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Published on: July 6, 2013
Optimizing age specific strategies of vaccination for prevention of cytomegalovirus infection in the US using
Dawei Wang1, Yao-Hsuan Chen2, Mario Ventresca3
1Health Economic and Decision Sciences, Merck & Co., Inc., Kenilworth, NJ, USA.
Background:
There is an urgent need to develop a cytomegalovirus (CMV) vaccine as it remains the leading cause of birth defects in the United States. While several CMV vaccine candidates are currently in late-stage clinical trials, the most effective vaccination program remains an open research question.
Methods:
To take into account the critical uncertainties when evaluating the vaccine impact on both vertical (congenital) and horizontal CMV transmissions, we developed a CMV agent-based model representative of the US population and contact network structures.
Results:
We evaluated 648 vaccination scenarios under various assumptions of vaccination age, vaccine efficacy, protection duration, and vaccination coverage. The optimal age of vaccination under all scenarios is shown to be during early childhood. However, a relatively modest benefit was also seen with vaccination of females of reproduction age (around age of 25) assuming near universal coverage and long vaccine-mediated protection.
Conclusions:
This study highlights the important need for a pediatric vaccination program in mitigating CMV in the United States. Our model is poised to investigate further location-based vaccine effectiveness questions in future planning of both clinical trials as well as eventual program implementation.
Insights
A pediatric cytomegalovirus (CMV) vaccination program is crucial for reducing birth defects. Early childhood vaccination offers the most benefit, though vaccinating reproductive-aged females also shows potential for CMV prevention.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Cytomegalovirus (CMV) is the leading cause of congenital birth defects in the US.
- Despite ongoing clinical trials for CMV vaccines, optimal vaccination strategies require further investigation.
Purpose of the Study:
- To evaluate the impact of different vaccination strategies on CMV transmission.
- To identify the most effective vaccination programs for CMV prevention in the US population.
Main Methods:
- Development of an agent-based model simulating CMV transmission within the US population.
- Evaluation of 648 vaccination scenarios varying age, efficacy, duration, and coverage.
Main Results:
- Early childhood vaccination emerged as the optimal strategy across all evaluated scenarios.
- Vaccinating females of reproductive age (around 25) showed modest benefits with high coverage and long-lasting protection.
Conclusions:
- A pediatric vaccination program is essential for mitigating CMV in the United States.
- The developed model can inform future CMV vaccine trial design and program implementation.
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