Eunha Shim1, Kenneth J Smith2, Mary Patricia Nowalk3, Jonathan M Raviotta3, Shawn T Brown4, Jay DePasse4, Richard K Zimmerman3. 1. Department of Mathematics, Soongsil University, Sangdo-ro 369, Dongjak-gu, Seoul 156-743 Republic of Korea. Electronic address: alicia@ssu.ac.kr. 2. University of Pittsburgh School of Medicine, 200 Meyran Ave, Suite 200, Pittsburgh, PA 15213, USA. 3. Department of Family Medicine, University of Pittsburgh School of Medicine, Suite 520 Schenley Place, 4420 Bayard Street, Pittsburgh, PA 15260, USA. 4. Pittsburgh Supercomputing Center, Carnegie Mellon University, 300 S. Craig Street, Pittsburgh, PA 15213, USA.
Abstract
BACKGROUND: Annual influenza vaccination is a key to preventing widespread influenza infections. Recent reports of influenza vaccine effectiveness (VE) indicate that vaccination in prior years may reduce VE in the current season, suggesting vaccine interference. The purpose of this study is to evaluate the potential effect of repeat influenza vaccinations in the presence of vaccine interference. METHODS: Using literature-based parameters, an age-structured influenza equation-based transmission model was used to determine the optimal vaccination strategy, while considering the effect of varying levels of interference. RESULTS: The model shows that, even in the presence of vaccine interference, revaccination reduces the influenza attack rate and provides individual benefits. Specifically, annual vaccination is a favored strategy over vaccination in alternate years, as long as the level of residual protection is less than 58% or vaccine interference effect is minimal. Furthermore, the negative impact of vaccine interference may be offset by increased vaccine coverage levels. CONCLUSIONS: Even in the presence of potential vaccine interference, our work provides a population-level perspective on the potential merits of repeated influenza vaccination. This is because repeat vaccination groups had lower attack rates than groups that omitted the second vaccination unless vaccine interference was at very high, perhaps implausible, levels.
BACKGROUND: Annual influenza vaccination is a key to preventing widespread influenza infections. Recent reports of influenza vaccine effectiveness (VE) indicate that vaccination in prior years may reduce VE in the current season, suggesting vaccine interference. The purpose of this study is to evaluate the potential effect of repeat influenza vaccinations in the presence of vaccine interference. METHODS: Using literature-based parameters, an age-structured influenza equation-based transmission model was used to determine the optimal vaccination strategy, while considering the effect of varying levels of interference. RESULTS: The model shows that, even in the presence of vaccine interference, revaccination reduces the influenza attack rate and provides individual benefits. Specifically, annual vaccination is a favored strategy over vaccination in alternate years, as long as the level of residual protection is less than 58% or vaccine interference effect is minimal. Furthermore, the negative impact of vaccine interference may be offset by increased vaccine coverage levels. CONCLUSIONS: Even in the presence of potential vaccine interference, our work provides a population-level perspective on the potential merits of repeated influenza vaccination. This is because repeat vaccination groups had lower attack rates than groups that omitted the second vaccination unless vaccine interference was at very high, perhaps implausible, levels.
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