Details:

Alternative Title:
Vaccine
Publisher's site:
http://dx.doi.org/10.1016/j.vaccine.2014.05.014
Personal Author:
Lanzieri, Tatiana M. ; Bialek, Stephanie R. ; Ortega-Sanchez, Ismael R. ; Gambhir, Manoj
Lanzieri, Tatiana M. ; Bialek, Stephanie R. ; Ortega-Sanchez, Ismael R. ; Gambhir, Manoj Less -
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.


Subject:
[+]
Adolescent Adult Article Child Child, Preschool Cytomegalovirus Infections Cytomegalovirus Vaccines Female Humans Infant Infectious Disease Transmission, Vertical Models, Theoretical Pregnancy Vaccination Young Adult
Source:
Vaccine. 32(30):3780-3786
Pubmed ID:
24837782
Pubmed Central ID:
PMC4843116
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
Brazil ; United States
Brazil ; United States Less -
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:

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