Reactive vaccination in the presence of disease hotspots.
Reactive vaccination in the presence of disease hotspots.
复制标题
在存在疾病热点的情况下，反应性疫苗接种。
DOI：
10.1098/rspb.2014.1341
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发表时间：
2015-01-07
期刊：
影响因子：
--
通讯作者：
Lessler J
中科院分区：
文献类型：
--
作者：
Azman AS;Lessler J
反应性疫苗接种最近被用作霍乱和其他传染病爆发的应对工具。由于全球口服霍乱疫苗短缺，卫生官员必须迅速决定向谁和向何处分发有限的疫苗。在传播热点地区（即传播效率高的地区）进行有针对性的疫苗接种可能是有效分配疫苗的一种潜在方法，但其有效性可能取决于具体情况。我们比较了在不同传播效率的多个地区分配疫苗的策略。我们构建了霍乱样疾病的集合种群模型，并比较了模拟的流行病：疫苗是针对高或低的传播效率，疫苗分布在整个人口的地区，并没有使用疫苗。我们发现，人口之间的连通性，传播效率，疫苗接种时间和可用疫苗的数量都塑造了不同的分配策略的性能。在高度连接的环境中（如城市），当在流行病早期接种疫苗时，将有限的疫苗瞄准传播热点通常是最佳的。一旦疫苗接种被推迟，瞄准热点地区很少是最佳的，在地区之间或针对非热点地区传播疫苗的策略将避免更多的病例。虽然热点可能是一个直观的疫情控制目标，我们表明，在许多情况下，热点流行病进展如此之快，以热点为目标的反应性疫苗接种将防止相对较少的情况下，和疫苗接种共享跨地区的传播可以持续往往是最好的。
Reactive vaccination has recently been adopted as an outbreak response tool for cholera and other infectious diseases. Owing to the global shortage of oral cholera vaccine, health officials must quickly decide who and where to distribute limited vaccine. Targeted vaccination in transmission hotspots (i.e. areas with high transmission efficiency) may be a potential approach to efficiently allocate vaccine, however its effectiveness will likely be context-dependent. We compared strategies for allocating vaccine across multiple areas with heterogeneous transmission efficiency. We constructed metapopulation models of a cholera-like disease and compared simulated epidemics where: vaccine is targeted at areas of high or low transmission efficiency, where vaccine is distributed across the population, and where no vaccine is used. We find that connectivity between populations, transmission efficiency, vaccination timing and the amount of vaccine available all shape the performance of different allocation strategies. In highly connected settings (e.g. cities) when vaccinating early in the epidemic, targeting limited vaccine at transmission hotspots is often optimal. Once vaccination is delayed, targeting the hotspot is rarely optimal, and strategies that either spread vaccine between areas or those targeted at non-hotspots will avert more cases. Although hotspots may be an intuitive outbreak control target, we show that, in many situations, the hotspot-epidemic proceeds so fast that hotspot-targeted reactive vaccination will prevent relatively few cases, and vaccination shared across areas where transmission can be sustained is often best.
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影响因子：
4.3
作者：
LONGINI, IM;ACKERMAN, E;ELVEBACK, LR
通讯作者：
ELVEBACK, LR
DOI：
10.1073/pnas.1102149108
发表时间：
2011-04-26
影响因子：
11.1
作者：
Chao, Dennis L.;Halloran, M. Elizabeth;Longini, Ira M., Jr.
通讯作者：
Longini, Ira M., Jr.
DOI：
10.1073/pnas.1019712108
发表时间：
2011-05-24
影响因子：
11.1
作者：
Mukandavire, Zindoga;Liao, Shu;Morris, J Glenn Jr
通讯作者：
Morris, J Glenn Jr
影响因子：
5.5
作者：
Hens, Niel;Van Ranst, Marc;Beutels, Philippe
通讯作者：
Beutels, Philippe
DOI：
10.1073/pnas.1203517109
发表时间：
2012-06-12
影响因子：
11.1
作者：
Dowdy, David W.;Golub, Jonathan E.;Saraceni, Valeria
通讯作者：
Saraceni, Valeria