期刊
EPIDEMIOLOGY AND INFECTION
卷 139, 期 2, 页码 265-274出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0950268810001329
关键词
Mathematical modelling; measles (rubeola); vaccine policy development
资金
- Bill and Melinda Gates Foundation
- Science and Technology Directorate, Department of Homeland Security
- Fogarty International Center, National Institutes of Health
Measles vaccine efficacy is higher at 12 months than 9 months because of maternal immunity, but delaying vaccination exposes the children most vulnerable to measles mortality to infection. We explored how this trade-off changes as a function of regionally varying epidemiological drivers, e. g. demography, transmission seasonality, and vaccination coverage. High birth rates and low coverage both favour early vaccination, and initiating vaccination at 9-11 months, then switching to 12-14 months can reduce case numbers. Overall however, increasing the age-window of vaccination decreases case numbers relative to vaccinating within a narrow age-window (e. g. 9-11 months). The width of the age-window that minimizes mortality varies as a function of birth rate, vaccination coverage and patterns of access to care. Our results suggest that locally age-targeted strategies, at both national and sub-national scales, tuned to local variation in birth rate, seasonality, and access to care may substantially decrease case numbers and fatalities for routine vaccination.
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