title: Projected Impact of Dengue Vaccination in Yucatán, Mexico.
abstract: Dengue vaccines will soon provide a new tool for reducing dengue disease, but the effectiveness of widespread vaccination campaigns has not yet been determined. We developed an agent-based dengue model representing movement of and transmission dynamics among people and mosquitoes in Yucatán, Mexico, and simulated various vaccine scenarios to evaluate effectiveness under those conditions. This model includes detailed spatial representation of the Yucatán population, including the location and movement of 1.8 million people between 375,000 households and 100,000 workplaces and schools. Where possible, we designed the model to use data sources with international coverage, to simplify re-parameterization for other regions. The simulation and analysis integrate 35 years of mild and severe case data (including dengue serotype when available), results of a seroprevalence survey, satellite imagery, and climatological, census, and economic data. To fit model parameters that are not directly informed by available data, such as disease reporting rates and dengue transmission parameters, we developed a parameter estimation toolkit called AbcSmc, which we have made publicly available. After fitting the simulation model to dengue case data, we forecasted transmission and assessed the relative effectiveness of several vaccination strategies over a 20 year period. Vaccine efficacy is based on phase III trial results for the Sanofi-Pasteur vaccine, Dengvaxia. We consider routine vaccination of 2, 9, or 16 year-olds, with and without a one-time catch-up campaign to age 30. Because the durability of Dengvaxia is not yet established, we consider hypothetical vaccines that confer either durable or waning immunity, and we evaluate the use of booster doses to counter waning. We find that plausible vaccination scenarios with a durable vaccine reduce annual dengue incidence by as much as 80% within five years. However, if vaccine efficacy wanes after administration, we find that there can be years with larger epidemics than would occur without any vaccination, and that vaccine booster doses are necessary to prevent this outcome.
authors.affiliation: Department of Biology, University of Florida, Gainesville, Florida, United States of America.|Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Thomas J
authors.identifier: 0000-0003-1819-6235
authors.initials: TJ
authors.lastname: Hladish
authors.affiliation: Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Carl A B
authors.initials: CA
authors.lastname: Pearson
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Chao
authors.affiliation: Department of Epidemiology, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Diana Patricia
authors.initials: DP
authors.lastname: Rojas
authors.affiliation: Institute for Intelligent Systems, University of Memphis, Memphis, Tennessee, United States of America.
authors.forename: Gabriel L
authors.initials: GL
authors.lastname: Recchia
authors.affiliation: Health Systems Research Center, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
authors.forename: Héctor
authors.initials: H
authors.lastname: Gómez-Dantés
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.|Center for Inference and Dynamics of Infectious Diseases, Seattle, Washington, United States of America.|Department of Biostatistics, University of Washington, Seattle, Washington, United States of America.
authors.forename: M Elizabeth
authors.initials: ME
authors.lastname: Halloran
authors.affiliation: Department of Biology, University of Florida, Gainesville, Florida, United States of America.|Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Juliet R C
authors.initials: JR
authors.lastname: Pulliam
authors.affiliation: Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America.|Department of Biostatistics, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Ira M
authors.initials: IM
authors.lastname: Longini
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D003715:Dengue / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D053059:Dengue Vaccines / Q000008:administration & dosage / Q000191:economics / Q000276:immunology; D058872:Epidemics / Q000517:prevention & control; D005260:Female; D005544:Forecasting; D006801:Humans; D017589:Immunization Programs; D007117:Immunization, Secondary; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D014611:Vaccination / Q000639:trends
chemical_list: D053059:Dengue Vaccines