McLean A R
Wellcome Centre for Infectious Disease Research, Zoology Department, Oxford University, England.
Dev Biol Stand. 1998;95:225-33.
The effectiveness of a vaccine can be broadly defined as a practical measure of its costs and benefits when used in a community setting. What then is the relationship between a vaccine's efficacy and its effectiveness? Effectiveness certainly includes efficacy, but also encompasses secondary effects of vaccination, long-term efficacy of a vaccine (beyond that measured in conventional efficacy trials), the impact of vaccinating against one strain upon cross-reacting infections, costs of vaccination programmes and logistic considerations for vaccine delivery. This paper considers some of the biological determinants of effectiveness namely; secondary effects, long-term efficacy and competitive interactions amongst strains. Mathematical models of the transmission dynamics of infection and its disruption by vaccination are used as tools to help unravel some of the complexities that may arise when making interventions in non-linear biological systems.
疫苗的有效性可大致定义为其在社区环境中使用时成本与效益的一种实际衡量标准。那么疫苗的效力与有效性之间的关系是什么呢？有效性当然包括效力，但还涵盖疫苗接种的次要效应、疫苗的长期效力（超出传统效力试验所测范围）、针对一种毒株接种对交叉反应感染的影响、疫苗接种计划的成本以及疫苗配送的后勤考量。本文探讨了有效性的一些生物学决定因素，即次要效应、长期效力以及毒株间的竞争相互作用。感染传播动态及其因疫苗接种而中断的数学模型被用作工具，以帮助阐明在对非线性生物系统进行干预时可能出现的一些复杂性。
