Comparison of individual- and population-level benefits of one- and two-dose campaigns by vaccination start time and relative single-dose efficacy.

<p>Colors in each panel represent the cumulative incidence ratio, comparing cumulative incidence among those ever receiving vaccine in one-dose campaigns (numerator) with the cumulative incidence among those ever receiving vaccine in two-dose campaigns (denominator). Solid lines in each panel outline the region where single-dose campaigns are better for vaccinees (a result of indirect effects). Dashed lines represent the population-level threshold above which overall cumulative incidence is lower in a one-dose campaign compared to a two-dose campaign. Panels illustrate settings where enough susceptibility-reducing vaccine is available to cover (A) 20%, (B) 40%, and (C) 100% of the population with a single dose. In each plot, region 1 corresponds to the area where two doses are better for both the vaccinees and population, region 2 is where one dose is better for the population but not the vaccinees, and region 3 is where one dose is better for vaccinees and the population. Similar plots for different forms of vaccine protection are shown in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001867#pmed.1001867.s005" target="_blank">S4 Text</a>. VE, vaccine efficacy.</p

Core parameters used in deterministic transmission models.

<p>Models described in more detail in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001867#pmed.1001867.s002" target="_blank">S1 Text</a>.</p><p>^§Vaccination rates varied to keep the duration of the campaigns constant.</p><p>Core parameters used in deterministic transmission models.</p

Illustration of the susceptibility-reducing vaccine model.

<p>Circles represent states, with the variable letters representing susceptible, exposed, infectious, and removed states and the subscripts indicating the number of doses of vaccine those in that state have received. Arrows between states represent rates of transition between states, with values indicated in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001867#pmed.1001867.t001" target="_blank">Table 1</a>. More details can be found in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001867#pmed.1001867.s002" target="_blank">S1 Text</a>.</p

Short-term protection from one and two doses of oral cholera vaccine.

<p>Reported estimates and results from random effects regression models (filled diamonds) for both one (bottom) and two (top) doses of OCV. VE, vaccine efficacy.</p

Illustration of minimum relative single-dose efficacy in example vaccination campaigns starting at week 1 and week 12.

<p>Bars represent the final epidemic size for one-dose (green) and two-dose (orange) campaigns as a function of the RSE or the absolute single-dose efficacy (assuming a two-dose efficacy of 88%, in parentheses) on the <i>x</i>-axis for campaigns starting at week 1 (A) and week 12 (B) of the outbreak. The MRSE (dashed vertical line) is the RSE at which the final epidemic sizes for one- and two-dose campaigns are equal.</p

Mean projected epidemic trajectories from simulated one- and two-dose reactive vaccination campaigns compared to observed epidemics.

<p>(A) Zimbabwe. (B) Port-au-Prince, Haiti. (C) Conakry, Guinea. Simulated campaigns had enough vaccine to cover 50% of the population with a single dose of a severity-reducing vaccine. Shown are reported cholera cases (grey X’s), the mean number of cases at each time point in simulated epidemics with no vaccination (dashed grey line), simulated epidemics with a two-dose campaign (blue line), and simulated epidemics with a single-dose campaign (green line). See <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001867#pmed.1001867.s004" target="_blank">S3 Text</a> for details and additional results.</p

Additional file 1: of Ciprofloxacin for contacts of cases of meningococcal meningitis as an epidemic response: study protocol for a cluster-randomized trial

Populated SPIRIT checklist. These are our responses to the standard SPIRIT checklist. (DOC 121 kb

Number of pregnant women admitted in the cholera treatment unit per week.

<p>Léogâne, Haiti, 2010–2011.</p

Pregnancy outcomes in specialized cholera unit, Léogâne, Haiti, December 2010–July 2011.

<p>Pregnancy outcomes in specialized cholera unit, Léogâne, Haiti, December 2010–July 2011.</p

Risk factors for fetal death during cholera episode. Léogâne, Haiti, December 2010–July 2011.

*<p>RR, risk ratio.</p>†<p>CI, confidence interval.</p>#<p>, P-value<0.05.</p