Successes and Failures of the Live-attenuated Influenza Vaccine: Can We Do Better?
| العنوان: | Successes and Failures of the Live-attenuated Influenza Vaccine: Can We Do Better? |
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| المؤلفون: | Laura Matrajt, Rustom Antia, M. Elizabeth Halloran |
| المصدر: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| بيانات النشر: | Oxford University Press, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Microbiology (medical), Influenza vaccine, business.industry, Strain (biology), Influenza season, live-attenuated influenza vaccine (LAIV), Biology, Antigenic distance, Infectious Diseases, Vaccine strain, AcademicSubjects/MED00290, Antigen, Immunity, vaccine, Immunology, Medicine, Live attenuated influenza vaccine, business, influenza, Articles and Commentaries, mathematical model |
| الوصف: | Background The effectiveness of the live-attenuated influenza vaccine (LAIV) can vary widely, ranging from 0% to 50%. The reasons for these discrepancies remain largely unclear. Methods We use mathematical models to explore how the efficacy of LAIV is affected by the degree of mismatch with the currently circulating influenza strain and interference with pre-existing immunity. The models incorporate 3 key antigenic distances: the distances between the vaccine strain, pre-existing immunity, and the challenge strain. Results Our models show that an LAIV that is matched with the currently circulating strain is likely to have only modest efficacy. Our results suggest that the efficacy of the vaccine would be increased (optimized) if, rather than being matched to the circulating strain, it is antigenically slightly further from pre-existing immunity than the circulating strain. The models also suggest 2 regimes in which LAIV that is matched to circulating strains may be protective: in children before they have built immunity to circulating strains and in response to novel strains (such as antigenic shifts) which are at substantial antigenic distance from previously circulating strains. We provide an explanation for the variation in vaccine effectiveness between studies and countries of vaccine effectiveness observed during the 2014–2015 influenza season. Conclusions LAIV is offered to children across the world; however, its effectiveness significantly varies between studies. Here, we propose a mechanistic explanation to understand these differences. We further propose a way to select the LAIV strain that would have a higher chance of being protective. Live-attenuated influenza vaccine (LAIV) studies have found effectiveness ranging from 0–50%. Using mathematical models we show that this can be the result of negative interference and LAIV will not be immunogenic for broad regimes. We make suggestions for optimally choosing vaccine strains. |
| اللغة: | English |
| تدمد: | 1537-6591 1058-4838 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9ea067b4063c9870f72adf0490cfaf03 http://europepmc.org/articles/PMC7319054 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9ea067b4063c9870f72adf0490cfaf03 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15376591 10584838 |
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