YELLOW FEVER VACCINATION OF THE AGED AND IMMUNOCOMPROMISED

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. The World Health Organization has estimated that urban yellow fever causes 200,000 cases and 30,000 deaths annually. The current live YFV vaccine, YF-VAX¿, has provided significant protection against YFV infection but the risks of vaccination may outweigh the benefits. For instance, immunization with YF-VAX¿ results in 1 to 2 vaccine-associated deaths per million doses administered  including fatalities in young, otherwise healthy adults. Adverse events occur at much higher rates in vulnerable populations such as the elderly, and the live vaccine is formally contraindicated in other vulnerable populations such as infants or individuals with immune disorders. In this project, we present evidence demonstrating that we have developed a novel vaccine platform that provides an effective and safe alternative to live virus vaccines. We show that virus inactivation using hydrogen peroxide enhances antigenicity and immunogenicity in comparison with other approaches such as formaldehyde-based inactivation techniques. Using this vaccine platform, we propose the development of a new YFV vaccine for use in both healthy individuals and vulnerable populations that have contraindications for immunization with live viral vaccines. This work will involve 1) development of an appropriately rigorous YFV infection model, 2) analysis and optimization of an inactivated YFV vaccine formulation, and 3) characterization of vaccine-mediated immune responses and protection against lethal challenge with clinically relevant strains of virulent YFV. The establishment of this second-generation YFV vaccine will represent the first advance in YFV vaccination in 50 years and provide a much needed vaccine alternative for immunologically vulnerable populations. In summary, we have successfully established a virulent YFV challenge model in rhesus macaques, designed and validated a new approach to quantify virulent YFV strains that are not amenable to traditional plaque assays, and have initiated our vaccine efficacy studies. Moreover, we have 3 papers published (or in press) and will submit 2 more papers within the next 2-6 months.