Model Analysis of Diphtheria Disease Transmission with Vaccination, Quarantine, and Hand-Washing Behavior

Recently, diphtheria outbreaks occur in many countries. According to the latest data from the World Health Organization, the number of registered cases and incidence of diphtheria in 2021 will be 8,638 cases worldwide. Diphtheria is generally an acute respiratory infection with most infections being asymptomatic or having a relatively slight clinical course. However, many sufferers are afflicted by breathing obstruction. In this study, we developed and analyzed the diphtheria spread model by considering transmission by contact with an exposed and infected individual, progression for vaccinated exposed individuals becoming infected, quarantine for both exposed and infected people, and hand-washing behavior. Besides that, we proved the stability analysis around the equilibrium points and did the numerical simulations of models. The results of this study show that the model system has two steady states, namely disease-free equilibrium and endemic equilibrium. The disease-free equilibrium is stable if the basic reproduction number is less than one, either is unstable. The endemic equilibrium exists and is stable if the basic reproduction number is greater than one. The numerical simulations show that there is a significant effect of vaccination, quarantine, and hand-washing behavior for infected numbers, respectively. Vaccination, quarantine, and hand-washing behavior could significantly reduce the basic reproductive and the infected number. Whereas vaccination for exposed people could increase the basic reproductive and the infected number.

Vaccine

In 2016, the Immunization Technical Advisory Group of the South-East Asia Region (SEAR) endorsed a regional goal to achieve 641% prevalence of hepatitis B surface antigen (HBsAg) among 5-year-old children by 2020. Chronic hepatitis B virus (HBV) infection is largely preventable with a birth dose of hepatitis B vaccine (HepB-BD) followed by two to three additional doses. We reviewed the progress towards hepatitis B control through vaccination in SEAR during 1992-2015. We summarized hepatitis B vaccination data and reviewed the literature to determine the prevalence of chronic HBV infection pre- and post-vaccine introduction. We used a mathematical model to determine post-vaccine prevalence of HBsAg among 5\u202fyear olds in countries lacking national serosurvey data and estimated the impact of vaccination on disease burden. Regional coverage with three doses of hepatitis B vaccine (HepB3) increased from 56% in 2011 to 87% in 2015. By 2016, 7 of 11 countries had introduced universal HepB-BD. Regional HepB-BD coverage increased from 9% in 2011 to 34% in 2015. In 2015, estimated HBsAg among 5\u202fyear olds was 1.1% with variability among countries. Myanmar (3.8%), Timor-Leste (2.7%), Indonesia (1.8%), and India (1%) had the highest prevalence of HBsAg. During 1992-2015, vaccination prevented approximately 16 million chronic HBV infections and 2.6 million related deaths. In 2015, around 197,640 perinatal HBV infections occurred in SEAR with majority occurring in India (62%), Bangladesh (24%), and Myanmar (8%). Myanmar had the highest rate of perinatal chronic HBV infections at 16 per 1000 live births. Despite significant progress in the control of HBV, SEAR needs to secure political commitment for elimination and consider additional strategies, such as promoting health facility births, universal birth dose administration, developing strong coordination between health sectors, and using alternative vaccine delivery methods, to improve HepB-BD coverage and subsequently achieve HBV control and elimination.20172019-01-02T00:00:00Z001/World Health Organization/InternationalCC999999/Intramural CDC HHS/United States29174317PMC5774012889

Inclusion of Additional Unintended Consequences in Economic Evaluation: A Systematic Review of Immunization and Tuberculosis Cost-Effectiveness Analyses.

OBJECTIVE: Our objective was to review economic evaluations of immunization and tuberculosis to determine the extent to which additional unintended consequences were taken into account in the analysis and to describe the methodological approaches used to estimate these, where possible. METHODS: We sourced the vaccine economic evaluations from a previous systematic review by Nymark et al. (2009-2015) and searched PubMed/MEDLINE and Embase from 2015 to 2019 using the same search strategy. For tuberculosis economic evaluations, we extracted studies from 2009 to 2019 that were published in a previous review by Siapka et al. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Studies were classified according to the categories and subcategories (e.g., herd immunity, non-specific effects, and labor productivity) defined in a framework identifying additional unintended consequences by Nymark and Vassall. Where possible, methods for estimating the additional unintended consequences categories and subcategories were described. We evaluated the reporting quality of included studies according to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) extraction guideline. RESULTS: We identified 177 vaccine cost-effectiveness analyses (CEAs) between 2009 and 2019 that met the inclusion criteria. Of these, 98 included unintended consequences. Of the total 98 CEAs, overall health consequence categories were included 73 times; biological categories: herd immunity 43 times; pathogen response: resistance 15 times; and cross-protection 15 times. For health consequences pertaining to the supply-side (health systems) categories, side effects were included five times. On the nonhealth demand side (intrahousehold), labor productivity was included 60 times. We identified 29 tuberculosis CEAs from 2009 to 2019 that met the inclusion criteria. Of these, six articles included labor productivity, four included indirect transmission effects, and one included resistance. Between 2009 and 2019, only 34% of tuberculosis CEAs included additional unintended consequences, compared with 55% of vaccine CEAs. CONCLUSIONS: The inclusion of additional unintended consequences in economic evaluations of immunization and tuberculosis continues to be limited. Additional unintended consequences of economic benefits, such as those examined in this review and especially those that occur outside the health system, offer valuable information to analysts. Further work on appropriate ways to value these additional unintended consequences is still warranted

Vaccine impact: Benefits for human health

n/

Estudio del efecto de la vacunación en modelos de epidemias con transmisión estocástica

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Estudios Estadísticos, leída el 15-12-2022Mathematical epidemic models are frequently used in biology for analyzing transmission dynamics of infectious diseases and assessing control measures to interrupt their expansion. In order to select and develop properly the above mathematical models, it is necessary to take into account the particularities of an epidemic process as type of disease, mode of transmission and population characteristics. In this thesis we focus on infectious diseases with stochastic transmission including vaccination as a control measure to stop the spread of the pathogen. To that end, we consider constant and moderate size populations where individuals are homogeneously mixed. We assume that characteristics related to the transmission/recovery of the infectious disease present a common probabilistic behavior for individuals in the population. To assure herd immunity protection, we consider that a percentage of the population is protected against the disease by a vaccine, prior to the start of the outbreak.The administered vaccine is imperfect in the sense that some individuals, who have been previously vaccinated, failed to increase antibody levels and, in consequence, they could be infected. Pathogenic transmission occurs by direct contact with infected individuals. As population is not isolated, disease spreads from direct contacts with infected individuals inside or outside the population...Los modelos matemáticos epidemiológicos se usan frecuentemente en biología para analizar las dinámicas de transmisión de enfermedades infecciosas y para evaluar medidas de control con el objetivo de frenar su expansión. Para poder seleccionar y desarrollar adecuadamente estos modelos es necesario tener en cuenta las particularidades propias del proceso epidémico tales como el tipo de enfermedad, modo de transmisión y características de la población. En esta tesis nos centramos en el estudio de enfermedades de tipo infeccioso con transmisión por contacto directo, que disponen de una vacuna como medida de contención en la propagación del patógeno. Para ello, consideramos poblaciones de tamaño moderado, que permanece constante a lo largo de un brote y asumiremos que los individuos no tienen preferencia a la hora de relacionarse y que las características referentes a la transmisión de la enfermedad se representan en términos de variables aleatorias, comunes para todos los individuos. La población no está aislada y la transmisión del patógeno se produce mediante contacto directo con cualquier persona infectada, tanto de dentro de la población como fuera de ella. Asumimos que, antes del inicio del brote epidémico, se ha administrado la vacuna a un porcentaje suficiente de individuos de la población, de forma que se asegure la inmunidad de rebaño. Consideramos que la vacuna administrada es imperfecta en el sentido que algunos individuos vacunados no logran desarrollar anticuerpos frente a la enfermedad y por lo tanto, podrían resultar infectados al contactar con individuos enfermos...Fac. de Estudios EstadísticosTRUEunpu

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement.

Immunization during pregnancy has been recommended in an increasing number of countries. The aim of this strategy is to protect pregnant women and infants from severe infectious disease, morbidity and mortality and is currently limited to tetanus, inactivated influenza, and pertussis-containing vaccines. There have been recent advancements in the development of vaccines designed primarily for use in pregnant women (respiratory syncytial virus and group B Streptococcus vaccines). Although there is increasing evidence to support vaccination in pregnancy, important gaps in knowledge still exist and need to be addressed by future studies. This collaborative consensus paper provides a review of the current literature on immunization during pregnancy and highlights the gaps in knowledge and a consensus of priorities for future research initiatives, in order to optimize protection for both the mother and the infant

Group B Streptococcus vaccine development: present status and future considerations, with emphasis on perspectives for low and middle income countries.

Globally, group B Streptococcus (GBS) remains the leading cause of sepsis and meningitis in young infants, with its greatest burden in the first 90 days of life. Intrapartum antibiotic prophylaxis (IAP) for women at risk of transmitting GBS to their newborns has been effective in reducing, but not eliminating, the young infant GBS disease burden in many high income countries. However, identification of women at risk and administration of IAP is very difficult in many low and middle income country (LMIC) settings, and is not possible for home deliveries. Immunization of pregnant women with a GBS vaccine represents an alternate pathway to protecting newborns from GBS disease, through the transplacental antibody transfer to the fetus in utero. This approach to prevent GBS disease in young infants is currently under development, and is approaching late stage clinical evaluation. This manuscript includes a review of the natural history of the disease, global disease burden estimates, diagnosis and existing control options in different settings, the biological rationale for a vaccine including previous supportive studies, analysis of current candidates in development, possible correlates of protection and current status of immunogenicity assays. Future potential vaccine development pathways to licensure and use in LMICs, trial design and implementation options are discussed, with the objective to provide a basis for reflection, rather than recommendations