Poor Vaccine Responders Mask the True Trend in Vaccine Effectiveness Against Progression to Severe Disease.

Details

• Alternative Title:
  Vaccine, 2025, v. 43, no. 2: Poor Vaccine Responders Mask the True Trend in Vaccine Effectiveness Against Progression to Severe Disease.
• Journal Article:
  Vaccine
• Personal Author:
  Dean, Natalie E. ; Halloran, M. Elizabeth ; Zarnitsyna, Veronika I.
• Description:
  Vaccines can reduce an individual's risk of infection and their risk of progression to severe disease given infection. The latter effect is less commonly estimated but is relevant for vaccine impact modeling and cost-effectiveness calculations. Using a motivating example from the COVID-19 literature, we note how vaccine effectiveness against progression to severe disease can appear to increase from below 0 % to over 70 % within 8 months. With true biological strengthening of this magnitude being unlikely, we use a mathematical modeling framework to identify parameter combinations where this phenomenon can occur. Fundamental features are an immunocompetent population with high initial protection against infection, contrasted with a vulnerable subpopulation with poor vaccine response against infection and progression. As a result, the earliest infections are among those with the weakest protection against severe disease. This work highlights methodological challenges in isolating a vaccine's effect on progression to severe disease after infection, and it signals the need for refined analytical methods to adjust for differences between the vaccinated infected and the unvaccinated infected populations.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • COVID-19
  • Disease Progression
  • COVID-19 Vaccines
  • SARS-CoV-2
  • Vaccine Efficacy
  • Models, Theoretical
  • Vaccination
• Keywords:
  • Vaccine waning
  • protection against infection
  • progression to severe disease
• Source:
  Vaccine, 2025, v. 43, no. 2
• DOI:
  https://doi.org/10.1016/j.vaccine.2024.126516
• ISSN:
  0264-410X ; 1873-2518
• Pubmed ID:
  39586191
• Pubmed Central ID:
  PMC11822770
• Document Type:
  Text
• Funding:
  R01 AI139761/AI/NIAID NIH HHSUnited States/ ; U01 AI150747/AI/NIAID NIH HHSUnited States/ ; U19 AI057266/AI/NIAID NIH HHSUnited States/ ; NU38FT000001/CC/CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  126516 (18 pdf pages)
• Volume:
  43
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/261904/cdc_261904_DS1.pdf
• File Type:
  [PDF - 1.57 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:f97d9d7c36cf701e40ec86e31c50b37b67c5cc897c78fe4bbbd71f8b570bbf2587d99c067c30fc5d2267f6cbf42f78e3379bfddb0fab05a99f371bac6a5ad947