{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:47:02Z","timestamp":1783727222916,"version":"3.55.0"},"reference-count":64,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the context of ongoing debate about whether a single dose of the yellow fever (YF) vaccine provides lifelong protection, addressing key unanswered questions\u2014such as the extent to which revaccination enhances humoral and cell-mediated immune (CMI) responses, and the true duration of immunity\u2014is particularly important for protecting high-risk groups. This systematic review evaluated the immunogenicity of YF revaccination, to support evidence-based vaccination policies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search in electronic databases was conducted to identify relevant studies that evaluated humoral or CMI responses following booster YF vaccination in both adults and children from endemic and non-endemic regions. Interventions included full-dose and fractional-dose YF vaccine boosters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one studies (n\u2009=\u20091821 participants) were included. Revaccination temporarily enhances neutralizing antibody titres, particularly in individuals with low or undetectable baseline immunity. Long-term seropositivity remained high in most cohorts. Individuals with high baseline titres showed limited humoral response, suggesting a limited boosting effect. In terms of CMI, booster generally results in minimal activation of T-cell markers compared to primary vaccination, suggesting that revaccination primarily sustains memory responses rather than inducing new activation. In individuals with low baseline immunity, it restores both T-cell and B-cell functional memories. Memory T-cell subsets remain detectable for over 10\u00a0years. Children vaccinated at \u2264\u20092\u00a0years and immunocompromised individuals showed marked benefits from revaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine YF revaccination appears unnecessary for most immunocompetent individuals across different age groups given durable protection conferred by a single dose. However, booster doses may benefit specific high-risk groups such as individuals vaccinated at very young ages, those with low baseline immunity or with altered immunocompetence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taaf106","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:17:01Z","timestamp":1760012221000},"source":"Crossref","is-referenced-by-count":2,"title":["Is a second dose of yellow fever vaccine needed? A systematic review of humoral and cell-mediated immunity after revaccination"],"prefix":"10.1093","volume":"32","author":[{"given":"Pietro","family":"Ferrara","sequence":"first","affiliation":[{"name":"Center for Public Health Research, University of Milan-Bicocca , Via Cadore 48, I-20900 Monza ,","place":["Italy"]},{"name":"Laboratory of Public Health, IRCCS Istituto Auxologico Italiano , Via Ariosto 13, 20145 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriano","family":"La Vecchia","sequence":"additional","affiliation":[{"name":"Center for Public Health Research, University of Milan-Bicocca , Via Cadore 48, I-20900 Monza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Losa","sequence":"additional","affiliation":[{"name":"Center for Public Health Research, University of Milan-Bicocca , Via Cadore 48, I-20900 Monza ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo G","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Center for Public Health Research, University of Milan-Bicocca , Via Cadore 48, I-20900 Monza ,","place":["Italy"]},{"name":"Laboratory of Public Health, IRCCS Istituto Auxologico Italiano , Via Ariosto 13, 20145 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Plana","sequence":"additional","affiliation":[{"name":"AIDS Research Group, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona , Carrer del Rossell\u00f3 149, 08036 Barcelona ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII) , Calle Monforte de Lemos 3-5, 28029 Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Ag\u00fcero","sequence":"additional","affiliation":[{"name":"Preventive Medicine Unit, Hospital Universitari General de Catalunya , Quir\u00f3nsalud, Carrer de Pedro i Pons 1, 08190 Sant Cugat del Vall\u00e8s, Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"2025121704463773000_ref1","volume-title":"Yellow Fever Fact Sheet","author":"World Health Organization","year":"2019"},{"key":"2025121704463773000_ref2","volume-title":"Countries with Risk of Yellow Fever Transmission and Countries Requiring Yellow Fever Vaccination (2022)","author":"World Health Organization","year":"2022"},{"key":"2025121704463773000_ref3","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1186\/s12879-021-06728-x","article-title":"The incidence and mortality of yellow fever in Africa: A systematic review and meta-analysis","volume":"21","author":"Nwaiwu","year":"2021","journal-title":"BMC Infect Dis"},{"key":"2025121704463773000_ref4","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/B978-0-323-35761-6.00063-8","volume-title":"Plotkin\u2019s Vaccines","author":"Staples","year":"2018"},{"key":"2025121704463773000_ref5","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1080\/14760584.2016.1198259","article-title":"Questions regarding the safety and duration of immunity following live yellow fever vaccination","volume":"15","author":"Amanna","year":"2016","journal-title":"Expert Rev Vaccines"},{"key":"2025121704463773000_ref6","doi-asserted-by":"crossref","first-page":"e445","DOI":"10.1016\/S2214-109X(23)00556-9","article-title":"Long-term immunity following yellow fever vaccination: A systematic review and meta-analysis","volume":"12","author":"Schnyder","year":"2024","journal-title":"Lancet Glob Health"},{"key":"2025121704463773000_ref7","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1080\/21645515.2021.1891752","article-title":"Yellow fever virus vaccination: An emblematic model to elucidate robust human immune responses","volume":"17","author":"Bovay","year":"2021","journal-title":"Hum Vaccin Immunother"},{"key":"2025121704463773000_ref8","doi-asserted-by":"crossref","first-page":"434","DOI":"10.4269\/ajtmh.13-0264","article-title":"Efficacy and duration of immunity after yellow fever vaccination: Systematic review on the need for a booster every 10 years","volume":"89","author":"Gotuzzo","year":"2013","journal-title":"Am J Trop Med Hyg"},{"key":"2025121704463773000_ref9","doi-asserted-by":"crossref","first-page":"e0149871","DOI":"10.1371\/journal.pone.0149871","article-title":"A single 17D yellow fever vaccination provides lifelong immunity; 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