模拟澳大利亚产妇呼吸道合胞病毒 (RSV) 疫苗接种的流行病学影响

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-10-17 DOI:10.1016/j.vaccine.2024.126418

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引用次数: 0

摘要

背景呼吸道合胞病毒（RSV）是婴儿呼吸道疾病的主要病因。澳大利亚最近批准注册了一种可保护幼儿的母体 RSV 疫苗。我们估算了澳大利亚未来全年母体 RSV 疫苗接种计划在预防 RSV 感染和住院方面的人口效益。方法我们使用一个年龄结构分区模型来描述 RSV 传播，该模型根据澳大利亚每月汇总的 5 岁儿童 RSV 编码住院病例进行校准。我们在模型中考虑了母亲和婴儿的相互作用，以更真实地反映群体效应。利用该模型，我们估算了在疫苗效力、覆盖率和持久性等一系列假设条件下每年预防的特定年龄 RSV 感染和住院人数，从而估算出全年为母亲接种 RSV 疫苗对婴儿和更广泛人群的未来影响。结果假设基本情况下的疫苗效力、6 个月的保护期和 70% 的覆盖率，预计 3 个月大婴儿的 RSV 住院率将下降 60%（从每 100 人 3.0 例降至 1.2 例），3-5 个月大婴儿的 RSV 住院率将下降 40%（从每 100 人 1.9 例降至 1.1 例）。这些益处主要归功于接种疫苗的母亲对婴儿的直接保护。据预测，该疫苗计划可将人群 RSV 感染率降低约 4%。覆盖率和持续时间假设具有影响力，覆盖率越高，6 个月婴儿的感染率下降幅度越大，保护持续时间越长，6-8 个月大婴儿的感染和住院风险下降幅度越大。结论如果疫苗接种率与澳大利亚其他母体疫苗的接种率相似，全年 RSV 母体疫苗接种计划预计可将 6 个月以下婴儿的 RSV 住院人数减少约一半。基础案例预测的群体效应较小，但如果疫苗覆盖率或保护持续时间超过基础案例假设，则有可能产生更大的效益。

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Modelling the epidemiological impact of maternal respiratory syncytial virus (RSV) vaccination in Australia

Background

Respiratory syncytial virus (RSV) is a leading cause of respiratory illness among infants. A maternal RSV vaccine that protects young infants has recently been approved for registration in Australia. We estimated the population benefits of a future year-round maternal RSV vaccination program in terms of prevented RSV infections and hospitalisations in Australia.

Methods

We described RSV transmission using an age-structured compartmental model calibrated to Australian aggregated monthly RSV-coded hospitalisations in children aged <5 years. We accounted for mother and infant interactions in the model to capture herd effects more realistically. Using the model, we estimated the annual age-specific RSV infections and hospitalisations prevented for a range of assumptions for vaccine efficacy, coverage, and durability to estimate the future impact of year-round maternal RSV vaccination on infants and the wider population.

Results

Assuming base case vaccine efficacy, 6 months duration of protection and 70% coverage, RSV hospitalisations were predicted to fall by 60% (from 3.0 to 1.2 per 100 persons) in infants aged <3 months and 40% (from 1.9 to 1.1 per 100 persons) in 3–5-month-olds. These benefits were primarily due to direct protection to infants of vaccinated mothers. This vaccine program was predicted to reduce the population-level RSV infection by about 4%. Coverage and duration assumptions were influential, with higher coverage leading to larger declines in infants <6 months, and increased duration of protection leading to additional declines in infection and hospitalisation risk in older infants aged 6–8 months.

Conclusions

With vaccine uptake similar to that achieved for other maternal vaccines in Australia, a year-round RSV maternal vaccination program is predicted to approximately halve the number of RSV hospitalisations in infants younger than 6 months. There was a small herd effect predicted in the base case but potential for larger benefits if vaccine coverage or the duration of protection exceeds base case assumptions.

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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