Potential impact of dengue vaccination: a modeling approach
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2012
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ELSEVIER SCI LTD
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INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.16, suppl.1, p.E5-E5, 2012
Resumo
Dengue is a major public health concern in Brazil. Dengue vaccines should help, when available, to significantly reduce the burden of dengue but raise a number of question around their best use. In this context, mathematical models can provide insights on questions such as optimal age for vaccination or respective benefits of routine and catch-up vaccination at different coverage rates. We first present analytical results related to the optimal age for vaccination and expected benefits from catch-up campaigns using the most recent seroprevalence data available for Brazil. We then present the results obtained with an age-structured, host-vector compartmental model that captures seasonality and interactions between the four dengue serotypes. This model was adapted to the Brazilian situation through the use of surveillance data for age and severity-specific incidence as well as available information on vector density and dengue seroprevalence according to age. Both analyses lead to the conclusion that starting routine vaccination at an early age (2 years of age) provides the largest reduction of dengue incidence per vaccine dose administered whatever the force of infection, vaccine coverage or efficacy considered. Routine vaccination alone is however expected to get a limited impact on dengue incidence the first year of its implementation. Complementing routine vaccination by catch-up campaigns enables to obtain very rapidly a high level of disease control if offered to a sufficient number of cohorts (e.g. children from 3 to 14 years of age). The results of an ongoing efficacy and large scale safety study should help to refine the results on the benefits expected from a dengue vaccination program.