Potential for a booster dose of rotavirus vaccine to further reduce diarrhea mortality.
Potential for a booster dose of rotavirus vaccine to further reduce diarrhea mortality.
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DOI：
10.1016/j.vaccine.2017.10.027
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发表时间：
2017-12-18
期刊：
影响因子：
5.5
通讯作者：
Parashar UD
中科院分区：
文献类型：
--
作者：
Burnett E;Lopman BA;Parashar UD
人们越来越担心，在发展中国家接种过轮状病毒疫苗的儿童，由于免疫力下降，可能在两岁时易患轮状病毒腹泻。已建议在9或12 个月大的婴儿接种麻疹疫苗时增加轮状病毒疫苗的加强剂，作为解决这一问题的一种策略。我们评估了假设的增强剂量对降低轮状病毒死亡率的潜在益处。预计避免的死亡人数是根据国家一级全系列疫苗接种覆盖率、按周龄估计的全国轮状病毒死亡人数以及根据已发表文献得出的<12 月龄和≥12 月龄的VE来计算的。我们假设了基于VE估计的三种函数形式的衰减：逐步、线性和对数。我们模拟了三种可能的促进情景：(a)将出生后第二年的VE减少50%，(b)将出生后第二年的VE恢复到出生后第一年的水平，以及(c)将第一年的VE提高到第一年和第二年之间VE差异的50%。为了表达由参数引起的不确定性，使用输入值的随机样本运行了9个模型中的每个模型1000次。在世卫组织所有区域，通过逐步模型，我们估计在VE减弱、VE重建和VE增强的情况下，轮状病毒死亡人数的中位数为9800人（95%CI: 9400, 10,200）、19,600人（95%CI: 18,800, 20,400）和29,400人（95%CI: 28,200, 30,700）。与逐步模型相比，如果免疫力以线性或对数方式减弱，则可避免的死亡减少约65-80%，这些估计值对假设的功能形式减弱高度敏感。虽然这些预测将受益于改进的输入数据点，但我们的结果提示考虑轮状病毒疫苗的加强剂量。
Concern has grown that children vaccinated against rotavirus in developing countries may be vulnerable to rotavirus diarrhea in the second year of life due to waning immunity. Adding a booster dose of rotavirus vaccine at 9 or 12 months of age with measles vaccine has been suggested as a strategy to address this. We evaluated the hypothetical potential benefits of a booster dose on reduction of rotavirus mortality. The projected number of deaths averted were calculated using national level full series vaccination coverage, estimated national rotavirus deaths by week of age, and VE at <12 months of age and ≥12 months of age derived from the published literature. We assumed three functional forms of waning based on the VE estimates: stepwise, linear, and logarithmic. We modeled three potential boosting scenarios: (a) reduced VE waning in the second year of life by 50%, (b) reestablished second year of life VE to the levels in the first year of life, and (c) boosted first year VE by 50% of the difference between VE in the first and second years. To express uncertainty resulting from the parameters, each of the nine models were run 1000 times using a random sample of input values. Across all WHO regions, with the stepwise models we estimated a median of 9800 (95%CI: 9400, 10,200), 19,600 (95%CI: 18,800, 20,400), and 29,400 (95%CI: 28,200, 30,700) additional rotavirus deaths averted in the reduced VE waning, reestablished VE, and boosted VE scenarios. These estimates were highly sensitive to the assumed functional form of waning with approximately 65–80% fewer deaths averted if immunity waned in a linear or logarithmic fashion compared to the stepwise model. While these projections will benefit from improved input data points, our results inform consideration of booster doses of rotavirus vaccine.
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影响因子：
158.5
作者：
Isanaka, Sheila;Guindo, Ousmane;Grais, Rebecca F.
通讯作者：
Grais, Rebecca F.
DOI：
10.1136/bmj.f3726
发表时间：
2013-06-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Patel MM;Patzi M;Pastor D;Nina A;Roca Y;Alvarez L;Iniguez V;Rivera R;Tam KI;Quaye O;Bowen M;Parashar U;De Oliveira LH
通讯作者：
De Oliveira LH
影响因子：
11.8
作者：
Tate, Jacqueline E.;Burton, Anthony H.;Parashar, Umesh D.
通讯作者：
Parashar, Umesh D.
DOI：
10.1016/s0140-6736(13)62630-6
发表时间：
2014-06-21
期刊：
Lancet (London, England)
影响因子：
--
作者：
Bhandari N;Rongsen-Chandola T;Bavdekar A;John J;Antony K;Taneja S;Goyal N;Kawade A;Kang G;Rathore SS;Juvekar S;Muliyil J;Arya A;Shaikh H;Abraham V;Vrati S;Proschan M;Kohberger R;Thiry G;Glass R;Greenberg HB;Curlin G;Mohan K;Harshavardhan GV;Prasad S;Rao TS;Boslego J;Bhan MK;India Rotavirus Vaccine Group
通讯作者：
India Rotavirus Vaccine Group
影响因子：
11.8
作者：
Sahakyan, Gayane;Grigoryan, Svetlana;Cortese, Margaret M.
通讯作者：
Cortese, Margaret M.