Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.

Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protecti...

Full description

Bibliographic Details
Main Authors: Virginia E Pitzer, Katherine E Atkins, Birgitte Freiesleben de Blasio, Thierry Van Effelterre, Christina J Atchison, John P Harris, Eunha Shim, Alison P Galvani, W John Edmunds, Cécile Viboud, Manish M Patel, Bryan T Grenfell, Umesh D Parashar, Ben A Lopman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3418263?pdf=render
_version_ 1818976080801824768
author Virginia E Pitzer
Katherine E Atkins
Birgitte Freiesleben de Blasio
Thierry Van Effelterre
Christina J Atchison
John P Harris
Eunha Shim
Alison P Galvani
W John Edmunds
Cécile Viboud
Manish M Patel
Bryan T Grenfell
Umesh D Parashar
Ben A Lopman
author_facet Virginia E Pitzer
Katherine E Atkins
Birgitte Freiesleben de Blasio
Thierry Van Effelterre
Christina J Atchison
John P Harris
Eunha Shim
Alison P Galvani
W John Edmunds
Cécile Viboud
Manish M Patel
Bryan T Grenfell
Umesh D Parashar
Ben A Lopman
author_sort Virginia E Pitzer
collection DOAJ
description Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but results have varied. To better understand the magnitude and sources of variability in model projections, we undertook a comparative analysis of transmission dynamic models for rotavirus. We fit five models to reported rotavirus gastroenteritis (RVGE) data from England and Wales, and evaluated outcomes for short- and long-term vaccination effects. All of our models reproduced the important features of rotavirus epidemics in England and Wales. Models predicted that during the initial year after vaccine introduction, incidence of severe RVGE would be reduced 1.8-2.9 times more than expected from the direct effects of the vaccine alone (28-50% at 90% coverage), but over a 5-year period following vaccine introduction severe RVGE would be reduced only by 1.1-1.7 times more than expected from the direct effects (54-90% at 90% coverage). Projections for the long-term reduction of severe RVGE ranged from a 55% reduction at full coverage to elimination with at least 80% coverage. Our models predicted short-term reductions in the incidence of RVGE that exceeded estimates of the direct effects, consistent with observations from the United States and other countries. Some of the models predicted that the short-term indirect benefits may be offset by a partial shifting of the burden of RVGE to older unvaccinated individuals. Nonetheless, even when such a shift occurs, the overall reduction in severe RVGE is considerable. Discrepancies among model predictions reflect uncertainties about age variation in the risk and reporting of RVGE, and the duration of natural and vaccine-induced immunity, highlighting important questions for future research.
first_indexed 2024-12-20T16:06:10Z
format Article
id doaj.art-7d3829eea2f846ef838b81b141ab44c2
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-20T16:06:10Z
publishDate 2012-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-7d3829eea2f846ef838b81b141ab44c22022-12-21T19:34:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0178e4232010.1371/journal.pone.0042320Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.Virginia E PitzerKatherine E AtkinsBirgitte Freiesleben de BlasioThierry Van EffelterreChristina J AtchisonJohn P HarrisEunha ShimAlison P GalvaniW John EdmundsCécile ViboudManish M PatelBryan T GrenfellUmesh D ParasharBen A LopmanEarly observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but results have varied. To better understand the magnitude and sources of variability in model projections, we undertook a comparative analysis of transmission dynamic models for rotavirus. We fit five models to reported rotavirus gastroenteritis (RVGE) data from England and Wales, and evaluated outcomes for short- and long-term vaccination effects. All of our models reproduced the important features of rotavirus epidemics in England and Wales. Models predicted that during the initial year after vaccine introduction, incidence of severe RVGE would be reduced 1.8-2.9 times more than expected from the direct effects of the vaccine alone (28-50% at 90% coverage), but over a 5-year period following vaccine introduction severe RVGE would be reduced only by 1.1-1.7 times more than expected from the direct effects (54-90% at 90% coverage). Projections for the long-term reduction of severe RVGE ranged from a 55% reduction at full coverage to elimination with at least 80% coverage. Our models predicted short-term reductions in the incidence of RVGE that exceeded estimates of the direct effects, consistent with observations from the United States and other countries. Some of the models predicted that the short-term indirect benefits may be offset by a partial shifting of the burden of RVGE to older unvaccinated individuals. Nonetheless, even when such a shift occurs, the overall reduction in severe RVGE is considerable. Discrepancies among model predictions reflect uncertainties about age variation in the risk and reporting of RVGE, and the duration of natural and vaccine-induced immunity, highlighting important questions for future research.http://europepmc.org/articles/PMC3418263?pdf=render
spellingShingle Virginia E Pitzer
Katherine E Atkins
Birgitte Freiesleben de Blasio
Thierry Van Effelterre
Christina J Atchison
John P Harris
Eunha Shim
Alison P Galvani
W John Edmunds
Cécile Viboud
Manish M Patel
Bryan T Grenfell
Umesh D Parashar
Ben A Lopman
Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.
PLoS ONE
title Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.
title_full Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.
title_fullStr Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.
title_full_unstemmed Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.
title_short Direct and indirect effects of rotavirus vaccination: comparing predictions from transmission dynamic models.
title_sort direct and indirect effects of rotavirus vaccination comparing predictions from transmission dynamic models
url http://europepmc.org/articles/PMC3418263?pdf=render
work_keys_str_mv AT virginiaepitzer directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT katherineeatkins directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT birgittefreieslebendeblasio directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT thierryvaneffelterre directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT christinajatchison directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT johnpharris directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT eunhashim directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT alisonpgalvani directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT wjohnedmunds directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT cecileviboud directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT manishmpatel directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT bryantgrenfell directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT umeshdparashar directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels
AT benalopman directandindirecteffectsofrotavirusvaccinationcomparingpredictionsfromtransmissiondynamicmodels