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*A systematic review found incidences of YF across African countries were '''quite heterogenous (I<sup>2</sup>=99.4%) ''' as per 100,000 population ranging from '''<1 in Nigeria''' to '''10,350 in Ghana''' and failed in quantitative synthesis for meta-analysis.
{{quote
|content=Nwaiwu, A. U., Musekiwa, A., Tamuzi, J. L., Sambala, E. Z., & Nyasulu, P. S. (2021). The incidence and mortality of yellow fever in Africa: a systematic review and meta-analysis. BMC Infectious Diseases, 21(1), 1–11. https://doi.org/10.1186/s12879-021-06728-x
}}
*A systematic review and meta-analysis concluded from which synthesized 14 articles concluded that '''case fatality rate of YF among severe disease''' is '''39%''' (95%CI 31-47).
{{quote
|content=Servadio, J. L., Muñoz-Zanzi, C., & Convertino, M. (2021). Estimating case fatality risk of severe Yellow Fever cases: systematic literature review and meta-analysis. BMC Infectious Diseases, 21(1), 1–12. https://doi.org/10.1186/s12879-021-06535-4
===Effectiveness (real world research)===
===Effectiveness of fractional dose in emergency campaigns===
===Correlates of protection===
*Neutralization titer ≥1:10
*Log<sub>10</sub> neutralization index (LNI) ≥0.7
===Severe side effects===
===YF vaccine and Multiple sclerosis===
*In a ''prospective'' self-controlled case series study published in 2011 reported that '''between 1 and 5 weeks after YF immunization''' ('at risk period') MS patients experienced '''higher exacerbation rate''' compared to other periods ('''rate ratio 12.778'''; '''8.57 episodes per year''' at risk period vs '''0.67 episodes per year''' at non-risk period).
{{quote
|content=Farez, M. F., & Correale, J. (2011). Yellow fever vaccination and increased relapse rate in travelers with multiple sclerosis. Archives of Neurology, 68(10), 1267–1271. https://doi.org/10.1001/archneurol.2011.131
}}
*Whereas another ''retrospective'' self-controlled cohort published in 2020 reported that '''during 3 months after YF immunization''' ('exposure risk period') MS patients '''did not experienced significant increase of disease exacerbation''' associated with YF immunization.
{{quote
|content=Huttner, A., Eperon, G., Lascano, A. M., Roth, S., Schwob, J. M., Siegrist, C. A., & Lalive, P. H. (2020). Risk of MS relapse after yellow fever vaccination: A self-controlled case series. Neurology(R) Neuroimmunology & Neuroinflammation, 7(4), 1–6. https://doi.org/10.1212/NXI.0000000000000726
}}
===YF vaccine and Egg allergy===
===New vaccine development===
*'''Inactivated YF vaccine ''' has been under development. '''Phase 1''' trial of '''XRX-001''' purified whole-virus, β-propiolactone-'''inactivated vaccine ''' (cultured in Vero cell, adjuvanted with alumninum hydroxide) investigated 2 separated doses in 21 days apart with antigen of 4.8 μg, 0.48 μg and placebo.
{{quote
|content=Monath, T. P., Fowler, E., Johnson, C. T., Balser, J., Morin, M. J., Sisti, M., & Trent, D. W. (2011). An Inactivated Cell-Culture Vaccine against Yellow Fever. New England Journal of Medicine, 364(14), 1326–1333. https://doi.org/10.1056/NEJMoa1009303
}}
*'''Non-replicating viral vector YF vaccine''' has been under development. '''Phase 1''' trial of '''YF protein-producing Modified Vaccinia Ankara-Bavarian Nordic virus''' has been completed but has not been reported in peer-reviewed journals.
{{quote
|content=NCT02743455 - A Trial to Evaluate the Safety, Reactogenicity, and Immunogenicity of MVA-BN Yellow Fever Vaccine With and Without Montanide ISA-720 Adjuvant in 18-45 Year Old Healthy Volunteers. https://classic.clinicaltrials.gov/ct2/show/NCT02743455
}}
*'''mRNA YF vaccine''' is under development in '''mice and macaque models'''.
{{quote
|content=Medina-Magües, L. G., Mühe, J., Jasny, E., Medina-Magües, E. S., Roth, N., Lopera-Madrid, J., Salas-Quinchucua, C., Knuese, C., Petsch, B., & Osorio, J. E. (2023). Immunogenicity and protective activity of mRNA vaccine candidates against yellow fever virus in animal models. Npj Vaccines, 8(1). https://doi.org/10.1038/s41541-023-00629-7
}}
