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Multiple dose vaccination against childhood diseases: high coverage with the first dose remains crucial for
A C Paulo1, M C Gomes, A C Casinhas
1Center of Mathematics and Fundamental Applications, DBV, Lisboa, Portugal.
Insights
Achieving eradication of childhood diseases like measles requires high first-dose vaccine coverage. A second dose aids eradication but is less critical than high initial immunization rates.
Area of Science:
- Epidemiology
- Mathematical Biology
- Public Health
Background:
- High vaccination coverage is essential for eradicating communicable diseases such as measles, mumps, and rubella.
- Many countries have introduced a second vaccine dose to improve eradication potential.
Purpose of the Study:
- To investigate the conditions for eradicating childhood diseases using multiple vaccine doses.
- To obtain analytical solutions for a classical compartmental model to analyze vaccination schedules.
Main Methods:
- Utilized a classical compartmental model (P-S-E-I-R) with an age-independent force of infection.
- Derived explicit analytical solutions to evaluate the impact of vaccination schedules with multiple doses.
- Analyzed the effects of dose number, vaccination age, and coverage rates.
Main Results:
- Demonstrated that high first-dose immunization coverage (over 90%) is crucial for eradication, even with a second dose.
- Showed that with high first-dose coverage, eradication is less sensitive to the timing of the second dose.
- Moderate coverage rates for the second dose are sufficient when first-dose coverage is high.
Conclusions:
- High first-dose vaccination coverage is paramount for eradicating childhood diseases.
- Vaccination strategies involving multiple doses can be optimized by prioritizing high initial coverage.
- Mathematical modeling provides quantitative insights into the long-term impact of vaccination schedules on disease eradication.
Abstract:
The high vaccination coverage required to eradicate communicable diseases like measles, mumps and rubella, with a single dose of vaccine, has prompted many countries to introduce a second dose. In this paper we investigate the conditions to eradicate childhood diseases with multiple doses of vaccine by obtaining explicit analytical solutions to the classical compartment model that assumes an age-independent force of infection and conceptualizes the host population as divided into maternally protected (P), susceptibles (S), latents (E), infectious (I), and removed (R). The solutions allow a quantitative discussion of the long-term impact of vaccination schedules with an arbitrary number of doses of vaccine. It becomes possible to determine the effect of the number of doses, ages at vaccination, and coverage rates of vaccines against childhood diseases. In an example with a two-dose vaccination schedule against measles, we show that, in spite of a second dose, a high (> 90%) immunization coverage in the first dose is still crucial to achieve eradication. With a high first-dose coverage, however, eradication is relatively insensitive to the age of the second dose and requires only moderate coverage rates in the latter.