Limited available evidence supports theoretical predictions of reduced vaccine efficacy at higher exposure dose
| dc.contributor.author | Langwig, Kate E. | en |
| dc.contributor.author | Gomes, M. Gabriela M. | en |
| dc.contributor.author | Clark, Mercedes D. | en |
| dc.contributor.author | Kwitny, Molly | en |
| dc.contributor.author | Yamada, Steffany A. | en |
| dc.contributor.author | Wargo, Andrew R. | en |
| dc.contributor.author | Lipsitch, Marc | en |
| dc.contributor.department | Biological Sciences | en |
| dc.date.accessioned | 2019-03-11T11:57:57Z | en |
| dc.date.available | 2019-03-11T11:57:57Z | en |
| dc.date.issued | 2019 | en |
| dc.description.abstract | Understanding the causes of vaccine failure is important for predicting disease dynamics in vaccinated populations and planning disease interventions. Pathogen exposure dose and heterogeneity in host susceptibility have both been implicated as important factors that may reduce overall vaccine efficacy and cause vaccine failure. Here, we explore the effect of pathogen dose and heterogeneity in host susceptibility in reducing efficacy of vaccines. Using simulation-based methods, we find that increases in pathogen exposure dose decrease vaccine efficacy, but this effect is modified by heterogeneity in host susceptibility. In populations where the mode of vaccine action is highly polarized, vaccine efficacy decreases more slowly with exposure dose than in populations with less variable protection. We compared these theoretical results to empirical estimates from a systematic literature review of vaccines tested over multiple exposure doses. We found that few studies (nine of 5,389) tested vaccine protection against infection over multiple pathogen challenge doses, with seven studies demonstrating a decrease in vaccine efficacy with increasing exposure dose. Our research demonstrates that pathogen dose has potential to be an important determinant of vaccine failure, although the limited empirical data highlight a need for additional studies to test theoretical predictions on the plausibility of reduced host susceptibility and high pathogen dose as mechanisms responsible for reduced vaccine efficacy in high transmission settings. | en |
| dc.description.sponsorship | Funding was provided by the NIH EEID grant R01GM113233. MGMG was funded by Fundação para a Ciência e a Tecnologia (IF/01346/2014) and is a member of the Human Infection Challenge Network for Vaccine Development (HIC-Vac), which is funded by the GCRF Networks in Vaccines Research and Development, which was co-funded by the MRC and BBSRC. | en |
| dc.format.mimetype | application/pdf | en |
| dc.identifier.doi | https://doi.org/10.1038/s41598-019-39698-x | en |
| dc.identifier.uri | http://hdl.handle.net/10919/88388 | en |
| dc.identifier.volume | 9 | en |
| dc.language.iso | en_US | en |
| dc.publisher | Nature | en |
| dc.rights | Creative Commons Attribution 4.0 International | en |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en |
| dc.title | Limited available evidence supports theoretical predictions of reduced vaccine efficacy at higher exposure dose | en |
| dc.title.serial | Scientific Reports | en |
| dc.type | Article - Refereed | en |
| dc.type.dcmitype | Text | en |