PDF(Pubmed)
Abstract：
UNASSIGNED: CYD-TDV (Dengvaxia®) was the first dengue vaccine approved, launched in Brazil in 2015 for individuals aged 9-44 years. We aimed to estimate the effectiveness of CYD-TDV in preventing symptomatic dengue cases during a campaign targeting individuals aged 15-27 years in selected municipalities in Paraná, Brazil. Additionally, we examined whether a history of dengue, as recorded by the surveillance system, modified the vaccine\'s effectiveness.
UNASSIGNED: We conducted a case-cohort analysis comparing the frequency of vaccination, with at least one dose of CYD-TDV, in individuals with dengue confirmed by RT-PCR, identified by the surveillance system during 2019 and 2020, with the vaccination coverage in the target population. Moreover, in a case-control design using weighted controls, we assessed the documented history of dengue as a modifier of the vaccine\'s effectiveness. We used a logistic random-effects regression model, with data clustered in municipalities and incorporating covariates such as the incidence of dengue before the campaign, age, and sex. We calculated vaccine effectiveness (VE) as (1-relative risk) x 100%.
UNASSIGNED: 1869 dengue cases were identified, which had a vaccination frequency significantly lower than the overall vaccination coverage in the target population (50.3% vs. 57.2%, respectively; overall VE: 21.3%; 95% confidence interval [CI]: 13.4%-28.4%). In individuals with a documented history of dengue, vaccination had a VE of 71% (95% CI: 58%-80%) in reducing the incidence of dengue. However, vaccination was not associated with a significant reduction in the overall dengue case risk in individuals without a documented history of dengue (VE: 12%; 95% CI: -21% to 36%). In this last stratum, vaccination was associated with reduced cases due to DENV-1 and DENV-4, but an excess of DENV-2 cases.
UNASSIGNED: Vaccination led to a significant reduction in reported dengue cases within the target population. The case-control design suggested that this reduction was primarily driven by the benefits observed in individuals with a documented history of dengue. In endemic regions with limited serological testing facilities, a previous history of dengue diagnosis recorded by epidemiological surveillance could be used to triage candidates for CYD-TDV vaccination.
UNASSIGNED: Research supported by Sanofi.
UNASSIGNED: We conducted a case-cohort analysis comparing the frequency of vaccination, with at least one dose of CYD-TDV, in individuals with dengue confirmed by RT-PCR, identified by the surveillance system during 2019 and 2020, with the vaccination coverage in the target population. Moreover, in a case-control design using weighted controls, we assessed the documented history of dengue as a modifier of the vaccine\'s effectiveness. We used a logistic random-effects regression model, with data clustered in municipalities and incorporating covariates such as the incidence of dengue before the campaign, age, and sex. We calculated vaccine effectiveness (VE) as (1-relative risk) x 100%.
UNASSIGNED: 1869 dengue cases were identified, which had a vaccination frequency significantly lower than the overall vaccination coverage in the target population (50.3% vs. 57.2%, respectively; overall VE: 21.3%; 95% confidence interval [CI]: 13.4%-28.4%). In individuals with a documented history of dengue, vaccination had a VE of 71% (95% CI: 58%-80%) in reducing the incidence of dengue. However, vaccination was not associated with a significant reduction in the overall dengue case risk in individuals without a documented history of dengue (VE: 12%; 95% CI: -21% to 36%). In this last stratum, vaccination was associated with reduced cases due to DENV-1 and DENV-4, but an excess of DENV-2 cases.
UNASSIGNED: Vaccination led to a significant reduction in reported dengue cases within the target population. The case-control design suggested that this reduction was primarily driven by the benefits observed in individuals with a documented history of dengue. In endemic regions with limited serological testing facilities, a previous history of dengue diagnosis recorded by epidemiological surveillance could be used to triage candidates for CYD-TDV vaccination.
UNASSIGNED: Research supported by Sanofi.
摘要：
■CYD-TDV（Dengvaxia®）是第一个批准的登革热疫苗，2015年在巴西推出，面向9-44岁的个人。我们旨在评估CYD-TDV在预防有症状的登革热病例中的有效性，该活动针对巴拉那州选定城市的15-27岁的个人，巴西。此外,我们检查了登革热的历史，根据监控系统的记录,改变了疫苗的有效性。
■我们进行了病例队列分析，比较了疫苗接种的频率，至少服用一剂CYD-TDV,在通过RT-PCR确认的登革热个体中，由监测系统在2019年和2020年确定，目标人群的疫苗接种覆盖率。此外，在使用加权控制的案例控制设计中，我们评估了登革热作为疫苗有效性调节剂的历史。我们使用了逻辑随机效应回归模型，数据聚集在市政当局中，并结合了协变量，如运动前的登革热发病率，年龄,和性爱。我们计算疫苗有效性(VE)为(1-相对风险)×100%。
■确定了1869例登革热病例，其疫苗接种频率显著低于目标人群的总体疫苗接种覆盖率(50.3%vs.57.2%,分别为；总体VE：21.3%；95%置信区间[CI]：13.4%-28.4%）。在有登革热病史的人中，疫苗接种在降低登革热发病率方面的VE为71%(95%CI:58%-80%).然而,在没有登革热病史的个体中,接种疫苗与登革热总体风险的显著降低无关(VE:12%;95%CI:-21%~36%).在这最后一层，疫苗接种与DENV-1和DENV-4引起的病例减少相关,但DENV-2病例过多。
■疫苗接种导致目标人群中报告的登革热病例显着减少。病例对照设计表明，这种减少主要是由在有登革热病史的个体中观察到的益处驱动的。在血清学检测设施有限的流行地区，通过流行病学监测记录的既往登革热诊断史可用于筛选CYD-TDV疫苗的候选者.
■赛诺菲支持的研究。
■我们进行了病例队列分析，比较了疫苗接种的频率，至少服用一剂CYD-TDV,在通过RT-PCR确认的登革热个体中，由监测系统在2019年和2020年确定，目标人群的疫苗接种覆盖率。此外，在使用加权控制的案例控制设计中，我们评估了登革热作为疫苗有效性调节剂的历史。我们使用了逻辑随机效应回归模型，数据聚集在市政当局中，并结合了协变量，如运动前的登革热发病率，年龄,和性爱。我们计算疫苗有效性(VE)为(1-相对风险)×100%。
■确定了1869例登革热病例，其疫苗接种频率显著低于目标人群的总体疫苗接种覆盖率(50.3%vs.57.2%,分别为；总体VE：21.3%；95%置信区间[CI]：13.4%-28.4%）。在有登革热病史的人中，疫苗接种在降低登革热发病率方面的VE为71%(95%CI:58%-80%).然而,在没有登革热病史的个体中,接种疫苗与登革热总体风险的显著降低无关(VE:12%;95%CI:-21%~36%).在这最后一层，疫苗接种与DENV-1和DENV-4引起的病例减少相关,但DENV-2病例过多。
■疫苗接种导致目标人群中报告的登革热病例显着减少。病例对照设计表明，这种减少主要是由在有登革热病史的个体中观察到的益处驱动的。在血清学检测设施有限的流行地区，通过流行病学监测记录的既往登革热诊断史可用于筛选CYD-TDV疫苗的候选者.
■赛诺菲支持的研究。
