TY - JOUR
T1 - Benefits and risks of the sanofi-pasteur dengue vaccine
T2 - Modeling optimal deployment
AU - Ferguson, Neil M.
AU - Rodríguez-Barraquer, Isabel
AU - Dorigatti, Ilaria
AU - Mier-Y-Teran-Romero, Luis
AU - Laydon, Daniel J.
AU - Cummings, Derek A.T.
N1 - Funding Information:
The authors acknowledge research funding from the UK Medical Research Council, the UK National Institute of Health Research under the Health Protection Research Unit initiative, National Institute of Allergy and Infectious Diseases and National Institute of General Medical Sciences (NIH) under the MIDAS initiative, and the Bill and Melinda Gates Foundation. Views expressed do not necessarily represent those of the funders. N.M.F., I.R.-B., and D.A.T.C. have advised Sanofi Pasteur Ltd., without payment, on the implications that this work has on the use of their vaccine. We thank N. Grassly for comments on the manuscript and N. Jackson and L. Coudeville at Sanofi Pasteur for useful discussions. All clinical trial data used for these models are publicly available in the original publications (cited), and model code is available from the authors.
PY - 2016/9/2
Y1 - 2016/9/2
N2 - The first approved dengue vaccine has now been licensed in six countries. We propose that this live attenuated vaccine acts like a silent natural infection in priming or boosting host immunity. A transmission dynamic model incorporating this hypothesis fits recent clinical trial data well and predicts that vaccine effectiveness depends strongly on the age group vaccinated and local transmission intensity. Vaccination in low-transmission settings may increase the incidence of more severe "secondary-like" infection and, thus, the numbers hospitalized for dengue. In moderate transmission settings, we predict positive impacts overall but increased risks of hospitalization with dengue disease for individuals who are vaccinated when seronegative. However, in high-transmission settings, vaccination benefits both the whole population and seronegative recipients. Our analysis can help inform policy-makers evaluating this and other candidate dengue vaccines.
AB - The first approved dengue vaccine has now been licensed in six countries. We propose that this live attenuated vaccine acts like a silent natural infection in priming or boosting host immunity. A transmission dynamic model incorporating this hypothesis fits recent clinical trial data well and predicts that vaccine effectiveness depends strongly on the age group vaccinated and local transmission intensity. Vaccination in low-transmission settings may increase the incidence of more severe "secondary-like" infection and, thus, the numbers hospitalized for dengue. In moderate transmission settings, we predict positive impacts overall but increased risks of hospitalization with dengue disease for individuals who are vaccinated when seronegative. However, in high-transmission settings, vaccination benefits both the whole population and seronegative recipients. Our analysis can help inform policy-makers evaluating this and other candidate dengue vaccines.
UR - http://www.scopus.com/inward/record.url?scp=84984863679&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84984863679&partnerID=8YFLogxK
U2 - 10.1126/science.aaf9590
DO - 10.1126/science.aaf9590
M3 - Article
C2 - 27701113
AN - SCOPUS:84984863679
SN - 0036-8075
VL - 353
SP - 1033
EP - 1036
JO - Science
JF - Science
IS - 6303
ER -