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Pertussis immunity and epidemiology: mode and duration of vaccine-induced immunity

Published online by Cambridge University Press:  04 September 2015

F. M. G. MAGPANTAY ,
M. DOMENECH DE CELLÈS ,
P. ROHANI  and
A. A. KING
F. M. G. MAGPANTAY
Affiliation:
Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA
M. DOMENECH DE CELLÈS
Affiliation:
Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA
P. ROHANI
Affiliation:
Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI 48109, USA Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA
A. A. KING*
Affiliation:
Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI 48109, USA Fogarty International Center, National Institutes of Health, Bethesda, MD 20892, USA Department of Mathematics, University of Michigan, Ann Arbor, MI 48109, USA
*
*Corresponding author. Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109, USA. E-mail: [email protected]
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Summary

The resurgence of pertussis in some countries that maintain high vaccination coverage has drawn attention to gaps in our understanding of the epidemiological effects of pertussis vaccines. In particular, major questions surround the nature, degree and durability of vaccine protection. To address these questions, we used mechanistic transmission models to examine regional time series incidence data from Italy in the period immediately following the introduction of acellular pertussis (aP) vaccine. Our results concur with recent animal-challenge experiments wherein infections in aP-vaccinated individuals proved as transmissible as those in naive individuals but much less symptomatic. On the other hand, the data provide evidence for vaccine-driven reduction in susceptibility, which we quantify via a synthetic measure of vaccine impact. As to the precise nature of vaccine failure, the data do not allow us to distinguish between leakiness and waning of vaccine immunity, or some combination of these. Across the range of well-supported models, the nature and duration of vaccine protection, the age profile of incidence and the range of projected epidemiological futures differ substantially, underscoring the importance of the remaining unknowns. We identify key data gaps: sources of data that can supply the information needed to eliminate these remaining uncertainties.

Keywords

pertussisimperfect vaccineleaky vaccinewaning immunitydisease dynamicsiterated filteringlikelihood-based inference
Type
Special Issue Article
Information
Parasitology , Volume 143 , Special Issue 7: Mathematical modelling of infectious diseases , June 2016 , pp. 835 - 849
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Copyright
Copyright © Cambridge University Press 2015 

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