Moulton L H, O'Brien K L, Reid R, Weatherholtz R, Santosham M, Siber G R
Center for American Indian Health, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
J Biopharm Stat. 2006;16(4):453-62. doi: 10.1080/10543400600719343.
When a sufficiently high proportion of a population is immunized with a vaccine, reduction in secondary transmission of disease can confer significant protection to unimmunized population members. We propose a straightforward method to estimate the degree of this indirect effect of vaccination in the context of a community-randomized vaccine trial. A conditional logistic regression model that accounts for within-randomization unit correlation over time is described, which models risk of disease as a function of community-level covariates. The approach is applied to an example data set from a pneumococcal conjugate vaccine study, with study arm and immunization levels forming the covariates of interest for the investigation of indirect effects.
当足够高比例的人群接种疫苗后,疾病二次传播的减少可为未接种疫苗的人群成员提供显著保护。我们提出了一种简单的方法,用于在社区随机疫苗试验的背景下估计疫苗这种间接效应的程度。描述了一种考虑随时间变化的随机化单位内相关性的条件逻辑回归模型,该模型将疾病风险建模为社区水平协变量的函数。该方法应用于肺炎球菌结合疫苗研究的一个示例数据集,研究组和免疫水平构成了用于研究间接效应的感兴趣协变量。