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A Change in Vaccine Efficacy and Duration of Protection Explains Recent Rises in Pertussis Incidence in the United States

Title: A Change in Vaccine Efficacy and Duration of Protection Explains Recent Rises in Pertussis Incidence in the United States
Author(s): Gambhir, M
Clark, TA
Cauchemez, S
Tartof, SY
Swerdlow, DL
Ferguson, NM
Item Type: Journal Article
Abstract: Over the past ten years the incidence of pertussis in the United States (U.S.) has risen steadily, with 2012 seeing the highest case number since 1955. There has also been a shift over the same time period in the age group reporting the largest number of cases (aside from infants), from adolescents to 7–11 year olds. We use epidemiological modelling and a large case incidence dataset to explain the upsurge. We investigate several hypotheses for the upsurge in pertussis cases by fitting a suite of dynamic epidemiological models to incidence data from the National Notifiable Disease Surveillance System (NNDSS) between 1990–2009, as well as incidence data from a variety of sources from 1950–1989. We find that: the best-fitting model is one in which vaccine efficacy and duration of protection of the acellular pertussis (aP) vaccine is lower than that of the whole-cell (wP) vaccine, (efficacy of the first three doses 80% [95% CI: 78%, 82%] versus 90% [95% CI: 87%, 94%]), increasing the rate at which disease is reported to NNDSS is not sufficient to explain the upsurge and 3) 2010–2012 disease incidence is predicted well. In this study, we use all available U.S. surveillance data to: 1) fit a set of mathematical models and determine which best explains these data and 2) determine the epidemiological and vaccine-related parameter values of this model. We find evidence of a difference in efficacy and duration of protection between the two vaccine types, wP and aP (aP efficacy and duration lower than wP). Future refinement of the model presented here will allow for an exploration of alternative vaccination strategies such as different age-spacings, further booster doses, and cocooning.
Publication Date: 23-Apr-2015
Date of Acceptance: 16-Jan-2015
URI: http://hdl.handle.net/10044/1/40615
DOI: http://dx.doi.org/10.1371/journal.pcbi.1004138
ISSN: 1553-734X
Publisher: Public Library of Science
Journal / Book Title: PLOS Computational Biology
Volume: 11
Issue: 4
Sponsor/Funder: Medical Research Council (MRC)
Funder's Grant Number: MR/K010174/1B
Copyright Statement: The work is made available under the Creative Commons CC0 public domain dedication
Keywords: Science & Technology
Life Sciences & Biomedicine
Biochemical Research Methods
Mathematical & Computational Biology
Biochemistry & Molecular Biology
AGED 19-35 MONTHS
BORDETELLA-PERTUSSIS
COVERAGE
EPIDEMIOLOGY
RESURGENCE
CHILDREN
ADOLESCENTS
DIAGNOSIS
COMPLETENESS
PREVENTION
Adolescent
Adult
Age Distribution
Child
Child, Preschool
Computer Simulation
Diphtheria-Tetanus-Pertussis Vaccine
Female
Humans
Immunization Schedule
Incidence
Infant
Infant, Newborn
Male
Models, Statistical
Population Surveillance
Risk Assessment
Treatment Outcome
United States
Vaccination
Vaccine Potency
Whooping Cough
Young Adult
Humans
Whooping Cough
Diphtheria-Tetanus-Pertussis Vaccine
Treatment Outcome
Immunization Schedule
Vaccination
Population Surveillance
Incidence
Models, Statistical
Risk Assessment
Age Distribution
Computer Simulation
Adolescent
Adult
Child
Child, Preschool
Infant
Infant, Newborn
United States
Female
Male
Young Adult
Vaccine Potency
Bioinformatics
06 Biological Sciences
08 Information And Computing Sciences
01 Mathematical Sciences
Publication Status: Published
Article Number: e1004138
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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