David P Durham1, Meagan C Fitzpatrick2, Martial L Ndeffo-Mbah1, Alyssa S Parpia1, Nelson L Michael3, Alison P Galvani1. 1. Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut (D.P.D., M.L.N., A.S.P., A.P.G.). 2. Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, Connecticut, and Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland (M.C.F.). 3. U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Bethesda, Maryland (N.L.M.).
Abstract
Background: Mosquito-borne and sexually transmitted Zika virus has become widespread across Central and South America and the Caribbean. Many Zika vaccine candidates are under active development. Objective: To quantify the effect of Zika vaccine prioritization of females aged 9 to 49 years, followed by males aged 9 to 49 years, on incidence of prenatal Zika infections. Design: A compartmental model of Zika transmission between mosquitoes and humans was developed and calibrated to empirical estimates of country-specific mosquito density. Mosquitoes were stratified into susceptible, exposed, and infected groups; humans were stratified into susceptible, exposed, infected, recovered, and vaccinated groups. Age-specific fertility rates, Zika sexual transmission, and country-specific demographics were incorporated. Setting: 34 countries and territories in the Americas with documented Zika outbreaks. Target Population: Males and females aged 9 to 49 years. Intervention: Age- and sex-targeted immunization using a Zika vaccine with 75% efficacy. Measurements: Annual prenatal Zika infections. Results: For a base-case vaccine efficacy of 75% and vaccination coverage of 90%, immunizing females aged 9 to 49 years (the World Health Organization target population) would reduce the incidence of prenatal infections by at least 94%, depending on the country-specific Zika attack rate. In regions where an outbreak is not expected for at least 10 years, vaccination of women aged 15 to 29 years is more efficient than that of women aged 30 years or older. Limitation: Population-level modeling may not capture all local and neighborhood-level heterogeneity in mosquito abundance or Zika incidence. Conclusion: A Zika vaccine of moderate to high efficacy may virtually eliminate prenatal infections through a combination of direct protection and transmission reduction. Efficiency of age-specific targeting of Zika vaccination depends on the timing of future outbreaks. Primary Funding Source: National Institutes of Health.
Background: Mosquito-borne and sexually transmitted Zika virus has become widespread across Central and South America and the Caribbean. Many Zika vaccine candidates are under active development. Objective: To quantify the effect of Zika vaccine prioritization of females aged 9 to 49 years, followed by males aged 9 to 49 years, on incidence of prenatal Zika infections. Design: A compartmental model of Zika transmission between mosquitoes and humans was developed and calibrated to empirical estimates of country-specific mosquito density. Mosquitoes were stratified into susceptible, exposed, and infected groups; humans were stratified into susceptible, exposed, infected, recovered, and vaccinated groups. Age-specific fertility rates, Zika sexual transmission, and country-specific demographics were incorporated. Setting: 34 countries and territories in the Americas with documented Zika outbreaks. Target Population: Males and females aged 9 to 49 years. Intervention: Age- and sex-targeted immunization using a Zika vaccine with 75% efficacy. Measurements: Annual prenatal Zika infections. Results: For a base-case vaccine efficacy of 75% and vaccination coverage of 90%, immunizing females aged 9 to 49 years (the World Health Organization target population) would reduce the incidence of prenatal infections by at least 94%, depending on the country-specific Zika attack rate. In regions where an outbreak is not expected for at least 10 years, vaccination of women aged 15 to 29 years is more efficient than that of women aged 30 years or older. Limitation: Population-level modeling may not capture all local and neighborhood-level heterogeneity in mosquito abundance or Zika incidence. Conclusion: A Zika vaccine of moderate to high efficacy may virtually eliminate prenatal infections through a combination of direct protection and transmission reduction. Efficiency of age-specific targeting of Zika vaccination depends on the timing of future outbreaks. Primary Funding Source: National Institutes of Health.
Authors: Neil M Ferguson; Zulma M Cucunubá; Ilaria Dorigatti; Gemma L Nedjati-Gilani; Christl A Donnelly; Maria-Gloria Basáñez; Pierre Nouvellet; Justin Lessler Journal: Science Date: 2016-07-14 Impact factor: 47.728
Authors: Kate Russell; Susan L Hills; Alexandra M Oster; Charsey Cole Porse; Gregory Danyluk; Marshall Cone; Richard Brooks; Sarah Scotland; Elizabeth Schiffman; Carolyn Fredette; Jennifer L White; Katherine Ellingson; Allison Hubbard; Amanda Cohn; Marc Fischer; Paul Mead; Ann M Powers; John T Brooks Journal: Clin Infect Dis Date: 2016-10-19 Impact factor: 9.079
Authors: K S Vannice; B K Giersing; D C Kaslow; E Griffiths; H Meyer; A Barrett; A P Durbin; D Wood; J Hombach Journal: Vaccine Date: 2016-12-20 Impact factor: 3.641
Authors: Margaret A Honein; April L Dawson; Emily E Petersen; Abbey M Jones; Ellen H Lee; Mahsa M Yazdy; Nina Ahmad; Jennifer Macdonald; Nicole Evert; Andrea Bingham; Sascha R Ellington; Carrie K Shapiro-Mendoza; Titilope Oduyebo; Anne D Fine; Catherine M Brown; Jamie N Sommer; Jyoti Gupta; Philip Cavicchia; Sally Slavinski; Jennifer L White; S Michele Owen; Lyle R Petersen; Coleen Boyle; Dana Meaney-Delman; Denise J Jamieson Journal: JAMA Date: 2017-01-03 Impact factor: 56.272
Authors: David P Durham; Martial L Ndeffo-Mbah; Laura A Skrip; Forrest K Jones; Chris T Bauch; Alison P Galvani Journal: Proc Natl Acad Sci U S A Date: 2016-04-18 Impact factor: 11.205
Authors: Sarah M Bartsch; Lindsey Asti; Sarah N Cox; David P Durham; Samuel Randall; Peter J Hotez; Alison P Galvani; Bruce Y Lee Journal: J Infect Dis Date: 2019-08-09 Impact factor: 5.226