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Proc Natl Acad Sci U S A. 2016 Nov 15;113(46):13239-13244. Epub 2016 Oct 31.

Vaccination strategies against respiratory syncytial virus.

Author information

1
Department of Industrial Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel; yamind@post.tau.ac.il.
2
Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, Yale University, New Haven, CT 06510.
3
Division of Infectious Diseases Department of Pediatrics, Health Sciences Center, University of Tennessee, Memphis, TN 38103.
4
Department of Microbiology, Immunology, and Biochemistry, Health Sciences Center, University of Tennessee, Memphis, TN 38103.
5
Children's Foundation Research Institute at Le Bonheur Children's Hospital, Memphis, TN 38103.
6
Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
7
Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT 06511.
8
Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT 06510.

Abstract

Respiratory syncytial virus (RSV) is the most common cause of US infant hospitalization. Additionally, RSV is responsible for 10,000 deaths annually among the elderly across the United States, and accounts for nearly as many hospitalizations as influenza. Currently, several RSV vaccine candidates are under development to target different age groups. To evaluate the potential effectiveness of age-specific vaccination strategies in averting RSV incidence, we developed a transmission model that integrates data on daily infectious viral load and changes of behavior associated with RSV symptoms. Calibrating to RSV weekly incidence rates in Texas, California, Colorado, and Pennsylvania, we show that in all states considered, an infected child under 5 y of age is more than twice as likely as a person over 50 y of age to transmit the virus. Geographic variability in the effectiveness of a vaccination program across states arises from interplay between seasonality patterns, population demography, vaccination uptake, and vaccine mechanism of action. Regardless of these variabilities, our analysis showed that allocating vaccine to children under 5 y of age would be the most efficient strategy per dose to avert RSV in both children and adults. Furthermore, due to substantial indirect protection, the targeting of children is even predicted to reduce RSV in the elderly more than directly vaccinating the elderly themselves. Our results can help inform ongoing clinical trials and future recommendations on RSV vaccination.

KEYWORDS:

RSV; model; social contact; vaccination; viral load

PMID:
27799521
PMCID:
PMC5135296
[Available on 2017-05-15]
DOI:
10.1073/pnas.1522597113

Conflict of interest statement

A.P.G. and D.Y. report consulting for Sanofi Pasteur regarding modeling of infectious diseases unrelated to RSV and for Merck regarding RSV and other infectious diseases.

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