Multi-parameter approach to evaluate the timing of memory status after 17DD-YF primary vaccination.

In this investigation, machine-enhanced techniques were applied to bring about scientific insights to identify a minimum set of phenotypic/functional memory-related biomarkers for post-vaccination follow-up upon yellow fever (YF) vaccination. For this purpose, memory status of circulating T-cells (Naïve/early-effector/Central-Memory/Effector-Memory) and B-cells (Naïve/non-Classical-Memory/Classical-Memory) along with the cytokine profile (IFN/TNF/IL-5/IL-10) were monitored before-NV(day0) and at distinct time-points after 17DD-YF primary vaccination-PV(day30-45); PV(year1-9) and PV(year10-11). A set of biomarkers (eEfCD4; EMCD4; CMCD19; EMCD8; IFNCD4; IL-5CD8; TNFCD4; IFNCD8; TNFCD8; IL-5CD19; IL-5CD4) were observed in PV(day30-45), but not in NV(day0), with most of them still observed in PV(year1-9). Deficiencies of phenotypic/functional biomarkers were observed in NV(day0), while total lack of memory-related attributes was observed in PV(year10-11), regardless of the age at primary vaccination. Venn-diagram analysis pre-selected 10 attributes (eEfCD4, EMCD4, CMCD19, EMCD8, IFNCD4, IL-5CD8, TNFCD4, IFNCD8, TNFCD8 and IL-5CD4), of which the overall mean presented moderate accuracy to discriminate PV(day30-45)&PV(year1-9) from NV(day0)&PV(year10-11). Multi-parameter approaches and decision-tree algorithms defined the EMCD8 and IL-5CD4 attributes as the top-two predictors with moderated performance. Together with the PRNT titers, the top-two biomarkers led to a resultant memory status observed in 80% and 51% of volunteers in PV(day30-45) and PV(year1-9), contrasting with 0% and 29% found in NV(day0) and PV(year10-11), respectively. The deficiency of memory-related attributes observed at PV(year10-11) underscores the conspicuous time-dependent decrease of resultant memory following17DD-YF primary vaccination that could be useful to monitor potential correlates of protection in areas under risk of YF transmission.

Competing Interests: Seven participants of this study (MS, MSF, AMYY, AH, RMM, RHGF, MLSM) are employees at the 17DD-YF vaccine manufacturer (Bio-Manguinhos, Fundação Oswaldo Cruz), and nine participants work in other units of Fundação Oswaldo Cruz (ACCA, MSSA, VPM, LRVA, CTF, LABC, IRC, ATC and OAMF). Bias from competing interest was prevented by: (1) one collaboration with a general clinical Physician (HRP) from Brazilian Army, expert in infectious disease; (2) one general clinical Nurse (JACL) expert in vaccine epidemiological vigilance from State Health Department; (3) three Immunologists (LCCM) from Brazilian Research Academy and (MR and CC) from United States Department of Health; and (5) two independent professionals working as PhD student (CCP) or Post-Doc Researchers (JGCR) in the field of infectious diseases. (6) two authors (MSG and LRA) from the Universidade Federal de Alfenas contributed to bioinformatics analysis (decision tree algorithm). The FIOCRUZ extramural coworkers contributed with critical overview of the studystrategy, immunization of volunteers as well as medical care, blood sample collection, blind sample handling and processing, data collection, statistical analysis and data interpretation. The views and opinions expressed here are those of the authors and do not represent the official position of the US FDA.