Systematic review and meta-analysis of yellow fever vaccine in elderly population

Abstract

AbstractWe conducted a systematic review and meta-analysis to assess the risk of serious adverse events in the elderly after yellow fever vaccination compared to the non-elderly population. We searched multiple databases and grey literature and selected research without language and publication date restriction. Studies were analysed in a descriptive way, meta-analysed and expressed in terms of prevalence ratio and risk ratio with a 95% confidence interval, depending on the degree of heterogeneity found. A total of 18 studies were included, of which 10 were meta-analysed. Results obtained through the meta-analysis showed that the risk of serious adverse events after yellow fever vaccination is three times higher for elderlies when compared to non-elderly population and even five times higher for persons >70 years of age. Also, in relation adverse event type a greater risk was for viscerotropic disease associated with yellow fever vaccine up to six times higher when compared to the population under 60 years. The evidence found in this review supports that the vaccine indication in individuals over 60 years of age should be based on a careful analysis of the individual benefit-risk assessment. Results found suggest a higher risk of SAE for individuals over 70 years, especially for viscerotropic and neurotropic disease associated with YFV contraindicating the use of the YFV in this age group.