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ESTIMATION OF VARICELLA VACCINE EFFICACY
*M. Brisson (1,2), W.J. Edmunds (1,2), B. Law (3), N.J. Gay
(1), G. De Serres (4).
(1) PHLS Communicable Disease Surveillance Centre, London,
UK;
(2) City University, London, UK; (3) Department of Paediatrics
and Child Health, University of Manitoba, Winnipeg Public
health Research Unit, Winnipeg, Manitoba, Canada; (4) CHUL
Research Centre, Faculty of Medicine, Laval University, Quebec,
Quebec, Canada
The
objective of this study was to quantify key parameters describing
varicella zoster virus (VZV) vaccine efficacy. To do so a
mathematical model was developed to represent breakthrough
cases as a function of time after vaccination in vaccine efficacy
trials. Efficacy parameter sets were identified by fitting
the predicted annual number of breakthrough infections with
that observed in three clinical trials chosen to represent
the plausible range of vaccine efficacy. Results suggest that
varicella vaccination seems to result in a high proportion
of individuals who are initially totally protected (97% for
the base-case). However, individuals lose full protection
relatively rapidly (3% per year for the base-case). Once total
protection has waned individuals have a high probability of
developing a breakthrough infection if exposed to varicella
(73% of the probability in unvaccinated susceptibles for the
base-case). Results also highlight that vaccine efficacy parameters
should be estimated concurrently to take into account dependencies
between parameters.
Corresponding Author: M. Brisson, PHLS Communicable
Disease Surveillance Centre, 61 Colindale Avenue, London NW9
5EQ, United Kingdom