Yellow fever vaccination in non-immunocompetent patients

Any person travelling in countries where yellow fever (YF) is endemic and without presenting contra-indication for the vaccination against YF May be vaccinated. This vaccination can very rarely induce a potentially lethal neurotropic or viscerotropic disease. In severely immunodeficient patients, the vaccination is contra-indicated because postvaccinal encephalitis may occur after the vaccination, due to vaccine strain pathogenecity. It is important to evaluate the general health status in elderly individuals before vaccinating because of the increased risk of viscerotropic disease in people of 60 years of age and over. Pregnant women should not be vaccinated, except if departure to an endemic zone is unavoidable. YF vaccination is contra-indicated for newborns under six months of a e. Solid or-an,rafts, congenital immunodeficiency. leukemia, lymphoma, cancer, and immunosuppressive treatments are contra-indications for this vaccination. Nevertheless, YF immunization is possible after a bone marrow graft and a two-year period without graft-versus-host disease or immunosuppressive treatment. There is no data to Support that immunization of the donor prior to the graft Could confer protection against yellow Fever to the recipient. Low doses. short Courses of corticosteroids either as systemic treatment or intra-articular injections are not contra-indications for YF vaccination. Patients infected with HIV with stable clinical Status and T CD4-cell count above 200 cells per millimetre cube may lie vaccinated. Thymic diseases, including thymoma and thymectomy, are contra-indications for YF vaccination. Finally, it substantial residual level of antibodies beyond 10 years after the latest vaccination Could confer protection, thus avoiding a new vaccination when it is an issue. (C) 2008 Elsevier Masson SAS. Tons droits reserves.