The global landscape of smallpox vaccination history and implications for current and future orthopoxvirus susceptibility: a modelling study.
The global landscape of smallpox vaccination history and implications for current and future orthopoxvirus susceptibility: a modelling study.
复制标题
天花疫苗接种历史的全球格局以及对当前和未来正痘病毒易感性的影响：建模研究。
DOI：
10.1016/s1473-3099(22)00664-8
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Bansal,Shweta
中科院分区：
文献类型：
--
作者：
Taube,JulianaC;Rest,EvaC;Lloyd-Smith,JamesO;Bansal,Shweta
背景在天花根除40多年后，2022年猴痘暴发和其他正痘病毒传播事件的增加要求更好地了解正痘病毒的全球分布。我们的目标是描述当前天花疫苗接种历史和正痘病毒易感性的全球格局。方法我们通过整合当前人口学数据与根除文件和出版文献中天花疫苗接种计划的历史特征(覆盖率和停止日期)，在国家以下范围内表征全球天花疫苗接种格局。我们分析了这一情况，以确定与当前疫苗接种覆盖率的地理异质性最相关的因素。我们考虑了天花疫苗接种历史如何在不同的接种效果情景下转化为正痘病毒的年龄特定易感性。发现我们发现天花疫苗接种的全球空间异质性很大，全球1级行政区域(即比国家低一个行政级别的区域)的疫苗接种覆盖率估计在7%到60%之间，不确定性可以忽略不计(99.6%的地区的SD小于5%)。我们发现，疫苗接种覆盖率的地域差异主要是由国家以下人口统计学上的差异驱动的。此外，我们发现，基于停止接种时的年龄和特定年龄的覆盖范围，正痘病毒的易感性具有高度的年龄特异性；然而，年龄分布在疫苗有效性值之间是一致的。说明在目前的天花疫苗保护格局中，可以观察到根除天花的遗留问题。全球天花疫苗接种运动的力度和寿命，加上目前人口的异质性，塑造了当今的流行病学格局，揭示了正痘病毒易感性的巨大地理差异。这项研究提醒公共卫生决策者注意在2022年猴痘疫情广泛和持续传播的情况下可能面临最大风险的非流行地区，并强调了人口学和细尺度空间动力学在预测正痘病毒未来公共健康风险方面的重要性。
BackgroundMore than four decades after the eradication of smallpox, the ongoing 2022 monkeypox outbreak and increasing transmission events of other orthopoxviruses necessitate a greater understanding of the global distribution of susceptibility to orthopoxviruses. We aimed to characterise the current global landscape of smallpox vaccination history and orthopoxvirus susceptibility.MethodsWe characterised the global landscape of smallpox vaccination at a subnational scale by integrating data on current demography with historical smallpox vaccination programme features (coverage and cessation dates) from eradication documents and published literature. We analysed this landscape to identify the factors that were most associated with geographical heterogeneity in current vaccination coverage. We considered how smallpox vaccination history might translate into age-specific susceptibility profiles for orthopoxviruses under different vaccination effectiveness scenarios.FindingsWe found substantial global spatial heterogeneity in the landscape of smallpox vaccination, with vaccination coverage estimated to range from 7% to 60% within admin-1 regions (ie, regions one administrative level below country) globally, with negligible uncertainty (99·6% of regions have an SD less than 5%). We identified that geographical variation in vaccination coverage was driven mostly by differences in subnational demography. Additionally, we found that susceptibility for orthopoxviruses was highly age specific based on age at cessation and age-specific coverage; however, the age profile was consistent across vaccine effectiveness values.InterpretationThe legacy of smallpox eradication can be observed in the current landscape of smallpox vaccine protection. The strength and longevity of smallpox vaccination campaigns globally, combined with current demographic heterogeneity, have shaped the epidemiological landscape today, revealing substantial geographical variation in orthopoxvirus susceptibility. This study alerts public health decision makers to non-endemic regions that might be at greatest risk in the case of widespread and sustained transmission in the 2022 monkeypox outbreak and highlights the importance of demography and fine-scale spatial dynamics in predicting future public health risks from orthopoxviruses.FundingUS National Institutes of Health and US National Science Foundation.
登录
查看更多内容
影响因子：
64.8
作者：
Max F. Perutz
通讯作者：
Max F. Perutz
抗原肽与 II 类主要组织相容性分子 I-Ad 结合的动力学。
DOI：
10.1073/pnas.88.11.4661
发表时间：
1991
影响因子：
11.1
作者：
Tampé,R;McConnell,HM
通讯作者：
McConnell,HM
外来抗原的许多肽片段与宿主蛋白同源，从而引导 T 细胞反应。
DOI：
10.1073/pnas.88.8.3065
发表时间：
1991
影响因子：
11.1
作者：
Susumu Ohno
通讯作者：
Susumu Ohno
游离配体诱导 MHC-抗原复合物解离。
DOI：
--
发表时间：
1991
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
--
作者：
Pedrazzini,T;Sette,A;Albertson,M;Grey,HM
通讯作者：
Grey,HM
影响因子：
64.8
作者：
SETTE, A;BUUS, S;GREY, HM
通讯作者：
GREY, HM