The effect of random vaccine response on the vaccination coverage required to prevent epidemics
The effect of random vaccine response on the vaccination coverage required to prevent epidemics
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DOI：
10.1016/s0025-5564(98)10048-2
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发表时间：
1998-12-15
影响因子：
4.3
通讯作者：
Starczak, DN
中科院分区：
文献类型：
--
作者：
Becker, NG;Starczak, DN
人们对疫苗接种的反应各不相同，因为他们的免疫系统不同，疫苗失败发生。在这里，我们考虑的影响，随机反应，独立于每个接种者，对疫苗接种覆盖率所需的预防流行病在一个大的社区。对于均匀混合个体的群体，发现临界疫苗接种覆盖率（CVC）的明确表达式，并且疫苗应答的效果完全由平均值E（AB）确定，其中A和B分别反映接种个体的感染性和易感性。这一结果表明，通常的疫苗有效性概念，重点是疫苗提供给接种者的抗感染保护量，不足以描述当疫苗接种影响传染性时预防流行病的要求。由于A和B指的是同一个体的疫苗应答，因此E（AB）的估计存在问题。当存在不同类型的个体时，发现类似的结果，但是现在平均E（AB）可能在类型之间不同。然而，对于由家庭组成的社区，表明CVC还取决于疫苗应答分布的其他特征。在实践中，这意味着估计疫苗有效性的单一指标通常不足以确定CVC。对于一个特定的家庭社区，发现预防流行病所需的疫苗接种覆盖率随着疫苗反应的变化而减少。(C)1998年爱思唯尔科学公司All rights reserved.
The response people have to vaccination varies because their immune systems differ and vaccine failures occur. Here we consider the effect that a random response, independent for each vaccinee, has on the vaccination coverage required to prevent epidemics in a large community. For a community of uniformly mixing individuals an explicit expression is found for the critical vaccination coverage (CVC) and the effect of the vaccine response is determined entirely by the mean E(AB), where A and B, respectively, reflect the infectivity and susceptibility of a vaccinated individual. This result shows that the usual concept of vaccine efficacy, which focuses on the amount of protection the vaccine provides the vaccinee against infection, is not adequate to describe the requirements for preventing epidemics when vaccination affects infectivity. The estimation of E(AB) poses a problem because A and B refer to the vaccine response of the same individual. Similar results are found when there are different types of individual, but now the mean E(AB) may differ between types. However, for a community made up of households it is shown that the CVC also depends on other characteristics of the vaccine response distribution. In practice this means that estimating a single measure of vaccine effectiveness is generally not enough to determine the CVC. For a specific community of households it is found that the vaccination coverage required to prevent epidemics decreases as the variation in the vaccine response increases. (C) 1998 Elsevier Science Inc. All rights reserved.