National Centre for Biosecurity and Infectious Disease, Institute of Environmental Science and Research, Upper Hutt, Wellington, New Zealand; Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand.
Centre for Health Informatics, Computing, and Statistics, Lancaster Medical School, Lancaster University, Lancaster, United Kingdom.
Vaccine. 2021 Jul 13;39(31):4383-4390. doi: 10.1016/j.vaccine.2021.05.100. Epub 2021 Jun 17.
Mathematical models of respiratory syncytial virus (RSV) transmission can help describe seasonal epidemics and assess the impact of potential vaccines and immunoprophylaxis with monoclonal antibodies (mAb).
We developed a deterministic, compartmental model for RSV transmission, which was fitted to population-based RSV hospital surveillance data from Auckland, New Zealand. The model simulated the introduction of either a maternal vaccine or a seasonal mAb among infants aged less than 6 months and estimated the reduction in RSV hospitalizations for a range of effectiveness and coverage values.
The model accurately reproduced the annual seasonality of RSV epidemics in Auckland. We found that a maternal vaccine with effectiveness of 30-40% in the first 90 days and 15-20% for the next 90 days could reduce RSV hospitalizations by 18-24% in children younger than 3 months, by 11-14% in children aged 3-5 months, and by 2-3% in children aged 6-23 months. A seasonal infant mAb with 40-60% effectiveness for 150 days could reduce RSV hospitalizations by 30-43%, 34-48% and by 14-21% in children aged 0-2 months, 3-5 months and 6-23 months, respectively.
Our results suggest that either a maternal RSV vaccine or mAb would effectively reduce RSV hospitalization disease burden in New Zealand. Overall, a seasonal mAb resulted in a larger disease prevention impact than a maternal vaccine.
呼吸道合胞病毒（RSV）传播的数学模型可以帮助描述季节性流行，并评估潜在疫苗和单克隆抗体（mAb）免疫预防的效果。
我们开发了一种用于 RSV 传播的确定性、隔室模型，该模型拟合了来自新西兰奥克兰的基于人群的 RSV 医院监测数据。该模型模拟了在 6 个月以下婴儿中引入母体疫苗或季节性 mAb 的情况，并针对一系列有效性和覆盖范围值估计了 RSV 住院率的降低。
该模型准确地再现了奥克兰 RSV 流行的年度季节性。我们发现，在最初的 90 天内有效性为 30-40%，接下来的 90 天内有效性为 15-20%的母体疫苗可以将 3 个月以下儿童的 RSV 住院率降低 18-24%，3-5 个月儿童的 RSV 住院率降低 11-14%，6-23 个月儿童的 RSV 住院率降低 2-3%。对于 150 天的有效性为 40-60%的季节性婴儿 mAb，可以将 0-2 个月、3-5 个月和 6-23 个月的儿童的 RSV 住院率分别降低 30-43%、34-48%和 14-21%。
我们的结果表明，母体 RSV 疫苗或 mAb 都可以有效降低新西兰 RSV 住院疾病负担。总体而言，季节性 mAb 比母体疫苗产生的疾病预防效果更大。
