Wake Forest School of Medicine, Department of Internal Medicine, Section on Infectious Diseases, 1 Medical Center Blvd., Winston Salem, VA 27157-1024, United States; PATH, Enteric Vaccines Initiative, 455 Massachusetts Ave NW, Washington, DC 20001-2785, United States.
Vaccine. 2019 Aug 7;37(34):4775-4777. doi: 10.1016/j.vaccine.2019.02.061.
Diarrhea remains one of the top five causes of disease and death among young children in developing nations. Fortunately, scientists are making progress developing vaccines against enterotoxigenic E. coli (ETEC) and Shigella, two of the leading diarrhea pathogens. As vaccine developers start to consider field efficacy trials of these vaccines, they should be aware of the importance of evaluating not only vaccine direct effects on the immunized, but also the herd effects that vaccination can afford to the unimmunized in a community. In a workshop held at the conference titled "Vaccines against Shigella and ETEC (VASE)", we described to participants what herd effects are and we presented on methods used in cholera and rotavirus studies that could be useful for future ETEC and Shigella vaccine trials conducted in low and middle-income nations. We also presented evidence on the effects of vaccine herd effects for estimates of vaccine cost-effectiveness.
腹泻仍然是发展中国家导致儿童发病和死亡的五大原因之一。幸运的是，科学家在开发针对肠毒素性大肠杆菌（ETEC）和志贺氏菌的疫苗方面取得了进展，这两种病原体是导致腹泻的主要病菌。随着疫苗开发者开始考虑对这些疫苗进行现场疗效试验，他们应该意识到，不仅要评估疫苗对免疫人群的直接效果，还要评估疫苗对社区中未免疫人群的群体效应。在题为“针对志贺氏菌和肠毒素性大肠杆菌的疫苗（VASE）”的会议的一次研讨会上，我们向与会者介绍了群体效应是什么，并介绍了在霍乱和轮状病毒研究中使用的方法，这些方法对未来在中低收入国家进行的针对 ETEC 和志贺氏菌的疫苗试验可能有用。我们还提供了有关疫苗群体效应影响的证据，用于估算疫苗的成本效益。
