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Evaluating vaccination strategies for reducing infant respiratory syncytial virus infection in low-income settings
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Poletti, Piero, Merler, Stefano, Ajelli, Marco, Manfredi, Piero, Munywoki, Patrick K., Nokes, D. James and Melegaro, Alessia (2015) Evaluating vaccination strategies for reducing infant respiratory syncytial virus infection in low-income settings. BMC Medicine, Volume 13 (Number 1). pp. 1-11. Article number 49. doi:10.1186/s12916-015-0283-x ISSN 1741-7015.
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Official URL: http://dx.doi.org/10.1186/s12916-015-0283-x
Abstract
Background:
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease and related hospitalization of young children in least developed countries. Individuals are repeatedly infected, but it is the first exposure, often in early infancy, that results in the vast majority of severe RSV disease. Unfortunately, due to immunological immaturity, infants are a problematic RSV vaccine target. Several trials are ongoing to identify a suitable candidate vaccine and target group, but no immunization program is yet in place.
Methods:
In this work, an individual-based model that explicitly accounts for the socio-demographic population structure is developed to investigate RSV transmission patterns in a rural setting of Kenya and to evaluate the potential effectiveness of alternative population targets in reducing RSV infant infection.
Results:
We find that household transmission is responsible for 39% of infant infections and that school-age children are the main source of infection within the household, causing around 55% of cases. Moreover, assuming a vaccine-induced protection equivalent to that of natural infection, our results show that annual vaccination of students is the only alternative strategy to routine immunization of infants able to trigger a relevant and persistent reduction of infant infection (on average, of 35.6% versus 41.5% in 10 years of vaccination). Interestingly, if vaccination of pregnant women boosts maternal antibody protection in infants by an additional 4 months, RSV infant infection will be reduced by 31.5%.
Conclusions:
These preliminary evaluations support the efforts to develop vaccines and related strategies that go beyond targeting vaccines to those at highest risk of severe disease.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RJ Pediatrics | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||
Library of Congress Subject Headings (LCSH): | Respiratory therapy for newborn infants, Respiratory syncytial virus -- Vaccination | ||||||||
Journal or Publication Title: | BMC Medicine | ||||||||
Publisher: | BioMed Central Ltd. | ||||||||
ISSN: | 1741-7015 | ||||||||
Official Date: | 10 March 2015 | ||||||||
Dates: |
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Volume: | Volume 13 | ||||||||
Number: | Number 1 | ||||||||
Number of Pages: | 11 | ||||||||
Page Range: | pp. 1-11 | ||||||||
Article Number: | Article number 49 | ||||||||
DOI: | 10.1186/s12916-015-0283-x | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 29 December 2015 | ||||||||
Date of first compliant Open Access: | 29 December 2015 | ||||||||
Funder: | European Research Council (ERC), Seventh Framework Programme (European Commission) (FP7), Wellcome Trust (London, England) | ||||||||
Grant number: | 283955 (DECIDE) (ERC), 077092 (WT), 084633 (WT), 102975 (WT) |
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