Modelling measles re-emergence as a result of waning of immunity in vaccinated populations
Modelling measles re-emergence as a result of waning of immunity in vaccinated populations
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DOI：
10.1016/s0264-410x(03)00449-3
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发表时间：
2003-11-07
期刊：
影响因子：
5.5
通讯作者：
Muller, CP
中科院分区：
文献类型：
--
作者：
Mossong, J;Muller, CP
麻疹在接种疫苗人群中传播的年龄结构数学模型用于模拟从免疫来自自然感染的人群到免疫来自疫苗诱导的人群的转变。该模型考虑了接种疫苗人群免疫力的下降，这些人群最终将易感染一种较温和的疫苗修饰麻疹，其传播潜力低于未接种疫苗的传统麻疹。根据目前对疫苗衍生保护持续时间的估计，预计麻疹不会在常规疫苗持续高覆盖率的国家迅速重新出现。然而，在引入高水平疫苗接种几十年后，有可能再次出现。再次出现麻疹的时间主要取决于与传统麻疹相比疫苗改良麻疹病例的传染性。有趣的是，在接种疫苗比例较高的人群中，疫苗改良麻疹和经典麻疹基本上发生在同一年龄组。虽然广泛观察到疫苗接种者体液免疫能力下降，但在高度接种人群中麻疹的重新出现取决于需要更好估计的参数。(C) 2003 Elsevier Ltd.版权所有。
An age-structured mathematical model of measles transmission in a vaccinated population is used to simulate the shift from a population whose immunity is derived from natural infection to a population whose immunity is vaccine-induced. The model incorporates waning of immunity in a population of vaccinees that eventually will become susceptible to a milder form of vaccine-modified measles with a lower transmission potential than unvaccinated classical measles. Using current estimates of duration of vaccine-derived protection, measles would not be expected to re-emerge quickly in countries with sustained high routine vaccine coverage. However, re-emergence is possible to occur several decades after introduction of high levels of vaccination. Time until re-emergence depends primarily on the contagiousness of vaccine-modified measles cases in comparison to classical measles. Interestingly, in a population with a high proportion of vaccinees, vaccine-modified measles and classical measles would occur essentially in the same age groups. Although waning of humoral immunity in vaccinees is widely observed, re-emergence of measles in highly vaccinated populations depends on parameters for which better estimates are needed. (C) 2003 Elsevier Ltd. All rights reserved.