{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:55:31Z","timestamp":1789210531541,"version":"build-2803163510"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,4,2]],"date-time":"2019-04-02T00:00:00Z","timestamp":1554163200000},"content-version":"vor","delay-in-days":91,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005039","name":"Leiden University Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005039","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:label\/>\n                  <jats:p>Rationale for review: The global yellow fever vaccine supply is insufficient to provide full-dose vaccination to millions threatened by outbreaks. Given the excess of live-attenuated 17D yellow fever virus in the current single dose vials, dose sparing would increase available vaccine doses manifold. Fractional-dose yellow fever vaccination is now accepted as an emergency solution, as short-term protection has been confirmed in an outbreak situation in the Democratic Republic of Congo, but broader application of this dose-sparing strategy is still not recommended. In this review, important knowledge gaps that hamper this application such as long-term protection after fractional-dose vaccination, safety, comparability across different genetic backgrounds and different World Health Organization-licensed yellow fever vaccines and immunogenicity in infants are addressed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:label\/>\n                  <jats:p>Main findings: Recently, published results on long-term protection after fractional-dose vaccination in healthy young volunteers indicate that if a person mounts a protective response shortly after vaccination, the protective response will persist for 10\u00a0years and possibly longer. It also appears that fractional-dose vaccination does not elicit more serious adverse events than standard dose vaccination. Short-term immunogenicity studies are currently underway in specific populations (infants, human immunodeficiency virus (HIV)-infected persons and healthy adults living in Uganda and Kenya), of which the results will become available in 2021\u201322.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:label\/>\n                  <jats:p>Conclusions: Available results on long-lasting immunogenicity of fractional-dose yellow fever vaccination are encouraging, although confirmation is required in larger populations including young children living in yellow fever endemic areas.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jtm\/taz024","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T20:12:07Z","timestamp":1553803927000},"source":"Crossref","is-referenced-by-count":36,"title":["Fractional-dose yellow fever vaccination: an expert review"],"prefix":"10.1093","volume":"26","author":[{"given":"Anna H E","family":"Roukens","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases , Leiden University Medical Center, C5-P, Albinusdreef 2, ZA Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo G","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases , Leiden University Medical Center, C5-P, Albinusdreef 2, ZA Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,4,1]]},"reference":[{"key":"2022070209362372100_ref1","first-page":"193","article-title":"World Health Organization. Weekly epidemiological record. Eliminate Yellow fever Epidemics (EYE): a global strategy, 2017\u20132026","year":"2017"},{"key":"2022070209362372100_ref2","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":"2022070209362372100_ref3","volume-title":"Fractional Dose Yellow Fever Vaccine as a Dose-Sparing Option for Outbreak Response","author":"World Health Organization"},{"key":"2022070209362372100_ref4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0001993","article-title":"Intradermally administered yellow fever vaccine at reduced dose induces a protective immune response: a randomized controlled non-inferiority trial","volume":"3","author":"Roukens","year":"2008","journal-title":"PLoS One"},{"key":"2022070209362372100_ref5","first-page":"150","volume-title":"Plotkin\u2019s vaccines","author":"Siegrist","edition":"7th edn"},{"key":"2022070209362372100_ref6","doi-asserted-by":"crossref","first-page":"879","DOI":"10.4161\/hv.22982","article-title":"17DD yellow fever vaccine: a double blind, randomized clinical trial of immunogenicity and safety on a dose-response study","volume":"9","author":"Martins","year":"2013","journal-title":"Hum Vaccin Immunother"},{"key":"2022070209362372100_ref7","article-title":"Immunogenicity of fractional-dose vaccine during a yellow fever outbreak\u2014preliminary report","author":"Ahuka-Mundeke","year":"2018","journal-title":"N Engl J Med"},{"key":"2022070209362372100_ref8","doi-asserted-by":"crossref","first-page":"6170","DOI":"10.1016\/j.vaccine.2018.08.052","article-title":"Safety profile of fractional dosing of the 17DD yellow fever vaccine among males and females: experience of a community-based pharmacovigilance in Kinshasa, DR Congo","volume":"36","author":"Nzolo","year":"2018","journal-title":"Vaccine"},{"key":"2022070209362372100_ref9","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1056\/NEJMp1803433","article-title":"Fractional-dose yellow fever vaccination\u2014advancing the evidence base","volume":"379","author":"Vannice","year":"2018","journal-title":"N Engl J Med"},{"key":"2022070209362372100_ref10","doi-asserted-by":"crossref","first-page":"4112","DOI":"10.1016\/j.vaccine.2018.05.041","article-title":"Collaborative Group for Studies on duration of immunity from yellow fever vaccine. Duration of post-vaccination immunity to yellow fever in volunteers eight years after a dose-response study","volume":"36","author":"de Menezes Martins","year":"2018","journal-title":"Vaccine"},{"key":"2022070209362372100_ref11","doi-asserted-by":"crossref","first-page":"761","DOI":"10.7326\/M18-1529","article-title":"Long-term protection after fractional-dose yellow fever vaccination: follow-up study of a randomized, controlled, noninferiority trial","volume":"169","author":"Roukens","year":"2018","journal-title":"Ann Intern Med"},{"key":"2022070209362372100_ref12","volume-title":"Yellow fever supply and procurement roadmap, UPDATE 20th March 2017","author":"Gavi, the Vaccine Alliance"},{"key":"2022070209362372100_ref13","doi-asserted-by":"crossref","first-page":"5751","DOI":"10.1016\/j.vaccine.2017.06.087","article-title":"WHO position on the use of fractional doses\u2014June 2017, addendum to vaccines and vaccination against yellow fever WHO: position paper\u2014June 2013","volume":"35","author":"World Health Organization","year":"2017","journal-title":"Vaccine"},{"key":"2022070209362372100_ref14","volume-title":"Fractional dose yellow fever vaccine as a dose-sparing option for outbreak response","author":"WHO Secretariat information paper"},{"key":"2022070209362372100_ref15","doi-asserted-by":"crossref","first-page":"tay097","DOI":"10.1093\/jtm\/tay097","article-title":"Pandemic yellow fever: a potential threat to global health via travelers","volume":"25","author":"Gubler","year":"2018","journal-title":"J Travel Med"},{"key":"2022070209362372100_ref16","doi-asserted-by":"crossref","DOI":"10.1093\/jtm\/tay098","article-title":"Fractional dosing of yellow fever vaccine during shortages: perspective from Canada","volume":"25","author":"Teitelbaum","year":"2018","journal-title":"J Travel Med"},{"key":"2022070209362372100_ref17","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1016\/j.vaccine.2009.02.049","article-title":"Reduced intradermal test dose of yellow fever vaccine induces protective immunity in individuals with egg allergy","volume":"27","author":"Roukens","year":"2009","journal-title":"Vaccine"},{"key":"2022070209362372100_ref18","volume-title":"Short-term Research Priorities for Dose-sparing of Yellow Fever Vaccine","author":"WHO"},{"key":"2022070209362372100_ref19","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1056\/NEJMoa1009303","article-title":"An inactivated cell-culture vaccine against yellow fever","volume":"364","author":"Monath","year":"2011","journal-title":"N Engl J Med"}],"container-title":["Journal of Travel Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jtm\/advance-article-pdf\/doi\/10.1093\/jtm\/taz024\/28549346\/taz024.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jtm\/article-pdf\/26\/6\/taz024\/44374210\/taz024.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jtm\/article-pdf\/26\/6\/taz024\/44374210\/taz024.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T09:36:45Z","timestamp":1656754605000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jtm\/article\/doi\/10.1093\/jtm\/taz024\/5424969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":19,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,4,1]]},"published-print":{"date-parts":[[2019,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/jtm\/taz024","relation":{},"ISSN":["1195-1982","1708-8305"],"issn-type":[{"value":"1195-1982","type":"print"},{"value":"1708-8305","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019]]},"published":{"date-parts":[[2019]]},"article-number":"taz024"}}