Hogan Alexandra B, Campbell Patricia T, Blyth Christopher C, Lim Faye J, Fathima Parveen, Davis Stephanie, Moore Hannah C, Glass Kathryn
Research School of Population Health, The Australian National University, 62 Mills Rd, The Australian National University, Acton ACT 2601, Australia.
Doherty Epidemiology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Level 5, 792 Elizabeth St, Melbourne, Victoria 3000, Australia; Infection and Immunity, Murdoch Childrens Research Institute, Royal Children's Hospital, Flemington Rd, Parkville 3052, Victoria, Australia.
Vaccine. 2017 Oct 27;35(45):6172-6179. doi: 10.1016/j.vaccine.2017.09.043. Epub 2017 Sep 28.
Respiratory syncytial virus (RSV) is a major cause of respiratory morbidity and one of the main causes of hospitalisation in young children. While there is currently no licensed vaccine for RSV, a vaccine candidate for pregnant women is undergoing phase 3 trials. We developed a compartmental age-structured model for RSV transmission, validated using linked laboratory-confirmed RSV hospitalisation records for metropolitan Western Australia. We adapted the model to incorporate a maternal RSV vaccine, and estimated the expected reduction in RSV hospitalisations arising from such a program. The introduction of a vaccine was estimated to reduce RSV hospitalisations in Western Australia by 6-37% for 0-2month old children, and 30-46% for 3-5month old children, for a range of vaccine effectiveness levels. Our model shows that, provided a vaccine is demonstrated to extend protection against RSV disease beyond the first three months of life, a policy using a maternal RSV vaccine could be effective in reducing RSV hospitalisations in children up to six months of age, meeting the objective of a maternal vaccine in delaying an infant's first RSV infection to an age at which severe disease is less likely.
呼吸道合胞病毒（RSV）是导致呼吸道疾病的主要原因之一，也是幼儿住院的主要原因之一。虽然目前尚无获批的RSV疫苗，但一种针对孕妇的候选疫苗正在进行3期试验。我们开发了一个用于RSV传播的按年龄划分的 compartmental 模型，并使用西澳大利亚州首府地区实验室确诊的RSV住院记录进行了验证。我们对该模型进行了调整，纳入了母体RSV疫苗，并估计了该计划导致的RSV住院人数的预期减少情况。对于一系列疫苗效力水平，估计引入疫苗可使西澳大利亚州0至2个月大儿童的RSV住院人数减少6%至37%，3至5个月大儿童的RSV住院人数减少30%至46%。我们的模型表明，如果一种疫苗被证明能将针对RSV疾病的保护作用延长至生命的前三个月之后，那么使用母体RSV疫苗的政策可能有效地减少6个月以下儿童的RSV住院人数，实现母体疫苗将婴儿首次RSV感染推迟到不太可能患严重疾病年龄的目标。
