Herd Immunity to Ebolaviruses Is Not a Realistic Target for Current Vaccination Strategies

The recent West African Ebola virus pandemic, which affected >28,000 individuals increased interest in anti-Ebolavirus vaccination programs. Here, we systematically analyzed the requirements for a prophylactic vaccination program based on the basic reproductive number (R0, i.e. the number of secondary cases that result from an individual infection). Published R0 values were determined by systematic literature research and ranged from 0.37 to 20. R0s ?4 realistically reflected the critical early outbreak phases and superspreading events. Based on the R0, the herd immunity threshold (Ic) was calculated using the equation Ic=1–(1/R0). The critical vaccination coverage (Vc) needed to provide herd immunity was determined by including the vaccine effectiveness (E) using the equation Vc=Ic/E. At an R0 of 4, the Ic is 75% and at an E of 90%, more than 80% of a population need to be vaccinated to establish herd immunity. Such vaccination rates are currently unrealistic because of resistance against vaccinations, financial/ logistical challenges, and a lack of vaccines that provide long-term protection against all human-pathogenic Ebolaviruses. Hence, outbreak management will for the foreseeable future depend on surveillance and case isolation. Clinical vaccine candidates are only available for Ebola viruses. Their use will need to be focused on health care workers, potentially in combination with ring vaccination approaches

Penile vibratory stimulation in the recovery of urinary continence and erectile function after nerve‐sparing radical prostatectomy: a randomized, controlled trial

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107551/1/bju12501.pd

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

Microenvironmental regulation of metastasis

Metastasis is a multistage process that requires cancer cells to escape from the primary tumour, survive in the circulation, seed at distant sites and grow. Each of these processes involves rate-limiting steps that are influenced by non-malignant cells of the tumour microenvironment. Many of these cells are derived from the bone marrow, particularly the myeloid lineage, and are recruited by cancer cells to enhance their survival, growth, invasion and dissemination. This Review describes experimental data demonstrating the role of the microenvironment in metastasis, identifies areas for future research and suggests possible new therapeutic avenues

Data_Sheet_1_Herd Immunity to Ebolaviruses Is Not a Realistic Target for Current Vaccination Strategies.xlsx

<p>The recent West African Ebola virus pandemic, which affected >28,000 individuals increased interest in anti-Ebolavirus vaccination programs. Here, we systematically analyzed the requirements for a prophylactic vaccination program based on the basic reproductive number (R₀, i.e., the number of secondary cases that result from an individual infection). Published R₀ values were determined by systematic literature research and ranged from 0.37 to 20. R₀s ≥ 4 realistically reflected the critical early outbreak phases and superspreading events. Based on the R₀, the herd immunity threshold (I_c) was calculated using the equation I_c = 1 − (1/R₀). The critical vaccination coverage (V_c) needed to provide herd immunity was determined by including the vaccine effectiveness (E) using the equation V_c = I_c/E. At an R₀ of 4, the I_c is 75% and at an E of 90%, more than 80% of a population need to be vaccinated to establish herd immunity. Such vaccination rates are currently unrealistic because of resistance against vaccinations, financial/logistical challenges, and a lack of vaccines that provide long-term protection against all human-pathogenic Ebolaviruses. Hence, outbreak management will for the foreseeable future depend on surveillance and case isolation. Clinical vaccine candidates are only available for Ebola viruses. Their use will need to be focused on health-care workers, potentially in combination with ring vaccination approaches.</p

Data_Sheet_2_Herd Immunity to Ebolaviruses Is Not a Realistic Target for Current Vaccination Strategies.PDF

<p>The recent West African Ebola virus pandemic, which affected >28,000 individuals increased interest in anti-Ebolavirus vaccination programs. Here, we systematically analyzed the requirements for a prophylactic vaccination program based on the basic reproductive number (R₀, i.e., the number of secondary cases that result from an individual infection). Published R₀ values were determined by systematic literature research and ranged from 0.37 to 20. R₀s ≥ 4 realistically reflected the critical early outbreak phases and superspreading events. Based on the R₀, the herd immunity threshold (I_c) was calculated using the equation I_c = 1 − (1/R₀). The critical vaccination coverage (V_c) needed to provide herd immunity was determined by including the vaccine effectiveness (E) using the equation V_c = I_c/E. At an R₀ of 4, the I_c is 75% and at an E of 90%, more than 80% of a population need to be vaccinated to establish herd immunity. Such vaccination rates are currently unrealistic because of resistance against vaccinations, financial/logistical challenges, and a lack of vaccines that provide long-term protection against all human-pathogenic Ebolaviruses. Hence, outbreak management will for the foreseeable future depend on surveillance and case isolation. Clinical vaccine candidates are only available for Ebola viruses. Their use will need to be focused on health-care workers, potentially in combination with ring vaccination approaches.</p

Data_Sheet_3_Herd Immunity to Ebolaviruses Is Not a Realistic Target for Current Vaccination Strategies.PDF

<p>The recent West African Ebola virus pandemic, which affected >28,000 individuals increased interest in anti-Ebolavirus vaccination programs. Here, we systematically analyzed the requirements for a prophylactic vaccination program based on the basic reproductive number (R₀, i.e., the number of secondary cases that result from an individual infection). Published R₀ values were determined by systematic literature research and ranged from 0.37 to 20. R₀s ≥ 4 realistically reflected the critical early outbreak phases and superspreading events. Based on the R₀, the herd immunity threshold (I_c) was calculated using the equation I_c = 1 − (1/R₀). The critical vaccination coverage (V_c) needed to provide herd immunity was determined by including the vaccine effectiveness (E) using the equation V_c = I_c/E. At an R₀ of 4, the I_c is 75% and at an E of 90%, more than 80% of a population need to be vaccinated to establish herd immunity. Such vaccination rates are currently unrealistic because of resistance against vaccinations, financial/logistical challenges, and a lack of vaccines that provide long-term protection against all human-pathogenic Ebolaviruses. Hence, outbreak management will for the foreseeable future depend on surveillance and case isolation. Clinical vaccine candidates are only available for Ebola viruses. Their use will need to be focused on health-care workers, potentially in combination with ring vaccination approaches.</p

Data_Sheet_5_Herd Immunity to Ebolaviruses Is Not a Realistic Target for Current Vaccination Strategies.PDF

<p>The recent West African Ebola virus pandemic, which affected >28,000 individuals increased interest in anti-Ebolavirus vaccination programs. Here, we systematically analyzed the requirements for a prophylactic vaccination program based on the basic reproductive number (R₀, i.e., the number of secondary cases that result from an individual infection). Published R₀ values were determined by systematic literature research and ranged from 0.37 to 20. R₀s ≥ 4 realistically reflected the critical early outbreak phases and superspreading events. Based on the R₀, the herd immunity threshold (I_c) was calculated using the equation I_c = 1 − (1/R₀). The critical vaccination coverage (V_c) needed to provide herd immunity was determined by including the vaccine effectiveness (E) using the equation V_c = I_c/E. At an R₀ of 4, the I_c is 75% and at an E of 90%, more than 80% of a population need to be vaccinated to establish herd immunity. Such vaccination rates are currently unrealistic because of resistance against vaccinations, financial/logistical challenges, and a lack of vaccines that provide long-term protection against all human-pathogenic Ebolaviruses. Hence, outbreak management will for the foreseeable future depend on surveillance and case isolation. Clinical vaccine candidates are only available for Ebola viruses. Their use will need to be focused on health-care workers, potentially in combination with ring vaccination approaches.</p