Abstract #300957

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JSM 2003 Abstract #300957
Activity Number: 102
Type: Invited
Date/Time: Monday, August 4, 2003 : 10:30 AM to 12:20 PM
Sponsor: Section on Statistics in Epidemiology
Abstract - #300957
Title: How to Accommodate Disease Transmission When Assessing Vaccines
Author(s): Niels G. Becker*+
Companies: Australian National University
Address: NCEPH, Canberra, , , Australia
Keywords: application of MCMC methods ; control of disease transmission ; estimation by inequalities ; infection in households ; vaccine efficacy
Abstract:

A measure of vaccine efficacy (VE) is needed because most vaccines induce only partial protection. The measure of efficacy traditionally used to assess vaccines is VE = 1 - (proportion of cases in the vaccinated group)/(proportion of cases in the unvaccinated group). We describe realistic transmissible disease settings in which VE gives a very misleading assessment of a vaccine. For transmissible diseases, VE generally depends on the type of protection induced by the vaccine, the cumulative force of infection acting over the the vaccine trial period, and the structure of the community. This makes it difficult to translate a value for VE into the likely effect of vaccination on disease transmission in a different community. Furthermore, for transmissible infection, we are also interested to see if the vaccine reduces infectivity. VE is unable to measure this. We introduce a wide class of vaccine responses in terms of changes in susceptibility and infectivity and use this to describe alternative concepts of vaccine efficacy. Methods for estimating these alternative concepts of vaccine efficacy are explored and illustrated.

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Revised March 2003