Estimating Direct and Indirect Protective Effect of Influenza Vaccination in the United States
Estimating Direct and Indirect Protective Effect of Influenza Vaccination in the United States
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DOI：
10.1093/aje/kwx037
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发表时间：
2017-07-01
影响因子：
5
通讯作者：
Bresee, Joseph
中科院分区：
文献类型：
--
作者：
Arinaminpathy, Nimalan;Kim, Inkyu Kevin;Bresee, Joseph
美国流感疫苗接种率最近超过人口的 45%，了解疫苗接种对流感传播的影响非常重要。在这项研究中，我们使用贝叶斯建模方法，结合简单的流感传播动态模型来估计这种影响。该综合框架综合了来自与美国流感传播和疫苗接种相关的一系列数据源的证据。我们发现，对于季节性流行病，避免的感染人数从2006-2007季节的960万例（95%可信区间（CI）：8.7，10.9）到2012-2013季节的3720万例（95%可信区间（CI）：34.1，39.6）不等。以相对值表示，避免的比例从 2011-2012 季节的 20.8%（95% CI：16.8，24.3）到 2008-2009 季节的 47.5%（95% CI：43.7，50.8）。 2009 年 H1N1 大流行的避免百分比仅为 1.04%（95% CI：0.15，3.2），因为与北半球大流行相关的疫苗接种计划的时间较晚。未来，疫苗接种覆盖率的进一步提高以及流感疫苗的改进（尤其是对老年人提供更好保护的疫苗）可能会对每年的流感流行产生更大的影响。
With influenza vaccination rates in the United States recently exceeding 45% of the population, it is important to understand the impact that vaccination is having on influenza transmission. In this study, we used a Bayesian modeling approach, combined with a simple dynamical model of influenza transmission, to estimate this impact. The combined framework synthesized evidence from a range of data sources relating to influenza transmission and vaccination in the United States. We found that, for seasonal epidemics, the number of infections averted ranged from 9.6 million in the 2006-2007 season (95% credible interval (CI): 8.7, 10.9) to 37.2 million (95% CI: 34.1, 39.6) in the 2012-2013 season. Expressed in relative terms, the proportion averted ranged from 20.8% (95% CI: 16.8, 24.3) of potential infections in the 2011-2012 season to 47.5% (95% CI: 43.7, 50.8) in the 2008-2009 season. The percentage averted was only 1.04% (95% CI: 0.15, 3.2) for the 2009 H1N1 pandemic, owing to the late timing of the vaccination program in relation to the pandemic in the Northern hemisphere. In the future, further vaccination coverage, as well as improved influenza vaccines (especially those offering better protection in the elderly), could have an even stronger effect on annual influenza epidemics.