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Related Experiment Video

Updated: Jul 1, 2026

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation

Published on: May 2, 2013

Proxy immunization enabling yellow fever vaccination after thymectomy.

Emilie C Rijnink^1,2, Muriel Aguilar-Bretones³, Rory D de Vries³

¹Department of Internal Medicine, Section Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.

|June 29, 2026

Summary

Yellow fever vaccination is risky for those with thymic disorders. This case shows a safe, individualized approach for a thymectomy patient using immune competence testing before vaccination.

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Novel Protocol for Generating Physiologic Immunogenic Dendritic Cells

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Area of Science:

Immunology
Vaccinology
Virology

Background:

Yellow fever vaccination is contraindicated in individuals with thymic disorders due to risk of viscerotropic disease.
Thymectomy, removal of the thymus, can impact immune function and vaccine safety.
Increasing global travel necessitates evaluating vaccination strategies for at-risk populations.

Purpose of the Study:

To assess the safety and immunogenicity of Yellow Fever (YF) vaccination in a patient with a history of thymectomy.
To evaluate an individualized, immune-guided approach for YF vaccination in a post-thymectomy patient.
To determine the feasibility of using proxy immunization to assess immune competence prior to YF vaccination.

Main Methods:

Case report of a 25-year-old woman with childhood thymectomy for myasthenia gravis.
Immune competence evaluation using dengue vaccine (TAK-003) proxy immunization.
Administration of YF-17D-204 vaccine after confirming immune competence.
Monitoring for reactogenicity, viremia, seroconversion, and T-cell/B-cell responses.

Main Results:

The patient tolerated dengue vaccine proxy immunization with mild reactogenicity and developed specific immune responses.
Following confirmation of immune competence, YF-17D-204 vaccination was well-tolerated.
YF vaccination induced transient viremia, seroconversion, and functional YF-specific B- and T-cell responses.
B-cell maturation was preserved throughout the evaluation.

Conclusions:

An individualized, immune-guided strategy can enable safe YF vaccination in select post-thymectomy patients.
Proxy immunization can serve as a viable method to assess orthoflaviviral immune competence.
Further clinical studies are needed to validate this approach for broader application.