A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of São Paulo, Brazil

• Main Authors: Ana Freitas Ribeiro, Ciléa Tengan, Helena Keico Sato, Roberta Spinola, Melissa Mascheretti, Ana Cecilia Costa França, Marcio Port-Carvalho, Mariza Pereira, Renato Pereira de Souza, Marcos Amaku, Marcelo Nascimento Burattini, Francisco Antonio Bezerra Coutinho, Luis Fernandez Lopez, Eduardo Massad
• Format: Article
• Language: English
• Published: Instituto Oswaldo Cruz, Ministério da Saúde 2015-04-01
• Series: Memórias do Instituto Oswaldo Cruz.
• Subjects: yellow fever; vaccination; side-effects; mathematical models; optimisation; risk estimation
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762015000200230&lng=en&tlng=en
• ISSN: 1678-8060

We propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of São Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of São Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions.