used immunosuppressive drugs for rheumatologic diseases and those on immunosuppressive therapy for other diseases) were selected. The methodological quality of observational or non-randomized studies was assessed by the ROBINS-I tool. Two meta-analyses were performed, proportion and risk factor analyses, to identify the summary measure of relative risk (RR) in the studies that had variables suitable for combination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-five studies were included, most with risk of bias classified as critical. Thirteen studies had enough data to carry out the proposed meta-analyses. Seven studies without a comparator group had their results aggregated in the proportion meta-analysis, identifying an 8.5% [95% confidence interval (CI) 0.07\u201321.8] risk of immunocompromised individuals presenting adverse events after vaccination. Six cohort studies were combined, with an RR of 1.00 (95% CI 0.78\u20131.29). Subgroup analysis was performed according to the aetiology of immunosuppression and was also unable to identify an increased risk of adverse events following vaccination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It is not possible to affirm that immunocompromised individuals, regardless of aetiology, have a higher risk of adverse events after receiving the YF vaccine.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jtm\/taac095","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T22:24:21Z","timestamp":1660170261000},"source":"Crossref","is-referenced-by-count":14,"title":["Yellow fever vaccine safety in immunocompromised individuals: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4051-0334","authenticated-orcid":false,"given":"Let\u00edcia","family":"Wigg de Ara\u00fajo Lagos","sequence":"first","affiliation":[{"name":"N\u00facleo de Avalia\u00e7\u00e3o de Tecnologias em Sa\u00fade (NATS) , , Rio de Janeiro, RJ, Brazil"},{"name":"Instituto Nacional de Cardiologia , , Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5599-0991","authenticated-orcid":false,"given":"Ariane","family":"de Jesus Lopes de Abreu","sequence":"additional","affiliation":[{"name":"N\u00facleo de Avalia\u00e7\u00e3o de Tecnologias em Sa\u00fade (NATS) , , Rio de Janeiro, RJ, Brazil"},{"name":"Instituto Nacional de Cardiologia , , Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1480-2453","authenticated-orcid":false,"given":"Ros\u00e2ngela","family":"Caetano","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Social , Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5247-007X","authenticated-orcid":false,"given":"Jos\u00e9 Ueleres","family":"Braga","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Social , Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil"},{"name":"Escola Nacional de Sa\u00fade P\u00fablica S\u00e9rgio Arouca , Funda\u00e7\u00e3o Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"2023040512351134000_","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1590\/S0037-86822003000200012","article-title":"Febre amarela","volume":"36","author":"Vasconcelos","year":"2003","journal-title":"Soc Bras Med Trop"},{"key":"2023040512351134000_","first-page":"11","article-title":"Caracter\u00edsticas epidemiol\u00f3gicas da febre amarela no Brasil, 2000-2012*","volume":"25","author":"Cavalcante","year":"2016","journal-title":"Epidemiol Serv Sa\u00fade"},{"key":"2023040512351134000_"},{"key":"2023040512351134000_","volume-title":"Yellow Fever","author":"World Health Organization","year":"2019"},{"key":"2023040512351134000_","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1586\/erv.12.6","article-title":"Review of the risks and benefits of yellow fever vaccination including some new analyses","volume":"11","author":"Monath","year":"2012","journal-title":"Expert Rev Vaccines"},{"key":"2023040512351134000_","first-page":"245","article-title":"Vacina contra a febre amarela: rea\u00e7\u00f5es adversas e popula\u00e7\u00f5es de risco","volume":"1","author":"Marinho","year":"2017","journal-title":"Arq Asma Alerg Imunol"},{"key":"2023040512351134000_","doi-asserted-by":"publisher","DOI":"10.1093\/jtm\/taw045","article-title":"Adverse event reports following yellow fever vaccination, 2007\u201313","volume":"23","author":"Lindsey","year":"2016","journal-title":"J Travel Med"},{"key":"2023040512351134000_","volume-title":"Manual dos Centros de Refer\u00eancia para Imunobiol\u00f3gicos Especiais [recurso eletr\u00f4nico] \/Minist\u00e9rio da Sa\u00fade, Secretaria de Vigil\u00e2ncia em Sa\u00fade, Departamento de Imuniza\u00e7\u00e3o e Doen\u00e7as Transmiss\u00edveis, Coordena\u00e7\u00e3o-Geral do Programa Nacional de Imuniza\u00e7\u00f5es","year":"2019","edition":"5th"},{"key":"2023040512351134000_","volume-title":"Nota t\u00e9cnica 17\/04\/2017","author":"Sociedade Brasileira de Imunologia","year":"2017"},{"key":"2023040512351134000_","volume-title":"Nota T\u00e9cnica Conjunta sobre vacina\u00e7\u00e3o para a Febre Amarela (VFA) em pacientes com Doen\u00e7as Reum\u00e1ticas Imunomediadas (DRIM)","author":"Sociedade Brasileira de Reumatologia","year":"2018"},{"key":"2023040512351134000_","volume-title":"Secretaria de Aten\u00e7\u00e3o \u00e0 Sa\u00fade. - 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