{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T06:54:59Z","timestamp":1781506499733,"version":"3.54.1"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":127,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Yellow fever (YF) remains a re-emerging public health threat in South America, with recent outbreaks reporting high case-fatality rates. Although transmission has predominantly affected rural and sylvatic populations, mounting evidence indicates that older adults experience disproportionately severe outcomes and mortality. This commentary highlights the elderly as an overlooked high-risk group in the current epidemiological landscape. Age-related immunosenescence, comorbidities, endothelial dysfunction, and reduced hepatic reserve likely amplify the pathophysiological impact of YF virus infection. At the same time, concerns about vaccine-associated adverse events in individuals \u226560 years complicate risk\u2013benefit decision-making, contributing to under-vaccination in this vulnerable population. Delayed diagnosis and shifting eco-epidemiological patterns further exacerbate risk. As South America undergoes demographic aging alongside environmental change, targeted, age-specific strategies, including prioritized vaccination, tailored risk communication, and enhanced surveillance for older adults, are urgently needed to reduce preventable fatalities.<\/jats:p>","DOI":"10.1093\/sumbio\/qvag018","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:50:00Z","timestamp":1778241000000},"source":"Crossref","is-referenced-by-count":0,"title":["Yellow fever in older adults: an overlooked high-risk population in South American outbreaks"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9773-2192","authenticated-orcid":false,"given":"Alfonso J","family":"Rodriguez-Morales","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Universidad Cient\u00edfica del Sur , Lima 15074 ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"2026061502411450400_bib1","doi-asserted-by":"publisher","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":"2026061502411450400_bib2","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1093\/infdis\/jiac435","article-title":"Viral kinetics in sylvatic yellow fever cases","volume":"227","author":"Avelino-Silva","year":"2023","journal-title":"J Infect Dis"},{"key":"2026061502411450400_bib3","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1016\/j.bbrc.2017.01.079","article-title":"Is the absence or intermittent YF vaccination the major contributor to its persistent outbreaks in eastern Africa?","volume":"492","author":"Baba","year":"2017","journal-title":"Biochem Biophys Res Commun"},{"key":"2026061502411450400_bib4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1007\/s40475-025-00349-z","article-title":"Importance of epizootic surveillance in the epidemiology of yellow fever in South America","volume":"12","author":"Bonilla-Aldana","year":"2025","journal-title":"Curr Trop Med Rep"},{"key":"2026061502411450400_bib5","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1080\/17441692.2018.1512144","article-title":"Management and control of yellow fever virus: Brazilian outbreak January-April, 2018","volume":"14","author":"Callender","year":"2019","journal-title":"Global Public Health"},{"key":"2026061502411450400_bib6","doi-asserted-by":"crossref","first-page":"109439","DOI":"10.1016\/j.thromres.2025.109439","article-title":"Yellow fever virus infection triggers proinflammatory and prothrombotic responses in endothelial cells through NF-\u03baB and MAPK signaling pathways","volume":"254","author":"Char\u00f3","year":"2025","journal-title":"Thromb Res"},{"key":"2026061502411450400_bib7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40794-020-0101-0","article-title":"Yellow fever control: current epidemiology and vaccination strategies","volume":"6","author":"Chen","year":"2020","journal-title":"Trop Dis Travel Med Vaccines"},{"key":"2026061502411450400_bib8","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.3201\/eid3112.251209","article-title":"Reemergence of yellow fever, Magdalena Valley, Colombia, 2024\u20132025","volume":"31","author":"Cu\u00e9llar-S\u00e1enz","year":"2025","journal-title":"Emerg Infect Dis"},{"key":"2026061502411450400_bib9","doi-asserted-by":"publisher","first-page":"183","DOI":"10.3390\/vaccines14020183","article-title":"Impact of vaccines across the lifespan: a new perspective in public health\u2014conclusions of an expert panel\u2014part 1","volume":"14","author":"Debbag","year":"2026","journal-title":"Vaccines"},{"key":"2026061502411450400_bib10","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.3390\/v12111233","article-title":"Re-emergence of yellow fever in brazil during 2016\u20132019: challenges, lessons learned, and perspectives","volume":"12","author":"de\u00a0Oliveira\u00a0Figueiredo","year":"2020","journal-title":"Viruses"},{"key":"2026061502411450400_bib11","doi-asserted-by":"publisher","first-page":"105409","DOI":"10.1016\/j.ebiomed.2024.105409","article-title":"Yellow fever disease severity and endothelial dysfunction are associated with elevated serum levels of viral NS1 protein and syndecan-1","volume":"109","author":"de\u00a0Sousa","year":"2024","journal-title":"EBioMedicine"},{"key":"2026061502411450400_bib12","doi-asserted-by":"publisher","first-page":"126758","DOI":"10.1016\/j.vaccine.2025.126758","article-title":"Real-world evidence of yellow fever vaccination data-driven study","volume":"48","author":"Farnsworth","year":"2025","journal-title":"Vaccine"},{"key":"2026061502411450400_bib13","first-page":"101144","article-title":"Colombian consensus on the care of critically ill patients with suspected or confirmed severe yellow fever","volume":"48","author":"Forero-Delgadillo","year":"2025","journal-title":"Lancet Reg Health Am"},{"key":"2026061502411450400_bib14","doi-asserted-by":"publisher","first-page":"000300","DOI":"10.1099\/acmi.0.000300","article-title":"Dengue 2 serotype and yellow fever coinfection","volume":"3","author":"Gehrke","year":"2021","journal-title":"Access Microbiol"},{"key":"2026061502411450400_bib15","doi-asserted-by":"publisher","first-page":"2624234","DOI":"10.1080\/21645515.2026.2624234","article-title":"Immunofitness in the elderly: the role of vaccination in promoting healthy aging","volume":"22","author":"Gomez\u00a0Rial","year":"2026","journal-title":"Hum Vaccin Immunother"},{"key":"2026061502411450400_bib16","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/ajr.13101","article-title":"Yellow fever\u2014an old foe with new developments","volume":"32","author":"Grahn","year":"2024","journal-title":"Australian J Rural Health"},{"key":"2026061502411450400_bib17","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.ijid.2019.07.033","article-title":"A yellow flag on the horizon: the looming threat of yellow fever to North America","volume":"87","author":"J\u00e1come","year":"2019","journal-title":"Int J Infect Dis"},{"key":"2026061502411450400_bib18","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1002\/hep4.1504","article-title":"Molecular mechanism for protection against liver failure in human yellow fever infection","volume":"4","author":"Lemos","year":"2020","journal-title":"Hepatol Commun"},{"key":"2026061502411450400_bib19","doi-asserted-by":"publisher","first-page":"e35","DOI":"10.1590\/s1678-9946201961035","article-title":"Kidney involvement in yellow fever: a review","volume":"61","author":"Lopes","year":"2019","journal-title":"Rev Inst Med Trop S Paulo"},{"key":"2026061502411450400_bib20","doi-asserted-by":"publisher","first-page":"100438","DOI":"10.1016\/j.onehlt.2022.100438","article-title":"Multidisciplinary approach for surveillance and risk identification of yellow fever and other arboviruses in Colombia","volume":"15","author":"Mantilla-Granados","year":"2022","journal-title":"One Health"},{"key":"2026061502411450400_bib21","doi-asserted-by":"publisher","first-page":"1644","DOI":"10.1186\/s12889-022-14043-6","article-title":"Epidemiological description of and response to a large yellow fever outbreak in Edo state Nigeria, September 2018\u2013January 2019","volume":"22","author":"Nwachukwu\u00a0William","year":"2022","journal-title":"BMC Public Health"},{"key":"2026061502411450400_bib22","doi-asserted-by":"publisher","first-page":"398","DOI":"10.12688\/f1000research.11280.1","article-title":"Yellow fever in the Americas: the growing concern about new epidemics","volume":"6","author":"Ortiz-Mart\u00ednez","year":"2017","journal-title":"F1000Res"},{"key":"2026061502411450400_bib23","doi-asserted-by":"publisher","first-page":"e129","DOI":"10.1016\/S1473-3099(20)30170-5","article-title":"Prevention of yellow fever in travellers: an update","volume":"20","author":"Reno","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2026061502411450400_bib24","first-page":"9","article-title":"Deforestation and zoonotic arboviral diseases: a one health challenge in the context of oropouche and yellow fever re-emergence in Latin America","volume":"6","author":"Rodriguez-Morales","year":"2026","journal-title":"German J Veterinary Res"},{"key":"2026061502411450400_bib25","doi-asserted-by":"publisher","first-page":"e2688","DOI":"10.54034\/mic.e2688","article-title":"Diabetes and outcomes in yellow fever: an overlooked determinant in a re-emerging threat","volume":"6","author":"Rodriguez-Morales","year":"2026","journal-title":"Microbes Infect Chemother"},{"key":"2026061502411450400_bib26","doi-asserted-by":"publisher","first-page":"101651","DOI":"10.1016\/j.nmni.2025.101651","article-title":"Clinical features of yellow fever in cases from Bolivia, Ecuador, Colombia, and Peru (2023\u20132025): a descriptive retrospective study","volume":"68","author":"Rodriguez-Morales","year":"2025","journal-title":"New Microbes New Inf"},{"key":"2026061502411450400_bib27","doi-asserted-by":"publisher","first-page":"102964","DOI":"10.1016\/j.tmaid.2026.102964","article-title":"Yellow fever in older populations: marked age- and sex-based disparities in case-fatality rates in Colombia, Brazil, and Peru","author":"Rodr\u00edguez-Morales","year":"2026","journal-title":"Travel Med Inf Dis"},{"key":"2026061502411450400_bib28","first-page":"4","article-title":"Fiebre amarilla en Am\u00e9rica del Sur: casos y vectores, 2025","volume":"33","author":"Rodr\u00edguez-Morales","year":"2025","journal-title":"Actualizaciones en Sida e Infectolog\u00eda"},{"key":"2026061502411450400_bib29","doi-asserted-by":"publisher","first-page":"101737","DOI":"10.1016\/j.nmni.2026.101737","article-title":"Reemergence of yellow fever in Venezuela, 2025\/2026","volume":"70","author":"Rodriguez-Morales","year":"2026","journal-title":"New Microbes New Inf"},{"key":"2026061502411450400_bib30","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1016\/S1473-3099(17)30419-X","article-title":"Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis","volume":"17","author":"Shearer","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2026061502411450400_bib31","first-page":"434","article-title":"Yellow fever: global impact, epidemiology, pathogenesis, and integrated prevention approaches","volume":"32","author":"Srivastava","year":"2024","journal-title":"Infez Med"},{"key":"2026061502411450400_bib32","doi-asserted-by":"publisher","first-page":"65","DOI":"10.3390\/vaccines14010065","article-title":"The yellow fever vaccine journey: milestones and future directions","volume":"14","author":"Srivastava","year":"2026","journal-title":"Vaccines (Basel)"},{"key":"2026061502411450400_bib33","doi-asserted-by":"publisher","first-page":"ftab017","DOI":"10.1093\/femspd\/ftab107","article-title":"Incidence, drivers and global health implications of the 2019\/2020 yellow fever sporadic outbreaks in Sub-Saharan Africa","volume":"79","author":"Uchenna\u00a0Emeribe","year":"2021","journal-title":"Pathog Dis"}],"container-title":["Sustainable Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/sumbio\/advance-article-pdf\/doi\/10.1093\/sumbio\/qvag018\/68251380\/qvag018.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sumbio\/article-pdf\/3\/2\/qvag018\/68251380\/qvag018.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/sumbio\/article-pdf\/3\/2\/qvag018\/68251380\/qvag018.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T06:41:22Z","timestamp":1781505682000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/sumbio\/article\/doi\/10.1093\/sumbio\/qvag018\/8673133"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4,3]]}},"URL":"https:\/\/doi.org\/10.1093\/sumbio\/qvag018","relation":{},"ISSN":["2755-1970"],"issn-type":[{"value":"2755-1970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"qvag018"}}