Optimal vaccine trial design when estimating vaccine efficacy for susceptibility and infectiousness from multiple populations
Vaccination can have important indirect effects on the spread of an infectious agent by reducing the level of infectiousness of vaccinees who become infected. To estimate the effect of vaccination on infectiousness, one typically requires data on the contacts between susceptible and infected vaccina...
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Published in | Statistics in medicine Vol. 17; no. 10; pp. 1121 - 1136 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Chichester
Wiley Subscription Services, Inc., A Wiley Company
30.05.1998
Wiley |
Subjects | |
Online Access | Get full text |
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Summary: | Vaccination can have important indirect effects on the spread of an infectious agent by reducing the level of infectiousness of vaccinees who become infected. To estimate the effect of vaccination on infectiousness, one typically requires data on the contacts between susceptible and infected vaccinated and unvaccinated people. As an alternative, we propose a trial design that involves multiple independent and interchangeable populations. By varying the fraction of susceptible people vaccinated across populations, we obtain an estimate of the reduction in infectiousness that depends only on incidence data from the vaccine and control groups of the multiple populations. One can also obtain from these data an estimate of the reduction of susceptibility to infection. We propose a vaccination strategy that is a trade‐off between optimal estimation of vaccine efficacy for susceptibility and of vaccine efficacy for infectiousness. We show that the optimal choice depends on the anticipated efficacy of the vaccine as well as the basic reproduction number of the underlying infectious disease process. Smaller vaccination fractions appear desirable when vaccine efficacy is likely high and the basic reproduction number is not large. This strategy avoids the potential for too few infections to occur to estimate vaccine efficacy parameters reliably. © 1998 John Wiley & Sons, Ltd. |
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Bibliography: | istex:0890E880F12D27B47E7A29BEF7DC62F238B63BA8 ark:/67375/WNG-D2N8DGTZ-1 ArticleID:SIM824 National Institutes of Health - No. 1-R01-AI32042; No. 1-R29-AI31057 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0277-6715 1097-0258 |
DOI: | 10.1002/(SICI)1097-0258(19980530)17:10<1121::AID-SIM824>3.0.CO;2-E |