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Benefits and risks of the Sanofi-Pasteur dengue vaccine: Modeling optimal deployment.

ABSTRACT: The first approved dengue vaccine has now been licensed in six countries. We propose that this live attenuated vaccine acts like a silent natural infection in priming or boosting host immunity. A transmission dynamic model incorporating this hypothesis fits recent clinical trial data well and predicts that vaccine effectiveness depends strongly on the age group vaccinated and local transmission intensity. Vaccination in low-transmission settings may increase the incidence of more severe "secondary-like" infection and, thus, the numbers hospitalized for dengue. In moderate transmission settings, we predict positive impacts overall but increased risks of hospitalization with dengue disease for individuals who are vaccinated when seronegative. However, in high-transmission settings, vaccination benefits both the whole population and seronegative recipients. Our analysis can help inform policy-makers evaluating this and other candidate dengue vaccines.

SUBMITTER: Ferguson NM

PROVIDER: S-EPMC5268127 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Benefits and risks of the Sanofi-Pasteur dengue vaccine: Modeling optimal deployment.

Ferguson Neil M NM Rodríguez-Barraquer Isabel I Dorigatti Ilaria I Mier-Y-Teran-Romero Luis L Laydon Daniel J DJ Cummings Derek A T DA

Science (New York, N.Y.) 20160901 6303

The first approved dengue vaccine has now been licensed in six countries. We propose that this live attenuated vaccine acts like a silent natural infection in priming or boosting host immunity. A transmission dynamic model incorporating this hypothesis fits recent clinical trial data well and predicts that vaccine effectiveness depends strongly on the age group vaccinated and local transmission intensity. Vaccination in low-transmission settings may increase the incidence of more severe "seconda ...[more]

PMID: 27701113

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Project description:BackgroundDengue infection is endemic in many regions throughout the world. While insecticide fogging targeting the vector mosquito Aedes aegypti is a major control measure against dengue epidemics, the impact of this method remains controversial. A previous mathematical simulation study indicated that insecticide fogging minimized cases when conducted soon after peak disease prevalence, although the impact was minimal, possibly because seasonality and population immunity were not considered. Periodic outbreak patterns are also highly influenced by seasonal climatic conditions. Thus, these factors are important considerations when assessing the effect of vector control against dengue. We used mathematical simulations to identify the appropriate timing of insecticide fogging, considering seasonal change of vector populations, and to evaluate its impact on reducing dengue cases with various levels of transmission intensity.Methodology/principal findingsWe created the Susceptible-Exposed-Infectious-Recovered (SEIR) model of dengue virus transmission. Mosquito lifespan was assumed to change seasonally and the optimal timing of insecticide fogging to minimize dengue incidence under various lengths of the wet season was investigated. We also assessed whether insecticide fogging was equally effective at higher and lower endemic levels by running simulations over a 500-year period with various transmission intensities to produce an endemic state. In contrast to the previous study, the optimal application of insecticide fogging was between the onset of the wet season and the prevalence peak. Although it has less impact in areas that have higher endemicity and longer wet seasons, insecticide fogging can prevent a considerable number of dengue cases if applied at the optimal time.Conclusions/significanceThe optimal timing of insecticide fogging and its impact on reducing dengue cases were greatly influenced by seasonality and the level of transmission intensity. We suggest that these factors should be considered when planning a control strategy against dengue vectors.

Dataset Information

Benefits and risks of the Sanofi-Pasteur dengue vaccine: Modeling optimal deployment.

Publications

Benefits and risks of the Sanofi-Pasteur dengue vaccine: Modeling optimal deployment.

Similar Datasets

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