Forecasting Epidemiological Consequences of Maternal Immunization

Abstract

Background. The increase in the incidence of whooping cough (pertussis) in many countries with high vaccination coverage is alarming. Maternal pertussis immunization has been proposed as an effective means of protecting newborns during the interval between birth and the first routine dose. However, there are concerns regarding potential interference between maternal antibodies and the immune response elicited by the routine schedule, with possible long-term population-level effects.Methods. We formulated a transmission model comprising both primary routine and maternal immunization. This model was examined to evaluate the long-term epidemiological effects of routine and maternal immunization, together with consequences of potential immune interference scenarios.Results. Overall, our model demonstrates that maternal immunization is an effective strategy in reducing the incidence of pertussis in neonates prior to the onset of the primary schedule. However, if maternal antibodies lead to blunting, incidence increases among older age groups. For instance, our model predicts that with 60% routine and maternal immunization coverage and 30% blunting, the incidence among neonates (0–2 months) is reduced by 43%. Under the same scenario, we observe a 20% increase in incidence among children aged 5–10 years. However, the downstream increase in the older age groups occurs with a delay of approximately a decade or more.Conclusions. Maternal immunization has clear positive effects on infant burden of disease, lowering mean infant incidence. However, if maternally derived antibodies adversely affect the immunogenicity of the routine schedule, we predict eventual population-level repercussions that may lead to an overall increase in incidence in older age groups.

Maternal pertussis immunisation: clinical gains and epidemiological legacy

“…Our recent modelling study [12] identified a trade-off between the direct protection of infants via maternal immunisation and the reduced indirect effects of herd immunity, leading to a gradual increase in incidence among older age cohorts.…”

“…In a recent modelling study, we demonstrated that averting such an eventuality would require both prenatal and routine vaccination coverage to be sufficiently high [12]. Moreover, this study predicted that due to the slow rate of population turnover, such downstream increases in incidence would take decades to manifest.…”

Mandated and Voluntary Social Distancing During The COVID-19 Epidemic: A Review

“…However, infectious disease researchers have made heavy use of information from social contact surveys. These are point-in-time (cross-sectional) household or individual surveys that collect detailed information on each respondent's daily contacts with other people who have specific age and gender attributes (Mossong et al, 2008;Bento and Rohani, 2016;Prem et al, 2017). Static contact surveys have proven to be useful for studying endemic diseases and seasonal diseases that occur fairly reliably in a population because sudden disruptions of behavior are not expected.…”

Real-time predictive seasonal influenza model in Catalonia, Spain

“…Specific models have been designed for diseases such as measles,[ 7 ] rubella, chickenpox,[ 8 ] dengue fever,[ 9 ] whooping cough,[ 10 ] smallpox,[ 11 ] malaria,[ 12 ] HIV/AIDS [ 13 ] and others. [ 14 ] Most models take the basic reproduction number R0 of the causative agent, defined as the threshold quantity that determines when an infection can invade and persist in a new host population, as one of the main assets.…”