A Meta-Analysis of Serological Response Associated with Yellow Fever Vaccination

Am J Trop Med Hyg. 2016 Dec 7;95(6):1435-1439. doi: 10.4269/ajtmh.16-0401. Epub 2016 Oct 10.


Despite previous evidence of high level of efficacy, no synthetic metric of yellow fever (YF) vaccine efficacy is currently available. Based on the studies identified in a recent systematic review, we conducted a random-effects meta-analysis of the serological response associated with YF vaccination. Eleven studies conducted between 1965 and 2011 representing 4,868 individual observations were included in the meta-analysis. The pooled estimate of serological response was 97.5% (95% confidence interval [CI] = 82.9-99.7%). There was evidence of between-study heterogeneity (I2 = 89.1%), but this heterogeneity did not appear to be related to study size, study design, or seroconversion measurement or definition. Pooled estimates were significantly higher (P < 0.0001) among studies conducted in nonendemic settings (98.9%, 95% CI = 98.2-99.4%) than among those conducted in endemic settings (94.2%, 95% CI = 83.8-98.1%). These results provide background information against which to evaluate the efficacy of fractional doses of YF vaccine that may be used in outbreak situations.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Antibodies, Viral / blood
  • Humans
  • Serologic Tests*
  • Yellow Fever / blood
  • Yellow Fever / prevention & control*
  • Yellow Fever Vaccine / immunology*


  • Antibodies, Viral
  • Yellow Fever Vaccine