Center for Health Economic Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Universiteitsplein 1, Wilrijk, Belgium.
Vaccine. 2012 Apr 5;30(17):2795-800. doi: 10.1016/j.vaccine.2011.09.079. Epub 2011 Oct 1.
The estimation of herpes zoster (HZ) vaccine efficacy by time since vaccination and age at vaccination is crucial to assess the effectiveness and cost-effectiveness of HZ vaccination. Published estimates for the duration of protection from the vaccine diverge substantially, although based on data from the same trial for a follow-up period of 5 years. Different models were used to obtain these estimates, but it is unclear which of these models is most appropriate (if any). Only one study estimated vaccine efficacy by age at vaccination and time since vaccination combined. Recently, data became available from the same trial for a follow-up period of 7 years.
We aim to elaborate on estimating HZ vaccine efficacy (1) by estimating it as a function of time since vaccination and age at vaccination, (2) by comparing the fits of a range of models, and (3) by fitting these models on data for a follow-up period of 5 and 7 years.
Although the models' fit to data are very comparable, they differ substantially in how they estimate vaccine efficacy to change as a function of time since vaccination and age at vaccination.
An accurate estimation of HZ vaccine efficacy by time since vaccination and age at vaccination is hampered by the lack of insight in the biological processes underlying HZ vaccine protection, and by the fact that such data are currently not available in sufficient detail. Uncertainty about the choice of model to estimate this important parameter should be acknowledged in cost-effectiveness analyses.
通过接种时间和接种年龄来评估带状疱疹（HZ）疫苗的疗效，对于评估 HZ 疫苗的有效性和成本效益至关重要。虽然这些估计值基于同一试验的 5 年随访数据，但已发表的疫苗保护持续时间估计值存在很大差异。这些估计值是使用不同的模型得出的，但不清楚哪种模型最合适（如果有的话）。只有一项研究综合了接种年龄和接种时间来估计疫苗的疗效。最近，同一试验的 7 年随访数据可用。
我们旨在通过以下方式详细阐述 HZ 疫苗疗效的估计：（1）通过估计接种时间和接种年龄的函数来估计；（2）通过比较一系列模型的拟合度；（3）通过拟合这些模型来分析 5 年和 7 年的随访数据。
尽管模型对数据的拟合非常相似，但它们在如何估计疫苗疗效随接种时间和接种年龄变化的方式上存在很大差异。
由于缺乏对 HZ 疫苗保护背后的生物学过程的深入了解，以及目前没有足够详细的数据，因此通过接种时间和接种年龄准确估计 HZ 疫苗的疗效受到阻碍。在成本效益分析中，应该承认选择模型来估计这个重要参数的不确定性。
