Heffernan, J. M. and Keeling, Matthew James (2009) Implications of vaccination and waning immunity. Proceedings of the Royal Society B: Biological Sciences, Vol.276 (No.1664). pp. 2071-2080. doi:10.1098/rspb.2009.0057

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Abstract

For infectious diseases where immunization can offer lifelong protection, a variety of simple models can be used to explain the utility of vaccination as a control method. However, for many diseases, immunity wanes over time and is subsequently enhanced ( boosted) by asymptomatic encounters with the infection. The study of this type of epidemiological process requires a model formulation that can capture both the within-host dynamics of the pathogen and immune system as well as the associated population-level transmission dynamics. Here, we parametrize such a model for measles and show how vaccination can have a range of unexpected consequences as it reduces the natural boosting of immunity as well as reducing the number of naive susceptibles. In particular, we show that moderate waning times (40-80 years) and high levels of vaccination ( greater than 70%) can induce large-scale oscillations with substantial numbers of symptomatic cases being generated at the peak. In addition, we predict that, after a long disease-free period, the introduction of infection will lead to far larger epidemics than that predicted by standard models. These results have clear implications for the long-term success of any vaccination campaign and highlight the need for a sound understanding of the immunological mechanisms of immunity and vaccination.

Item Type:	Journal Article
Subjects:	Q Science > QH Natural history > QH301 Biology
Divisions:	Faculty of Science > Life Sciences (2010- ) > Biological Sciences ( -2010) Faculty of Science > Mathematics
Journal or Publication Title:	Proceedings of the Royal Society B: Biological Sciences
Publisher:	The Royal Society Publishing
ISSN:	0962-8452
Official Date:	7 June 2009
Dates:	Date Event 7 June 2009 Published
Volume:	Vol.276
Number:	No.1664
Number of Pages:	10
Page Range:	pp. 2071-2080
DOI:	10.1098/rspb.2009.0057
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Leverhulme Trust (LT), Medical Research Council, Natural Sciences and Engineering Research Council of Canada (NSERC), Shared Hierarchical Academic Research Computing Network (SHARCNET)

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