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Targeting vaccinations for the licensed dengue vaccine: considerations for serosurvey design

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Title: Targeting vaccinations for the licensed dengue vaccine: considerations for serosurvey design
Authors: Imai, N
Ferguson, NM
Item Type: Journal Article
Abstract: Background The CYD-TDV vaccine was unusual in that the recommended target population for vaccination was originally defined not only by age, but also by transmission setting as defined by seroprevalence. WHO originally recommended countries consider vaccination against dengue with CYD-TDV vaccine in geographic settings only where prior infection with any dengue serotype, as measured by seroprevalence, was >170% in the target age group. Vaccine was not recommended in settings where seroprevalence was <50%. Test-and-vaccinate strategies suggested following new analysis by Sanofi will still require age-stratified seroprevalence surveys to optimise age-group targeting. Here we address considerations for serosurvey design in the context of vaccination program planning. Methods To explore how the design of seroprevalence surveys affects estimates of transmission intensity, 100 age-specific seroprevalence surveys were simulated using a beta-binomial distribution and a simple catalytic model for different combinations of age-range, survey size, transmission setting, and test sensitivity/specificity. We then used a Metropolis-Hastings Markov Chain Monte-Carlo algorithm to estimate the force of infection from each simulated dataset. Results Sampling from a wide age-range led to more accurate estimates than merely increasing sample size in a narrow age-range. This finding was consistent across all transmission settings. The optimum test sensitivity and specificity given an imperfect test differed by setting with high sensitivity being important in high transmission settings and high specificity important in low transmission settings. Conclusions When assessing vaccination suitability by seroprevalence surveys, countries should ensure an appropriate age-range is sampled, considering epidemiological evidence about the local burden of disease.
Issue Date: 26-Jun-2018
Date of Acceptance: 7-Jun-2018
URI: http://hdl.handle.net/10044/1/61254
DOI: https://doi.org/10.1371/journal.pone.0199450
ISSN: 1932-6203
Publisher: Public Library of Science (PLoS)
Start Page: 1
End Page: 15
Journal / Book Title: PLoS ONE
Volume: 13
Issue: 6
Copyright Statement: © 2018 Imai, Ferguson. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: Medical Research Council (MRC)
Medical Research Council
Funder's Grant Number: MR/R015600/1
MR/R015600/1
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
INAPPROPRIATE SUBGROUP ANALYSES
IMMUNOLOGICAL BEHAVIOR
VIRUS-INFECTION
CAUSE HARM
CHILDREN
RATES
CONTROVERSY
HALSTEAD
EFFICACY
DISEASE
Adolescent
Adult
Child
Child, Preschool
Computer Simulation
Dengue
Dengue Vaccines
Humans
Infant
Infant, Newborn
Licensure
Models, Biological
Probability
Sensitivity and Specificity
Seroepidemiologic Studies
Surveys and Questionnaires
Vaccination
Young Adult
Humans
Dengue
Vaccination
Probability
Sensitivity and Specificity
Seroepidemiologic Studies
Models, Biological
Computer Simulation
Adolescent
Adult
Child
Child, Preschool
Infant
Infant, Newborn
Licensure
Dengue Vaccines
Young Adult
Surveys and Questionnaires
General Science & Technology
MD Multidisciplinary
Publication Status: Published online
Online Publication Date: 2018-06-26
Appears in Collections:School of Public Health