ArticleLancet (London, England)2016
Fractional dosing of yellow fever vaccine to extend supply: a modelling study.
Article in Lancet (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 52 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Yellow Fever Vaccine in Patients With Rheumatic Diseases Under Low Immunosuppression Level and Residing in a Risk Area
An Exploratory, Pilot Study of the Safety and Immunogenicity of Reduced Doses of the US Yellow Fever Vaccine
Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predicting Efficacies of Fractional Doses of Vaccines by Using Neutralizing Antibody Levels: Systematic Review and Meta-Analysis.JMIR public health and surveillance · 2024Pooled it
- Low-Dose Yellow Fever Vaccine in Adults in Africa.The New England journal of medicine · 2025Trial
- Could Less Be More? Accounting for Fractional-Dose Regimens and Different Number of Vaccine Doses When Measuring the Impact of the RTS,S/AS01E Malaria Vaccine.The Journal of infectious diseases · 2024Trial
- Immunogenicity and safety of fractional doses of 17D-213 yellow fever vaccine in HIV-infected people in Kenya (YEFE): a randomised, double-blind, non-inferiority substudy of a phase 4 trial.The Lancet. Infectious diseases · 2023Trial
- Safety, tolerability, and immunogenicity of influenza vaccination with a high-density microarray patch: Results from a randomized, controlled phase I clinical trial.PLoS medicine · 2020Trial
- Efficacy versus coverage: population-level impacts of vaccination schemes.Infectious Disease Modelling · 2027Article
- Review
- Mapping climate change-driven epidemics.Frontiers in epidemiology · 2025Article
- How mathematical modelling can inform outbreak response vaccination.BMC infectious diseases · 2024Review
- A safer cell-based yellow fever live attenuated vaccine protects mice against YFV infection.iScience · 2024Article
- Working with Convex Responses: Antifragility from Finance to Oncology.Entropy (Basel, Switzerland) · 2023Article
- Targeted randomization dose optimization trials enable fractional dosing of scarce drugs.PloS one · 2023Article
- Re-thinking yellow fever vaccines: fighting old foes with new generation vaccines.Human vaccines & immunotherapeutics · 2022Review
- Review
- Occurrence of yellow fever outbreaks in a partially vaccinated population: An analysis of the effective reproduction number.PLoS neglected tropical diseases · 2022Article
- Modeling comparative cost-effectiveness of SARS-CoV-2 vaccine dose fractionation in India.Nature medicine · 2022Article
- West Nile virus transmission potential in Portugal.Communications biology · 2022Article
- A Promising Vaccination Strategy against COVID-19 on the Horizon: Heterologous Immunization.Journal of microbiology and biotechnology · 2021Review
- Fractionating a COVID-19 Ad5-vectored vaccine improves virus-specific immunity.Science immunology · 2021Article
- Advancing sustainable development goals through immunization: a literature review.Globalization and health · 2021Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundThe ongoing yellow fever epidemic in Angola strains the global vaccine supply, prompting WHO to adopt dose sparing for its vaccination campaign in Kinshasa, Democratic Republic of the Congo, in July-August, 2016. Although a 5-fold fractional-dose vaccine is similar to standard-dose vaccine in safety and immunogenicity, efficacy is untested. There is an urgent need to ensure the robustness of fractional-dose vaccination by elucidation of the conditions under which dose fractionation would reduce transmission.
methodsWe estimate the effective reproductive number for yellow fever in Angola using disease natural history and case report data. With simple mathematical models of yellow fever transmission, we calculate the infection attack rate (the proportion of population infected over the course of an epidemic) with various levels of transmissibility and 5-fold fractional-dose vaccine efficacy for two vaccination scenarios, ie, random vaccination in a hypothetical population that is completely susceptible, and the Kinshasa vaccination campaign in July-August, 2016, with different age cutoff for fractional-dose vaccines.
findingsWe estimate the effective reproductive number early in the Angola outbreak was between 5·2 and 7·1. If vaccine action is all-or-nothing (ie, a proportion of vaccine recipients receive complete protection [VE] and the remainder receive no protection), n-fold fractionation can greatly reduce infection attack rate as long as VE exceeds 1/n. This benefit threshold becomes more stringent if vaccine action is leaky (ie, the susceptibility of each vaccine recipient is reduced by a factor that is equal to the vaccine efficacy). The age cutoff for fractional-dose vaccines chosen by WHO for the Kinshasa vaccination campaign (2 years) provides the largest reduction in infection attack rate if the efficacy of 5-fold fractional-dose vaccines exceeds 20%.
interpretationDose fractionation is an effective strategy for reduction of the infection attack rate that would be robust with a large margin for error in case fractional-dose VE is lower than expected.
fundingNIH-MIDAS, HMRF-Hong Kong.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.