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- Title
Review of Mathematical Models of Vaccination for Preventing Congenital Cytomegalovirus Infection.
- Authors
Lanzieri, Tatiana M; Gastañaduy, Paul A; Gambhir, Manoj; Plotkin, Stanley A
- Abstract
<bold>Background: </bold>Several cytomegalovirus (CMV) vaccine candidates are under development. To reduce the burden of congenital CMV infection, potential strategies under consideration include vaccination of adult women, adolescent girls, and/or young children (both sexes).<bold>Methods: </bold>We reviewed 5 studies that used infectious disease modeling to assess the potential impact of vaccination for preventing congenital CMV infection. All models assumed CMV vaccination would prevent primary infection and 2 models also assumed prevention of reinfections and reactivations.<bold>Results: </bold>Despite differences in structure, assumptions, and population data, infant vaccination (both sexes) was the optimal strategy in all models, but in 1 model vaccinating seronegative women at 19-21 years of age was also optimal (for duration of vaccine protection ≥8 years). In 3 models, infant vaccination increased average age at primary infection as a result of decreased secondary transmission (herd immunity) combined with waning vaccine-induced immunity. This effect could increase the risk of congenital CMV infections in populations where primary CMV infection occurs early in childhood but could be minimized by administering a second dose of vaccine during adolescence.<bold>Conclusions: </bold>Understanding vaccine efficacy and duration of immunity, and how these might vary depending on CMV serostatus and age at vaccination, will be key to defining CMV vaccination strategies.
- Subjects
CYTOMEGALOVIRUS diseases; VACCINATION; MATHEMATICAL models; COMMUNICABLE diseases; TEENAGE girls; IMMUNITY; CYTOMEGALOVIRUS disease prevention; CYTOMEGALOVIRUSES; PUBLIC health surveillance; IMMUNIZATION; VIRAL vaccines; WORLD health; THEORY; IMPACT of Event Scale; QUESTIONNAIRES; VERTICAL transmission (Communicable diseases)
- Publication
Journal of Infectious Diseases, 2020, Vol 221, pS86
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiz402