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Vaccine. 2014 Jan 16;32(4):514-20. doi: 10.1016/j.vaccine.2013.11.020. Epub 2013 Nov 19.

Potential opportunities and perils of imperfect dengue vaccines.

Author information

1
Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.
2
Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA; Nonlinear Systems Dynamics Section, Plasma Physics Division, U.S. Naval Research Laboratory, Washington, DC 20375, USA.
3
Nonlinear Systems Dynamics Section, Plasma Physics Division, U.S. Naval Research Laboratory, Washington, DC 20375, USA.
4
University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261, USA.
5
Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA. Electronic address: dcumming@jhsph.edu.

Abstract

Dengue vaccine development efforts have focused on the development of tetravalent vaccines. However, a recent Phase IIb trial of a tetravalent vaccine indicates a protective effect against only 3 of the 4 serotypes. While vaccines effective against a subset of serotypes may reduce morbidity and mortality, particular profiles could result in an increased number of cases due to immune enhancement and other peculiarities of dengue epidemiology. Here, we use a compartmental transmission model to assess the impact of partially effective vaccines in a hyperendemic Thai population. Crucially, we evaluate the effects that certain serotype heterogeneities may have in the presence of mass-vaccination campaigns. In the majority of scenarios explored, partially effective vaccines lead to 50% or greater reductions in the number of cases. This is true even of vaccines that we would not expect to proceed to licensure due to poor or incomplete immune responses. Our results show that a partially effective vaccine can have significant impacts on serotype distribution and mean age of cases.

KEYWORDS:

Dengue vaccine; Mathematical model; Vaccine effects

PMID:
24269318
PMCID:
PMC4142437
DOI:
10.1016/j.vaccine.2013.11.020
[Indexed for MEDLINE]
Free PMC Article

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