Epidemiology and Infection

Methods and modelling

Modelling immunization strategies with cytomegalovirus vaccine candidates

R. S. AZEVEDOa1 c1 and M. AMAKUa2

a1 Departamento de Patologia & LIM 01 HC, Faculdade de Medicina, Universidade de São Paulo, Brazil

a2 Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, Brazil

SUMMARY

In order to analyse the impact of vaccination against cytomegalovirus (CMV) on congenital infection incidence using current vaccines tested in phase II clinical trials, we simulated different scenarios by mathematical modelling, departing from the current vaccine characteristics, varying age at vaccination, immunity waning, vaccine efficacy and mixing patterns. Our results indicated that the optimal age for a single vaccination interval is from 2 to 6 months if there is no immunity waning. Congenital infection may increase if vaccine-induced immunity wanes before 20 years. Congenital disease should increase further when the mixing pattern includes transmission among children with a short duration of protection vaccine. Thus, the best vaccination strategy is a combined schedule: before age 1 year plus a second dose at 10–11 years. For CMV vaccines with low efficacy, such as the current ones, universal vaccination against CMV should be considered for infants and teenagers.

(Accepted February 16 2011)

(Online publication March 14 2011)

Correspondence:

c1 Author for correspondence: Professor R. S. Azevedo, Departamento de Patologia, Avenida Doutor Arnaldo 455, São Paulo, SP, 01246-903, Brazil. (Email: razevedo@usp.br)

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