Direct, Indirect, Total and Population Vaccination Effectiveness in Pandemic influenza Vaccination Pubblico
Xu, Songli (2012)
Published
Abstract
Most vaccination effectiveness studies focus on the direct
vaccination effectiveness
(VEd), defined as one minus the ratio of attack rates in vaccinated
and unvaccinated
persons, and pay little attention to the indirect (VEi) and
population (VEpop)
effectiveness, which can be interpreted as proportion of cases
prevented by
vaccination. Here, we use a stochastic simulation model to estimate
direct, indirect,
total and population vaccination effectiveness using data from the
1957/1958
influenza pandemic To estimate VEpop, which is unknown, from VEd
and the
vaccination fraction, which are known, linear regression modeling
and estimation
under the Susceptible-Infected-Removed (SIR) model were performed.
From
simulation results, we found the VEpop is usually higher, and in
many cases much
higher, than the VEd. In prediction studies, results from linear
regression models
showed that the estimates of population effectiveness were close to
the simulated
results when vaccination fractions were fixed, and that the
estimation of population
effectiveness can best approximate the simulated values when
vaccine efficacy (VEs)
is fixed and equals to 0.4. Our results also show that estimation
of VEpop based on
the SIR model provides a good approximation t0 the true population
effectiveness
even though, in the real world, the basic SIR model assumptions
that the population
is homogeneous and mixing is random are violated. We conclude that,
due to the
indirect vaccination effects, the VEpop is usually higher than the
VEd. In addition,
linear regression and SIR models can be applied to estimate
VEpop.
Direct, Indirect, Total and Population Vaccination Effectiveness in
Pandemic influenza Vaccination
B.S. Henan Normal University, China, 1991
M.S. Zhengzhou University School of Medicine, China, 1998
Ph.D. Fudan University School of Medicine, China, 2001
Thesis Committee Chair: Michael J Haber, Ph.D.
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
Master of Public Health
2012
Table of Contents
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