title: Use of vaccines as probes to define disease burden.
abstract: Vaccine probe studies have emerged in the past 15 years as a useful way to characterise disease. By contrast, traditional studies of vaccines focus on defining the vaccine effectiveness or efficacy. The underlying basis for the vaccine probe approach is that the difference in disease burden between vaccinated and unvaccinated individuals can be ascribed to the vaccine-specific pathogen. Vaccine probe studies can increase understanding of a vaccine's public health value. For instance, even when a vaccine has a seemingly low efficacy, a high baseline disease incidence can lead to a large vaccine-preventable disease burden and thus that population-based vaccine introduction would be justified. So far, vaccines have been used as probes to characterise disease syndromes caused by Haemophilus influenzae type b, pneumococcus, rotavirus, and early infant influenza. However, vaccine probe studies have enormous potential and could be used more widely in epidemiology, for example, to define the vaccine-preventable burden of malaria, typhoid, paediatric influenza, and dengue, and to identify causal interactions between different pathogens.
authors.affiliation: International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: dfeikin@jhsph.edu.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Feikin
authors.affiliation: KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: J Anthony G
authors.initials: JA
authors.lastname: Scott
authors.affiliation: Agence de Médecine Préventive, Ferney-Voltaire, France.
authors.forename: Bradford D
authors.initials: BD
authors.lastname: Gessner
mesh_terms: D003140:Communicable Disease Control / Q000379:methods; D003141:Communicable Diseases / Q000453:epidemiology*; D017281:Cost of Illness; D003906:Developing Countries; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic / Q000941:ethics / Q000379:methods; D012107:Research Design; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control; D014612:Vaccines; D014765:Viral Vaccines
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D014612:Vaccines; D014765:Viral Vaccines