Infectious Disease Epidemiology group, Max Planck Institute for Infection Biology, Charitéplatz 1, Campus Charité Mitte, Berlin, Germany.
Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Nat Commun. 2024 Nov 15;15(1):9919. doi: 10.1038/s41467-024-53415-x.
The persistence of measles in many countries demonstrates large immunity gaps, resulting from incomplete or ineffective immunization with measles-containing vaccines (MCVs). MCV impact is determined, in part, by vaccination age. Infants who receive dose 1 (MCV1) at older ages have a reduced risk of vaccine failure, but also an increased risk of contracting infection before vaccination. Here, we designed a new method-based on a mathematical transmission model incorporating realistic vaccination delays and age variations in MCV1 effectiveness-to capture the MCV1 age risk trade-off and estimate the optimal age for recommending MCV1. We applied this method to a range of synthetic populations representing lower- and higher-income populations. We predict a large heterogeneity in the optimal MCV1 ages (range: 6-20 months), contrasting the homogeneity of observed recommendations worldwide. Furthermore, we show that the optimal age depends on the local epidemiology of measles, with a lower optimal age predicted in populations having lower vaccination coverage or suffering higher transmission. Overall, our results suggest the scope for public health authorities to tailor the recommended schedule for better measles control.
在许多国家，麻疹的持续存在表明存在大量免疫空白，这是由于使用含麻疹成分疫苗（MCV）的免疫接种不完全或无效造成的。MCV 的效果在一定程度上取决于接种年龄。较晚接种第 1 剂（MCV1）的婴儿发生疫苗失败的风险降低，但在接种前感染的风险增加。在这里，我们设计了一种新的方法——基于包含现实接种延迟和 MCV1 有效性的年龄变化的数学传播模型——以捕捉 MCV1 年龄风险权衡，并估计推荐 MCV1 的最佳年龄。我们将该方法应用于一系列代表中低收入人群的合成人群。我们预测最佳 MCV1 年龄存在很大的异质性（范围：6-20 个月），与全球观察到的推荐方案的同质性形成对比。此外，我们表明最佳年龄取决于麻疹的当地流行情况，在疫苗接种覆盖率较低或传播率较高的人群中，最佳年龄较低。总的来说，我们的结果表明，公共卫生当局有机会调整推荐的时间表，以更好地控制麻疹。
