Modeling the Potential Impact of Vaccination on the Epidemiology of Congenital Cytomegalovirus Infection

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Lanzieri, Tatiana M. ; Bialek, Stephanie R. ; Ortega-Sanchez, Ismael R. ; Gambhir, Manoj
• Description:
  Background
  
  Understanding the potential for vaccination to change cytomegalovirus (CMV) epidemiology is important for developing CMV vaccines and designing clinical trials.
  
  Methods
  
  We constructed a deterministic, age-specific and time-dependent mathematical model of pathogen transmission, parameterized using CMV seroprevalence from the United States and Brazil, to predict the impact of vaccination on congenital CMV infection.
  
  Findings
  
  Concurrent vaccination of young children and adolescents would result in the greatest reductions in congenital CMV infections in populations with moderate and high baseline maternal seroprevalence. Such a vaccination strategy, assuming 70% vaccine efficacy, 90% coverage and 5-year duration of protection, could ultimately prevent 30%-50% of congenital CMV infections. At equilibrium, this strategy could result in a 30% reduction in congenital CMV infections due to primary maternal infection in the United States but a 3% increase in Brazil. The potential for an increase in congenital CMV infections due to primary maternal infections in Brazil was not predicted with use of a vaccine that confers protection for greater than 5 years.
  
  Interpretation
  
  Modeling suggests that vaccination strategies that include young children will result in greater declines in congenital CMV infection than those restricted to adolescents or women of reproductive age. Our study highlights the critical need for better understanding of the relative contribution of type of maternal infection to congenital CMV infection and disease, the main focus of vaccine prevention.
  
  
• Keywords:
  Adolescent Adult Brazil Child Child, Preschool Congenital Infection Cytomegalovirus Cytomegalovirus Infections Cytomegalovirus Vaccines Female Humans Infant Infectious Disease Transmission, Vertical Mathematical Model Models, Theoretical Pregnancy United States Vaccination Vaccination Impact Young Adult

  More +
• Source:
  Vaccine. 32(30):3780-3786
• Pubmed ID:
  24837782
• Pubmed Central ID:
  PMC4843116
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  32
• Issue:
  30
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a6d9da0140e155481a6311949e2e5c08219113f0606b14735d351be528161ca3
• Download URL:
  https://stacks.cdc.gov/view/cdc/39088/cdc_39088_DS1.pdf
• File Type:
  [PDF - 812.21 KB ]