Benefits and risks of the Sanofi-Pasteur dengue vaccine: Modeling optimal deployment.
Benefits and risks of the Sanofi-Pasteur dengue vaccine: Modeling optimal deployment.
复制标题
Sanofi-Pasteur登革热疫苗的好处和风险：建模最佳部署。
DOI：
10.1126/science.aaf9590
复制
发表时间：
2016-09-02
期刊：
影响因子：
--
通讯作者：
Cummings DA
中科院分区：
文献类型：
--
作者：
Ferguson NM;Rodríguez-Barraquer I;Dorigatti I;Mier-Y-Teran-Romero L;Laydon DJ;Cummings DA
首个获批的登革热疫苗现已在6个国家获得许可。我们认为这种减毒活疫苗在启动或增强宿主免疫方面的作用类似于一种沉默的自然感染。包含这一假设的传播动态模型很好地符合最近的临床试验数据，并预测疫苗的有效性在很大程度上取决于接种疫苗的年龄组和当地传播强度。在低传播环境中接种疫苗可能会增加更严重的“继发性”感染的发生率，从而增加因登革热住院的患者人数。在中度传播环境中，我们预测总体上有积极影响，但血清阴性时接种疫苗的个体因登革热住院的风险增加。然而，在高传播环境中，疫苗接种对整个人群和血清阴性接受者都有好处。我们的分析可以帮助决策者评估这种和其他候选登革热疫苗。
The first approved dengue vaccine has now been licensed in six countries. We propose that this live attenuated vaccine acts like a silent natural infection in priming or boosting host immunity. A transmission dynamic model incorporating this hypothesis fits recent clinical trial data well and predicts that vaccine effectiveness depends strongly on the age group vaccinated and local transmission intensity. Vaccination in low-transmission settings may increase the incidence of more severe “secondary-like” infection and, thus, the number of recipients hospitalized for dengue. In moderate transmission settings, we predict positive impacts overall but increased risks of hospitalization with dengue disease for individuals who are vaccinated when seronegative. However, in high-transmission settings, vaccination benefits both the whole population and seronegative recipients. Our analysis can help inform policy-makers evaluating this and other candidate dengue vaccines.