Pitzer, VE; Bennett, A; Bar-Zeev, N; Jere, KC; Lopman, BA; Lewnard, JA; Parashar, UD; Cunliffe, NA
(2019)
Evaluating strategies to improve rotavirus vaccine impact during the second year of life in Malawi.
Sci Transl Med, 11 (505).
eaav6419.
ISSN 1946-6242
https://doi.org/10.1126/scitranslmed.aav6419
SGUL Authors: Bennett, Aisleen
![]() |
Microsoft Word (.docx)
Accepted Version
Available under License ["licenses_description_publisher" not defined]. Download (238kB) |
![]() |
Microsoft Word (.docx) (Supplementary materials)
Accepted Version
Available under License ["licenses_description_publisher" not defined]. Download (4MB) |
Abstract
Rotavirus vaccination has substantially reduced the incidence of rotavirus-associated gastroenteritis (RVGE) in high-income countries, but vaccine impact and estimated effectiveness are lower in low-income countries for reasons that are poorly understood. We used mathematical modeling to quantify rotavirus vaccine impact and investigate reduced vaccine effectiveness, particularly during the second year of life, in Malawi, where vaccination was introduced in October 2012 with doses at 6 and 10 weeks. We fitted models to 12 years of prevaccination data and validated the models against postvaccination data to evaluate the magnitude and duration of vaccine protection. The observed rollout of vaccination in Malawi was predicted to lead to a 26 to 77% decrease in the overall incidence of moderate-to-severe RVGE in 2016, depending on assumptions about waning of vaccine-induced immunity and heterogeneity in vaccine response. Vaccine effectiveness estimates were predicted to be higher among 4- to 11-month-olds than 12- to 23-month-olds, even when vaccine-induced immunity did not wane, due to differences in the rate at which vaccinated and unvaccinated individuals acquire immunity from natural infection. We found that vaccine effectiveness during the first and second years of life could potentially be improved by increasing the proportion of infants who respond to vaccination or by lowering the rotavirus transmission rate. An additional dose of rotavirus vaccine at 9 months of age was predicted to lead to higher estimated vaccine effectiveness but to only modest (5 to 16%) reductions in RVGE incidence over the first 3 years after introduction, regardless of assumptions about waning of vaccine-induced immunity.
Item Type: | Article | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Additional Information: | This is the author’s version of the work. It is posted here by permission of the AAAS for personal use, not for redistribution. The definitive version was published in Science Translational Medicine on [Vol 11, 2019, DOI: 10.1126/scitranslmed.aav6419. | |||||||||||||||
Keywords: | Female, Humans, Incidence, Infant, Malawi, Male, Models, Theoretical, Rotavirus, Rotavirus Infections, Rotavirus Vaccines, Humans, Rotavirus, Rotavirus Infections, Rotavirus Vaccines, Incidence, Models, Theoretical, Infant, Malawi, Female, Male, Female, Humans, Incidence, Infant, Malawi, Male, Models, Theoretical, Rotavirus, Rotavirus Infections, Rotavirus Vaccines, 11 Medical and Health Sciences, 06 Biological Sciences | |||||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | |||||||||||||||
Journal or Publication Title: | Sci Transl Med | |||||||||||||||
ISSN: | 1946-6242 | |||||||||||||||
Language: | eng | |||||||||||||||
Dates: |
|
|||||||||||||||
Publisher License: | Publisher's own licence | |||||||||||||||
Projects: |
|
|||||||||||||||
PubMed ID: | 31413144 | |||||||||||||||
Go to PubMed abstract | ||||||||||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/112881 | |||||||||||||||
Publisher's version: | https://doi.org/10.1126/scitranslmed.aav6419 |
Statistics
Actions (login required)
![]() |
Edit Item |