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A missing dimension in measures of vaccination impacts
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Gomes, M. Gabriela M., Lipsitch, Marc, Wargo, Andrew R., Kurath, Gael, Rebelo, Carlota, Medley, Graham and Coutinho, Antonio (2014) A missing dimension in measures of vaccination impacts. PLoS Pathogens, Volume 10 (Number 3). Article number e1003849. doi:10.1371/journal.ppat.1003849
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Official URL: http://dx.doi.org/10.1371/journal.ppat.1003849
Abstract
Immunological protection, acquired from either natural infection or vaccination, varies among hosts, reflecting underlying biological variation and affecting population-level protection. Owing to the nature of resistance mechanisms, distributions of susceptibility and protection entangle with pathogen dose in a way that can be decoupled by adequately representing the dose dimension. Any infectious processes must depend in some fashion on dose, and empirical evidence exists for an effect of exposure dose on the probability of transmission to mumps-vaccinated hosts [1], the case-fatality ratio of measles [2], and the probability of infection and, given infection, of symptoms in cholera [3]. Extreme distributions of vaccine protection have been termed leaky (partially protects all hosts) and all-or-nothing (totally protects a proportion of hosts) [4]. These distributions can be distinguished in vaccine field trials from the time dependence of infections [5]. Frailty mixing models have also been proposed to estimate the distribution of protection from time to event data [6], [7], although the results are not comparable across regions unless there is explicit control for baseline transmission [8]. Distributions of host susceptibility and acquired protection can be estimated from dose-response data generated under controlled experimental conditions [9]–[11] and natural settings [12], [13]. These distributions can guide research on mechanisms of protection, as well as enable model validity across the entire range of transmission intensities. We argue for a shift to a dose-dimension paradigm in infectious disease science and community health.
| Item Type: | Journal Article | ||||
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| Subjects: | Q Science > QH Natural history > QH301 Biology Q Science > QR Microbiology > QR180 Immunology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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| Divisions: | Faculty of Science > Life Sciences (2010- ) | ||||
| Library of Congress Subject Headings (LCSH): | Vaccination -- Mathematical models, Virus diseases -- Transmission -- Mathematical models | ||||
| Journal or Publication Title: | PLoS Pathogens | ||||
| Publisher: | Public Library of Science | ||||
| ISSN: | 1553-7374 | ||||
| Official Date: | 2014 | ||||
| Dates: |
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| Volume: | Volume 10 | ||||
| Number: | Number 3 | ||||
| Article Number: | Article number e1003849 | ||||
| DOI: | 10.1371/journal.ppat.1003849 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access | ||||
| Funder: | Fundação para a Ciência e a Tecnologia (FCT), European Commission (EC), National Institute of General Medical Sciences (U.S.) (NIGMS) | ||||
| Grant number: | EC-ICT-231807 (EC), OE/MAT/UI0209/2011 (FCT), PTDC/MAT/113383/2009 (FCT), U54GM088558 (NIGMS) |
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