Defining risk groups to yellow fever vaccine-associated viscerotropic disease in the absence of denominator data

Am J Trop Med Hyg. 2014 Feb;90(2):267-71. doi: 10.4269/ajtmh.13-0542. Epub 2014 Jan 6.

Abstract

Several risk groups are known for the rare but serious, frequently fatal, viscerotropic reactions following live yellow fever virus vaccine (YEL-AVD). Establishing additional risk groups is hampered by ignorance of the numbers of vaccinees in factor-specific risk groups thus preventing their use as denominators in odds ratios (ORs). Here, we use an equation to calculate ORs using the prevalence of the factor-specific risk group in the population who remain well. The 95% confidence limits and P values can also be calculated. Moreover, if the estimate of the prevalence is imprecise, discrimination analysis can indicate the prevalence at which the confidence interval results in an OR of ∼1 revealing if the prevalence might be higher without yielding a non-significant result. These methods confirm some potential risk groups for YEL-AVD and cast doubt on another. They should prove useful in situations in which factor-specific risk group denominator data are not available.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Confidence Intervals
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Vaccination / statistics & numerical data
  • Vaccines, Attenuated / therapeutic use
  • Yellow Fever / epidemiology*
  • Yellow Fever / prevention & control*
  • Yellow Fever Vaccine / therapeutic use*
  • Yellow fever virus
  • Young Adult

Substances

  • Vaccines, Attenuated
  • Yellow Fever Vaccine