Modeling the impact of subclinical measles transmission in vaccinated populations with waning immunity
UNSPECIFIED. (1999) Modeling the impact of subclinical measles transmission in vaccinated populations with waning immunity. AMERICAN JOURNAL OF EPIDEMIOLOGY, 150 (11). pp. 1238-1249. ISSN 0002-9262Full text not available from this repository.
An increasing body of evidence suggests that a substantial proportion of individuals who respond to measles vaccine display an antibody boost accompanied by mild or no symptoms on exposure to wild virus. It is unknown whether this emerging class of individuals can support transmission. The epidemiologic consequences of vaccinated individuals able to transmit virus are investigated using a mathematical model. Parameters for this model are estimated using regression analysis on a Canadian serologic data set. The authors confirm that neutralizing antibodies are decaying significantly in absence of circulating virus. Based on a protective threshold plaque reduction neutralization (PRN) titer of 120, the authors estimate the mean duration of vaccine-induced protection in absence of reexposure to be 25 years (95% confidence interval (CI) 18, 48). After long-term absence of circulating virus, the mathematical model predicts that 80% (95% CI 65, 91) of all seroconverted vaccinees have titers below the protective threshold. In this case, elimination of measles virus cannot be achieved by a single-dose routine vaccination strategy if the basic reproduction number in vaccinated individuals exceeds 1.24 (95% CI 1.10, 1.53). For this reason, there is a need to establish the intensity and duration of infectiousness in vaccinated individuals.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine|
|Journal or Publication Title:||AMERICAN JOURNAL OF EPIDEMIOLOGY|
|Publisher:||JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH|
|Date:||1 December 1999|
|Number of Pages:||12|
|Page Range:||pp. 1238-1249|
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