ABSTRACT

Objectives

The emergence of human pathogens with pandemic potential motivates rapid vaccine development. We explore the role of vaccines in control and eradication of a novel emerging pathogen.

Methods

We hypothetically simulate emergence of a novel wild poliovirus (nWPV) in 2020 assuming an immunologically naïve population. Assuming different nonpharmaceutical interventions (NPIs), we explore the impacts of vaccines resembling serotype-specific oral poliovirus vaccine (OPV), novel OPV (nOPV), or inactivated poliovirus vaccine (IPV).

Results

Vaccines most effectively change the trajectory of an emerging disease when disseminated early, rapidly, and widely in the background of ongoing strict NPIs, unless the NPIs successfully eradicate the emerging pathogen before it establishes endemic transmission. Without strict NPIs, vaccines primarily reduce the burden of disease in the remaining susceptible individuals and in new birth cohorts. Live virus vaccines that effectively compete with the nWPVs can reduce disease burdens more than other vaccines. When relaxation of existing NPIs occurs at the time of vaccine introduction, nWPV transmission can counterintuitively increase in the short term.

Conclusions

Vaccines can increase the probability of disease eradication in the context of strict NPIs. However, successful eradication will depend on specific immunization strategies used and a global commitment to eradication.

中文翻译：

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假设 2020 年出现脊灰病毒：第 2 部分。探索疫苗在控制和根除中的潜在作用

摘要

目标

具有大流行潜力的人类病原体的出现推动了疫苗的快速开发。我们探索疫苗在控制和根除新型病原体方面的作用。

方法

我们假设在 2020 年模拟了一种新的野生脊髓灰质炎病毒 (nWPV) 的出现，假设人群是免疫学上幼稚的。假设不同的非药物干预 (NPI)，我们探讨了类似于血清型特异性口服脊髓灰质炎病毒疫苗 (OPV)、新型 OPV (nOPV) 或灭活脊髓灰质炎病毒疫苗 (IPV) 的疫苗的影响。

结果

在持续严格的 NPI 的背景下，疫苗在早期、快速和广泛传播时最有效地改变新发疾病的轨迹，除非 NPI 在新出现的病原体建立地方性传播之前成功地根除它。如果没有严格的 NPI，疫苗主要是减轻剩余易感个体和新生儿群体的疾病负担。与 nWPV 有效竞争的活病毒疫苗比其他疫苗更能减轻疾病负担。如果在引入疫苗时放松现有 NPI，nWPV 传播可能会在短期内违反直觉地增加。

结论

在严格的非营利机构的情况下，疫苗可以增加根除疾病的可能性。然而，成功根除将取决于所使用的具体免疫策略和全球根除承诺。