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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/42020
Title: Predicting the relative impacts of maternal and neonatal respiratory syncytial virus (RSV) vaccine target product profiles: A consensus modelling approach
Authors: Wirichada Pan-Ngum
Timothy Kinyanjui
Moses Kiti
Sylvia Taylor
Jean François Toussaint
Sompob Saralamba
Thierry Van Effelterre
D. James Nokes
Lisa J. White
Mahidol University
University of Manchester
Wellcome Trust Research Laboratories Nairobi
GSK Vaccines
The University of Warwick
Nuffield Department of Clinical Medicine
Janssen Research and Development
Keywords: Biochemistry, Genetics and Molecular Biology
Issue Date: 5-Jan-2017
Citation: Vaccine. Vol.35, No.2 (2017), 403-409
Abstract: © 2016 The Authors Background Respiratory syncytial virus (RSV) is the major viral cause of infant and childhood lower respiratory tract disease worldwide. Defining the optimal target product profile (TPP) is complicated due to a wide range of possible vaccine properties, modalities and an incomplete understanding of the mechanism of natural immunity. We report consensus population level impact projections based on two mathematical models applied to a low income setting. Method Two structurally distinct age-specific deterministic compartmental models reflecting uncertainty associated with the natural history of infection and the mechanism by which immunity is acquired and lost were constructed. A wide range of vaccine TPPs were explored including dosing regime and uptake, and effects in the vaccinated individual on infectiousness, susceptibility, duration of protection, disease severity and interaction with maternal antibodies and natural induced immunity. These were combined with a range of vaccine implementation strategies, targeting the highest priority age group and calibrated using hospitalization data from Kilifi County Hospital, Kenya. Findings Both models were able to reproduce the data. The impact predicted by the two models was qualitatively similar across the range of TPPs, although one model consistently predicted higher impact than the other. For a proposed realistic range of scenarios of TPP combinations, the models predicted up to 70% reduction in hospitalizations in children under five years old. Vaccine designs which reduced the duration and infectiousness of infection were predicted to have higher impacts. The models were sensitive to the coverage and rate of loss of vaccine protection but not to the interaction between vaccine and maternal/naturally acquired immunity. Conclusion The results suggest that vaccine properties leading to reduced virus circulation by lessening the duration and infectiousness of infection upon challenge are of major importance in population RSV disease control. These features should be a focus for vaccine development.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85006997930&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/42020
ISSN: 18732518
0264410X
Appears in Collections:Scopus 2016-2017

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