Pathogen adaptation under imperfect vaccination: implications for pertussis
Pathogen adaptation under imperfect vaccination: implications for pertussis
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DOI：
10.1098/rspb.2005.3108
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发表时间：
2005-08-07
影响因子：
4.7
通讯作者：
Kretzschmar, M
中科院分区：
文献类型：
--
作者：
van Boven, M;Mooi, FR;Kretzschmar, M
大规模疫苗接种运动大大减轻了传染病的负担。不幸的是，近年来几种传染病重新出现。百日咳就是一个众所周知的例子。受百日咳的启发，我们研究，通过流行病模型，接种疫苗的压力下的病原体种群的人口和进化动力学。免疫学幼稚个体中的感染（原发性感染）和免疫系统已通过疫苗接种或感染引发的个体中的感染（继发性感染）之间存在区别。结果表明：（1）如果继发感染的传染性高于原发感染，接种不完善疫苗可能不能成功地降低感染压力;（ii）能够逃避由疫苗接种诱导的免疫的病原体菌株仅在逃避突变体不产生适应性成本或仅产生适度适应性成本的情况下才能传播，以及（iii）进化的方向很大程度上取决于种群中不同类型易感者的分布。我们讨论了这些结果的设计和使用的疫苗，提供暂时的免疫力的影响。
Mass vaccination campaigns have drastically reduced the burden of infectious diseases. Unfortunately, in recent years several infectious diseases have re-emerged. Pertussis poses a well-known example. Inspired by pertussis, we study, by means of an epidemic model, the population and evolutionary dynamics of a pathogen population under the pressure of vaccination. A distinction is made between infection in immunologically naive individuals (primary infection) and infection in individuals whose immune system has been primed by vaccination or infection (secondary infection). The results show that (i) vaccination with an imperfect vaccine may not succeed in reducing the infection pressure if the transmissibility of secondary infections is higher than that of primary infections; (ii) pathogen strains that are able to evade the immunity induced by vaccination can only spread if escape mutants incur no or only a modest fitness cost and (iii) the direction of evolution depends crucially on the distribution of the different types of susceptibles in the population. We discuss the implications of these results for the design and use of vaccines that provide temporary immunity.