论文标题

估计疫苗有效性的减弱:一项模拟研究

Estimating Waning of Vaccine Effectiveness: a Simulation Study

论文作者

Nikas, Ariel, Ahmed, Hasan, Zarnitsyna, Veronika I.

论文摘要

开发准确可靠的方法来估计疫苗保护是免疫学和公共卫生的关键目标。尽管已经提出了几种统计方法,但需要严格研究疫苗诱导的保护的季节内季节中的潜在不准确性。为了比较疫苗有效性(VE)估计的统计方法,我们使用基于多尺度药物的流行病模型生成了模拟数据,该模型具有急性病毒感染和VE衰减的不同程度。我们根据观察数据丰富度扩展了先前提出的VE措施框架,以评估疫苗诱导的随着时间的影响的变化。尽管基于难以收集的信息(例如,暴露的确切时间安排)的VE措施是准确的,但通常研究依赖于感染时间和COX比例危害模型。我们发现,它利用缩放的Schoenfeld残差(以前提出的用于捕获VE衰减的残差)的扩展是在捕获衰落程度及其功能形式的程度并确定了导致这种不可靠性的数学因素。我们展示了COX模型中的分区时间和包括时间疫苗的相互作用项显着改善了VE的估计,即使在急剧,快速减弱的情况下也是如此。我们还建议如何优化分区方案。使用模拟数据,我们比较了VE的不同度量,以捕获疫苗诱导的保护的季节内减弱。我们提出了基于包括时间疫苗相互作用项的COX模型的扩展,并进一步优化了分区时间。这些发现可能指导观察数据中VE的未来分析。

Developing accurate and reliable methods to estimate vaccine protection is a key goal in immunology and public health. While several statistical methods have been proposed, their potential inaccuracy in capturing fast intra-seasonal waning of vaccine-induced protection needs to be rigorously investigated. To compare statistical methods for vaccine effectiveness (VE) estimation, we generated simulated data using a multiscale agent-based model of an epidemic with an acute viral infection and differing extents of VE waning. We extended the previously proposed framework for VE measures based on the observational data richness to assess changes of vaccine-induced protection with time. While VE measures based on hard-to-collect information (e.g. exact timing of exposures) were accurate, usually VE studies rely on time-to-infection data and the Cox proportional hazard model. We found that its extension utilizing scaled Schoenfeld residuals, previously proposed for capturing VE waning, was unreliable in capturing both the degree of waning and its functional form and identified the mathematical factors contributing to this unreliability. We showed that partitioning time and including a time-vaccine interaction term in the Cox model significantly improved estimation of VE waning, even in the case of dramatic, rapid waning. We also proposed how to optimize the partitioning scheme. Using simulated data, we compared different measures of VE for capturing the intra-seasonal waning of vaccine-induced protection. We propose an extension of the Cox model based on including a time-vaccine interaction term with further optimization of partitioning time. These findings may guide future analysis of VE waning in observational data.

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