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Inherited IFNAR1 deficiency in otherwise healthy patients with adverse reaction to measles and yellow fever live vaccines.

ABSTRACT: Vaccination against measles, mumps, and rubella (MMR) and yellow fever (YF) with live attenuated viruses can rarely cause life-threatening disease. Severe illness by MMR vaccines can be caused by inborn errors of type I and/or III interferon (IFN) immunity (mutations in IFNAR2, STAT1, or STAT2). Adverse reactions to the YF vaccine have remained unexplained. We report two otherwise healthy patients, a 9-yr-old boy in Iran with severe measles vaccine disease at 1 yr and a 14-yr-old girl in Brazil with viscerotropic disease caused by the YF vaccine at 12 yr. The Iranian patient is homozygous and the Brazilian patient compound heterozygous for loss-of-function IFNAR1 variations. Patient-derived fibroblasts are susceptible to viruses, including the YF and measles virus vaccine strains, in the absence or presence of exogenous type I IFN. The patients' fibroblast phenotypes are rescued with WT IFNAR1 Autosomal recessive, complete IFNAR1 deficiency can result in life-threatening complications of vaccination with live attenuated measles and YF viruses in previously healthy individuals.

SUBMITTER: Hernandez N

PROVIDER: S-EPMC6719432 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Inherited IFNAR1 deficiency in otherwise healthy patients with adverse reaction to measles and yellow fever live vaccines.

Hernandez Nicholas N Bucciol Giorgia G Moens Leen L Le Pen Jérémie J Shahrooei Mohammad M Goudouris Ekaterini E Shirkani Afshin A Changi-Ashtiani Majid M Rokni-Zadeh Hassan H Sayar Esra Hazar EH Reisli Ismail I Lefevre-Utile Alain A Zijlmans Dick D Jurado Andrea A Pholien Ruben R Drutman Scott S Belkaya Serkan S Cobat Aurelie A Boudewijns Robbert R Jochmans Dirk D Neyts Johan J Seeleuthner Yoann Y Lorenzo-Diaz Lazaro L Enemchukwu Chibuzo C Tietjen Ian I Hoffmann Hans-Heinrich HH Momenilandi Mana M Pöyhönen Laura L Siqueira Marilda M MM de Lima Sheila M Barbosa SMB de Souza Matos Denise C DC Homma Akira A Maia Maria de Lourdes S MLS da Costa Barros Tamiris Azamor TA de Oliveira Patricia Mouta Nunes PMN Mesquita Emersom Ciclini EC Gijsbers Rik R Zhang Shen-Ying SY Seligman Stephen J SJ Abel Laurent L Hertzog Paul P Marr Nico N Martins Reinaldo de Menezes RM Meyts Isabelle I Zhang Qian Q MacDonald Margaret R MR Rice Charles M CM Casanova Jean-Laurent JL Jouanguy Emmanuelle E Bossuyt Xavier X

The Journal of experimental medicine 20190703 9

Vaccination against measles, mumps, and rubella (MMR) and yellow fever (YF) with live attenuated viruses can rarely cause life-threatening disease. Severe illness by MMR vaccines can be caused by inborn errors of type I and/or III interferon (IFN) immunity (mutations in IFNAR2, STAT1, or STAT2). Adverse reactions to the YF vaccine have remained unexplained. We report two otherwise healthy patients, a 9-yr-old boy in Iran with severe measles vaccine disease at 1 yr and a 14-y ...[more]

PMID: 31270247

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Project description:Childhood immunisation services have been disrupted by the COVID-19 pandemic. WHO recommends considering outbreak risk using epidemiological criteria when deciding whether to conduct preventive vaccination campaigns during the pandemic. We used two to three models per infection to estimate the health impact of 50% reduced routine vaccination coverage in 2020 and delay of campaign vaccination from 2020 to 2021 for measles vaccination in Bangladesh, Chad, Ethiopia, Kenya, Nigeria, and South Sudan, for meningococcal A vaccination in Burkina Faso, Chad, Niger, and Nigeria, and for yellow fever vaccination in the Democratic Republic of Congo, Ghana, and Nigeria. Our counterfactual comparative scenario was sustaining immunisation services at coverage projections made prior to COVID-19 (i.e. without any disruption). Reduced routine vaccination coverage in 2020 without catch-up vaccination may lead to an increase in measles and yellow fever disease burden in the modelled countries. Delaying planned campaigns in Ethiopia and Nigeria by a year may significantly increase the risk of measles outbreaks (both countries did complete their supplementary immunisation activities (SIAs) planned for 2020). For yellow fever vaccination, delay in campaigns leads to a potential disease burden rise of >1 death per 100,000 people per year until the campaigns are implemented. For meningococcal A vaccination, short-term disruptions in 2020 are unlikely to have a significant impact due to the persistence of direct and indirect benefits from past introductory campaigns of the 1- to 29-year-old population, bolstered by inclusion of the vaccine into the routine immunisation schedule accompanied by further catch-up campaigns. The impact of COVID-19-related disruption to vaccination programs varies between infections and countries. Planning and implementation of campaigns should consider country and infection-specific epidemiological factors and local immunity gaps worsened by the COVID-19 pandemic when prioritising vaccines and strategies for catch-up vaccination. Bill and Melinda Gates Foundation and Gavi, the Vaccine Alliance.

Dataset Information

Inherited IFNAR1 deficiency in otherwise healthy patients with adverse reaction to measles and yellow fever live vaccines.

Publications

Inherited IFNAR1 deficiency in otherwise healthy patients with adverse reaction to measles and yellow fever live vaccines.

Similar Datasets

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