Departamento de Patologia & LIM 01 HC, Faculdade de Medicina, Universidade de São Paulo, Brazil.
Epidemiol Infect. 2011 Dec;139(12):1818-26. doi: 10.1017/S0950268811000343. Epub 2011 Mar 14.
In order to analyse the impact of vaccination against cytomegalovirus (CMV) on congenital infection incidence using current vaccines tested in phase II clinical trials, we simulated different scenarios by mathematical modelling, departing from the current vaccine characteristics, varying age at vaccination, immunity waning, vaccine efficacy and mixing patterns. Our results indicated that the optimal age for a single vaccination interval is from 2 to 6 months if there is no immunity waning. Congenital infection may increase if vaccine-induced immunity wanes before 20 years. Congenital disease should increase further when the mixing pattern includes transmission among children with a short duration of protection vaccine. Thus, the best vaccination strategy is a combined schedule: before age 1 year plus a second dose at 10-11 years. For CMV vaccines with low efficacy, such as the current ones, universal vaccination against CMV should be considered for infants and teenagers.
为了分析使用目前在 II 期临床试验中测试的疫苗预防巨细胞病毒（CMV）感染的效果，我们通过数学建模模拟了不同的情况，这些情况基于目前的疫苗特性，改变接种年龄、免疫衰退、疫苗效力和混合模式。我们的研究结果表明，如果没有免疫衰退，单次接种间隔的最佳年龄为 2 至 6 个月。如果疫苗诱导的免疫在 20 岁之前衰退，先天性感染可能会增加。当混合模式包括儿童之间具有短保护期疫苗的传播时，先天性疾病会进一步增加。因此，最佳的接种策略是联合方案：1 岁之前接种，10-11 岁时再接种一次。对于效力较低的 CMV 疫苗，例如目前的疫苗，应考虑对婴儿和青少年进行 CMV 疫苗的普遍接种。
