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Vaccination against colonizing bacteria with multiple serotypes

M Lipsitch1

  • 1Department of Biology, Emory University, Atlanta, GA 30322, USA.

Proceedings of the National Academy of Sciences of the United States of America
|June 10, 1997
PubMed
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Vaccination against specific Streptococcus pneumoniae and Haemophilus influenzae serotypes can lead to the increase of other serotypes. Mathematical modeling shows this serotype replacement is complex and depends on the number of interacting serotypes.

Area of Science:

  • Immunology
  • Epidemiology
  • Mathematical Biology

Background:

  • Conjugate vaccines provide serotype-specific protection against Streptococcus pneumoniae and Haemophilus influenzae.
  • Concerns exist regarding potential increases in nontargeted serotypes following vaccination due to serotype replacement.

Purpose of the Study:

  • To analyze a mathematical model predicting serotype replacement dynamics in response to conjugate vaccination.
  • To determine factors influencing the extent of nontargeted serotype increase and serotype coexistence or exclusion.

Main Methods:

  • Mathematical modeling of competing bacterial serotypes under mass vaccination scenarios.
  • Derivation of conditions for competitive exclusion and coexistence.
  • Determination of equilibrium carriage levels for targeted and nontargeted serotypes.

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Main Results:

  • Serotype-specific vaccines have a lower eradication threshold for targeted serotypes compared to bivalent vaccines.
  • In two-serotype models, nontargeted serotype increase is less than targeted serotype reduction.
  • With three or more interacting serotypes, vaccination may increase carriage of one nontargeted serotype more than it decreases a targeted serotype.

Conclusions:

  • Serotype replacement is a complex phenomenon influenced by the number of interacting serotypes and vaccine characteristics.
  • Theoretical findings offer insights into observed serotype replacement post-vaccination, informing vaccine policy decisions.