NYMC Faculty Publications

Defining Risk Groups to Yellow Fever Vaccine-Associated Viscerotropic Disease in the Absence of Denominator Data

Author Type(s)

Faculty

DOI

10.4269/ajtmh.13-0542

Journal Title

The American Journal of Tropical Medicine and Hygiene

First Page

267

Last Page

271

Document Type

Article

Publication Date

2-1-2014

Department

Pathology, Microbiology and Immunology

Keywords

Adolescent, Adult, Aged, Child, Child, Preschool, Cluster Analysis, Confidence Intervals, Female, Humans, Infant, Male, Middle Aged, Odds Ratio, Risk Factors, Vaccination, Vaccines, Attenuated, Yellow Fever, Yellow Fever Vaccine, Yellow fever virus, Young Adult

Disciplines

Medicine and Health Sciences

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.

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