Determining the Best Strategies for Maternally Targeted Pertussis Vaccination Using an Individual-Based Model
Authored by Nicholas Geard, Jodie McVernon, Patricia Therese Campbell
Date Published: 2017
DOI: 10.1093/aje/kwx002
Sponsors:
Australian Research Council (ARC)
Australian National Health and Medical Research Council (NHMRC)
Platforms:
Python
Model Documentation:
Other Narrative
Flow charts
Model Code URLs:
https://bitbucket.org/ngeard/pertussis-maternal-pub
Abstract
Rising pertussis incidence has prompted a number of countries to
implement maternally targeted vaccination strategies to protect
vulnerable infants, but questions remain about the optimal design of
such strategies. We simulated pertussis transmission within an
individual-based model parameterized to match Australian conditions,
explicitly linking infants and their mothers to estimate the
effectiveness of alternative maternally targeted vaccination strategies
(antenatal delivery vs. postnatal delivery) and the benefit of
revaccination over the course of multiple pregnancies. For firstborn
infants aged less than 2 months, antenatal immunization reduced annual
pertussis incidence by 60\%, from 780 per 100,000 firstborn children
under age 2 months (interquartile range (IQR), 682-862) to 315 per
100,000 (IQR, 260-370), while postnatal vaccination produced a minimal
reduction, with an incidence of 728 per 100,000 (IQR, 628-789).
Subsequent infants obtained limited protection from a single antenatal
dose, but revaccinating mothers during every pregnancy decreased
incidence for these infants by 58\%, from 1,878 per 100,000 subsequent
children under age 2 months (IQR, 1,712-2,076) to 791 per 100,000 (IQR,
683-915). Subsequent infants also benefited from household-level herd
immunity when antenatal vaccination for every pregnancy was combined
with a toddler booster dose at age 18 months; incidence was reduced to
626 per 100,000 (IQR, 548-691). Our approach provides useful information
to aid consideration of alternative maternally targeted vaccination
strategies and can inform development of outcome measures for program
evaluation.
Tags
Computer simulation
Population dynamics
protection
Disease transmission
population
transmission
United-states
Impact
Tetanus
Immunity
Pregnant-women
Diphtheria
Infectiousness
Maternally acquired immunity
Pertussis vaccine
Whooping cough
Infant pertussis
Tdap immunization