Journal of Mosquito Research, 2024, Vol.14, No.5, 264-275 http://emtoscipublisher.com/index.php/jmr 264 Review and Progress Open Access Vaccine Strategies for Yellow Fever: Current Status and Future Directions JieZhang Institute of Life Science, Jiyang College of Zhejiang AandF University, Zhuji, 311800, Zhejiang, China Corresponding email: jie.zhang@jicat.org Journal of Mosquito Research, 2024, Vol.14, No.5 doi: 10.5376/jmr.2024.14.0025 Received: 11 Sep., 2024 Accepted: 13 Oct., 2024 Published: 26 Oct., 2024 Copyright © 2024 Zhang, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Zhang J., 2024, Vaccine strategies for yellow fever: current status and future directions, Journal of Mosquito Research, 14(5): 264-275 (doi: 10.5376/jmr.2024.14.0025) Abstract This study explores the current status and future directions of yellow fever vaccines. Despite the availability of an effective live attenuated vaccine, challenges such as vaccine shortages, rare adverse reactions, and insufficient vaccination coverage remain major obstacles to controlling yellow fever. This study reviews the advantages and disadvantages of live attenuated vaccines, inactivated vaccines, and emerging DNA and RNA vaccines, highlighting the potential of nanoparticle and Virus-Like Particle (VLP) platforms. An analysis of recent vaccination efforts in Nigeria and other yellow fever-endemic regions underscores the importance of integrating vaccination with vector control strategies. To address these challenges, the article suggests enhancing vaccine production capacity, developing safer next-generation vaccines, and improving vaccination rates through public education and policy support. This study also points out that future research should focus on the long-term efficacy of fractional-dose vaccines and the development of multivalent vaccines to address the threat of multiple arboviruses. Keywords Yellow fever vaccine; Live attenuated vaccine; DNA vaccine; RNA vaccine; Nanoparticle vaccine 1 Introduction Yellow Fever (YF) is a vector-borne viral disease that remains a significant threat in many parts of the world, particularly in Africa and South America. Despite the availability of an effective vaccine for over 70 years, YF outbreaks continue to occur, influenced by factors such as vaccine coverage, environmental conditions, and socio-political changes. Understanding the dynamics of YF and developing effective vaccination strategies are essential for controlling and ultimately eliminating this disease. Yellow fever is caused by the Yellow Fever Virus (YFV), a flavivirus transmitted primarily by Aedes mosquitoes. It is endemic to tropical regions of Africa and South America, with recent outbreaks highlighting its re-emergence as a public health threat. The disease manifests as an acute febrile illness that can progress to severe forms with high mortality rates due to liver failure, hemorrhaging, and multi-organ dysfunction (Chen and Wilson, 2020). Recent studies have shown that the risk of YF outbreaks is closely tied to factors like mosquito population dynamics, human movement, and climate variability (Faria et al., 2018). Yellow fever has a significant public health impact, with estimates suggesting thousands of deaths annually due to outbreaks in areas with insufficient vaccination coverage. The World Health Organization’s Eliminate Yellow Fever Epidemics (EYE) strategy, launched in 2017, aims to mitigate these risks through targeted vaccination campaigns, surveillance, and rapid response strategies (Jean et al., 2020). The development of the YF vaccine represents a milestone in virology and vaccinology. The 17D live-attenuated vaccine, developed in the 1930s, remains one of the most effective vaccines, offering lifelong immunity with a single dose (Hansen and Barrett, 2021). Despite its efficacy, the availability of the vaccine has been a persistent issue, particularly during outbreaks when demand surges. The 2016-2018 outbreaks highlighted challenges in vaccine supply and led to the use of fractional dosing strategies to extend vaccine stocks, which have been shown to maintain immunogenicity (Nnaji et al., 2019). This study seeks to explore and assess current strategies for yellow fever vaccination, including fractional dosing and mass vaccination campaigns, evaluate their effectiveness in different epidemiological contexts, review
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