Herd immunity conferred by killed oral cholera vaccines in Bangladesh: a reanalysis
Herd immunity conferred by killed oral cholera vaccines in Bangladesh: a reanalysis
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DOI：
10.1016/s0140-6736(05)66550-6
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发表时间：
2005-07-02
期刊：
影响因子：
168.9
通讯作者：
Clemens, JD
中科院分区：
文献类型：
--
作者：
Ali, M;Emch, M;Clemens, JD
背景口服灭活霍乱疫苗可为接种者提供中等程度的直接保护，但是否使用这种疫苗取决于当疫苗覆盖率达到较高水平时，该疫苗是否也能提供间接（群体）保护。我们重新分析了孟加拉国一项实地试验的数据，以确定是否有证据表明口服灭活霍乱疫苗具有间接保护作用。方法：我们分析了孟加拉国儿童和成年妇女口服B亚单位灭活全细胞和仅灭活全细胞霍乱疫苗的安慰剂对照试验第一年的监测数据。在控制了潜在的混杂变量后，我们计算了居住群体中疫苗覆盖率水平与居住在该群体中的个体疫苗接种者或安慰剂接种者的霍乱发病率之间的关系是否存在反向单调趋势。目标人群的疫苗覆盖率从4%到65%不等。安慰剂接受者的霍乱发病率与疫苗覆盖率水平呈负相关(覆盖率最低的五分位数为7.01 / 1000，而最高的五分位数为1.47 / 1000
Background Decisions about the use of killed oral cholera vaccines, which confer moderate levels of direct protection to vaccinees, can depend on whether the vaccines also provide indirect (herd) protection when high levels of vaccine coverage are attained. We reanalysed data from a field trial in Bangladesh to ascertain whether there is evidence of indirect protection from killed oral cholera vaccines.Methods We analysed the first year of surveillance data from a placebo-controlled trial of B subunit-killed whole-cell and killed whole-cell-only oral cholera vaccines in children and adult women in Bangladesh. We calculated whether there was an inverse, monotonic trend for the relation between the level of vaccine coverage in a residential cluster and the incidence of cholera in individual vaccine recipients or placebo recipients residing in the cluster after controlling for potential confounding variables.Findings Vaccine coverage of the targeted population ranged from 4% to 65%. Incidence rates of cholera among placebo recipients were inversely related to levels of vaccine coverage (7.01 cases per 1000 in the lowest quintile of coverage vs 1.47 cases per 1000 in the highest quintile; p