title: Could a single dose of pneumococcal conjugate vaccine in children be effective? Modeling the optimal age of vaccination.
abstract: Using incidence rates from CDC's Active Bacterial Core surveillance and immunogenicity data from the Navajo/Apache trial of pneumococcal conjugate vaccine (PCV), we used Markov modeling to predict the optimal age to give a single dose of PCV. Antibody concentration thresholds of 0.35 and 1.0 mcg/ml were considered protective. Our outcome was vaccine serotype-specific invasive pneumococcal disease (IPD) incidence at 24 months. The models predicted the optimal age to vaccinate is 5-7 months with vaccine-induced immunologic memory and 8-10 months without memory. IPD reduction ranged from 15 to 62%, depending on model parameters. A single PCV dose in infants could prevent substantial IPD.
authors.affiliation: Emory University School of Medicine, Department of Pediatrics, Atlanta, GA, USA.
authors.forename: Ezra J
authors.initials: EJ
authors.lastname: Barzilay
authors.forename: Katherine L
authors.initials: KL
authors.lastname: O'Brien
authors.forename: Yeong S
authors.initials: YS
authors.lastname: Kwok
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hoekstra
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Zell
authors.forename: Raymond
authors.initials: R
authors.lastname: Reid
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.forename: Cynthia G
authors.initials: CG
authors.lastname: Whitney
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage / Q000276:immunology
chemical_list: D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate