How many published cases of serious adverse events after yellow fever vaccination meet Brighton Collaboration diagnostic criteria?

• 1st systematic review yellow fever vaccine severe adverse events by Brighton Collaboration criteria.
• 33 anaphylaxis cases, 41 neurological, 56 viscerotropic, 2 neurologic + viscerotropic met BC criteria.
• Under-detection and under-reporting of severe adverse events is likely.

ObjectivesTo perform a systematic review of all serious adverse events (SAEs) after yellow fever vaccination and to assess them according to Brighton Collaboration criteria.MethodsNine electronic databases were searched with the terms “yellow fever vaccine” and “adverse events” to 10 July 2013 (no language/date limits). Two reviewers independently assessed studies, entered data, and assessed cases with Brighton Collaboration criteria.ResultsOne hundred and thirty-one cases met Brighton Collaboration criteria: 32 anaphylaxis, 41 neurologic (one death), 56 viscerotropic (24 deaths), and 2 both neurologic and viscerotropic criteria. All SAEs occurred following first yellow fever (YF) vaccination. Two additional cases which met Brighton Collaboration criteria were proven due to wild virus.An additional 345 cases were presented with insufficient detail to meet Brighton Collaboration criteria: 173 neurological, 68 viscerotropic (24 deaths), 67 anaphylaxis, and 34 cases from a UK database and 3 from a Swiss database described as “serious adverse events” but not further classified into neurologic or viscerotropic. A further 253 cases were excluded as presenting insufficient data to be regarded as yellow fever vaccine (YFV) related SAEs.ConclusionsOne hundred and thirty-one cases met Brighton Collaboration criteria for serious adverse events after yellow fever vaccination. Another 345 cases did not meet Brighton criteria and 253 were excluded as presenting insufficient data to be regarded as serious adverse events after YFV. There are likely to be cases in areas that are remote or with insufficient diagnostic resources that are neither correctly assessed nor not published.