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Over- and under-estimation of vaccine effectiveness
Hilla De-Leon1,2, Dvir Aran3,4
1Faculty of Biology, Technion-Israel Institute of Technology, Technion-Israel Institute of Technology, 21 Sderot Rose, Haifa, 3095230, Israel.
BMC Medical Research Methodology
|July 2, 2025
Summary
Vaccine effectiveness against SARS-CoV-2 infection varies due to uncounted indirect protection. Accounting for interactions between vaccinated and unvaccinated individuals provides more accurate vaccine effectiveness (VE) estimates.
Area of Science:
- Epidemiology
- Mathematical Modeling
- Public Health
Background:
- Reported SARS-CoV-2 vaccine effectiveness (VE) varies widely (60-95%) across studies.
- Simultaneous studies in Israel reported conflicting VE estimates (90-95% vs. ~80%).
- This variability may stem from inadequate accounting for indirect protection and transmission blocking by vaccines.
Purpose of the Study:
- To investigate the impact of indirect protection on SARS-CoV-2 vaccine effectiveness estimates.
- To explain the discrepancy in VE reported by different studies.
- To propose a novel methodology for accurate VE estimation.
Main Methods:
- Developed a novel analytic heterogeneous infection model.
- Extended an agent-based model to incorporate heterogeneous interactions.
- Applied models to real-world regional data from Israel (early 2021).
- Estimated VE using population-based and secondary infection study designs.
Main Results:
- Estimated VE for an 85% efficacy vaccine ranged from 70-95% based on vaccinated/unvaccinated interactions.
- Different study designs capture varying interaction levels, explaining observed VE discrepancies.
- Proposed a methodology for accurate VE estimation independent of interaction knowledge.
Conclusions:
- Indirect protection significantly influences VE estimations.
- Study designs can introduce bias in VE reporting due to differing interaction captures.
- The proposed methodology offers a more accurate approach to understanding vaccine impact and informing public health policy.
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