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Predicting the relative impacts of maternal and neonatal respiratory syncytial virus (RSV) vaccine target product profiles : a consensus modelling approach
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Pan-Ngum, Wirichada, Kinyanjui, Timothy M., Kiti, Moses C., Taylor, Sylvia, Toussaint, Jean-François, Saralamba, Sompob, Van Effelterre, Thierry, Nokes, D. James and White, Lisa J. (2017) Predicting the relative impacts of maternal and neonatal respiratory syncytial virus (RSV) vaccine target product profiles : a consensus modelling approach. Vaccine, 35 (2). pp. 403-409. doi:10.1016/j.vaccine.2016.10.073 ISSN 0264-410X.
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Official URL: http://dx.doi.org/10.1016/j.vaccine.2016.10.073
Abstract
Background:
Respiratory syncytial virus (RSV) is the major viral cause of infant and childhood lower respiratory tract disease worldwide. Defining the optimal target product profile (TPP) is complicated due to a wide range of possible vaccine properties, modalities and an incomplete understanding of the mechanism of natural immunity. We report consensus population level impact projections based on two mathematical models applied to a low income setting.
Method:
Two structurally distinct age-specific deterministic compartmental models reflecting uncertainty associated with the natural history of infection and the mechanism by which immunity is acquired and lost were constructed. A wide range of vaccine TPPs were explored including dosing regime and uptake, and effects in the vaccinated individual on infectiousness, susceptibility, duration of protection, disease severity and interaction with maternal antibodies and natural induced immunity. These were combined with a range of vaccine implementation strategies, targeting the highest priority age group and calibrated using hospitalization data from Kilifi County Hospital, Kenya.
Findings:
Both models were able to reproduce the data. The impact predicted by the two models was qualitatively similar across the range of TPPs, although one model consistently predicted higher impact than the other. For a proposed realistic range of scenarios of TPP combinations, the models predicted up to 70% reduction in hospitalizations in children under five years old. Vaccine designs which reduced the duration and infectiousness of infection were predicted to have higher impacts. The models were sensitive to the coverage and rate of loss of vaccine protection but not to the interaction between vaccine and maternal/naturally acquired immunity.
Conclusion:
The results suggest that vaccine properties leading to reduced virus circulation by lessening the duration and infectiousness of infection upon challenge are of major importance in population RSV disease control. These features should be a focus for vaccine development.
Item Type: | Journal Article | ||||||||||
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Subjects: | Q Science > QR Microbiology > QR355 Virology | ||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||||
Library of Congress Subject Headings (LCSH): | Respiratory syncytial virus, Respiratory organs -- Diseases -- Treatment, Vaccines, Drug development | ||||||||||
Journal or Publication Title: | Vaccine | ||||||||||
Publisher: | Elsevier Ltd. | ||||||||||
ISSN: | 0264-410X | ||||||||||
Official Date: | 5 January 2017 | ||||||||||
Dates: |
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Volume: | 35 | ||||||||||
Number: | 2 | ||||||||||
Page Range: | pp. 403-409 | ||||||||||
DOI: | 10.1016/j.vaccine.2016.10.073 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
Date of first compliant deposit: | 5 January 2017 | ||||||||||
Date of first compliant Open Access: | 5 January 2017 | ||||||||||
Funder: | GlaxoSmithKline Biologicals SA, Wellcome Trust (London, England) | ||||||||||
Grant number: | 106698; 102975; 077092 |
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