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Quantitative investigations of different vaccination policies for the control of congenital rubella syndrome (CRS) in the United Kingdom

Published online by Cambridge University Press:  19 October 2009

R. M. Anderson  and
B. T. Grenfell
R. M. Anderson
Affiliation:
Parasite Epidemiology Research Group, Department of Pure and Applied Biology, Imperial College, London University, London SW7 2BB, England
B. T. Grenfell
Affiliation:
Parasite Epidemiology Research Group, Department of Pure and Applied Biology, Imperial College, London University, London SW7 2BB, England
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The paper examines predictions of the impact of various one-, two- and three-stage vaccination policies on the incidence of congenital rubella syndrome (CRS) in the United Kingdom with the aid of a mathematical model of the transmission dynamics of rubella virus. Parameter estimates for the model are derived from either serological data or case notifications, and special attention is given to the significance of age-related changes in the rate of exposure to rubella infection and heterogeneous mixing between age groups. Where possible, model predictions are compared with observed epidemiological trends.

The principal conclusion of the analyses is that benefit is to be gained in the UK, both in the short and long term, by the introduction of a multiple-stage vaccination policy involving high levels of vaccination coverage of young male and female children (at around two years of age) and teenage girls (between the ages of 10–15 years), plus continued surveillance and vaccination of adult women in the child-bearing age classes. Model predictions suggest that to reduce the incidence of CRS in future years, below the level generated by a continuation of the current UK policy (the vaccination of teenage girls), would require high rates of vaccination > 60%) of both boys and girls at around two years of age. Numerical studies also suggest that uniform vaccination coverage levels of greater than 80–85% of young male and female children could, in the long term (40 years or more), eradicate rubella virus from the population. The robustness of these conclusions with respect to the accuracy of parameter estimates and various assumptions concerning the pattern of age-related change in exposure to infections and ‘who acquires infection from whom’ is discussed.

Type
Research Article
Information
Journal of Hygiene , Volume 96 , Issue 2 , April 1986 , pp. 305 - 333
Copyright
Copyright © Cambridge University Press 1986

References

REFERENCES

Anderson, R. M., Grenfell, B. T. & May, R. M. (1984). Oscillatory fluctuations in the incidence of infectious disease and the impact of vaccination. Journal of Hygiene 93, 587–608.CrossRefGoogle ScholarPubMed
Anderson, T. M. & May, R. M. (1982). Directly transmitted infectious diseases: control by vaccination. Science 215, 1053–1060.CrossRefGoogle ScholarPubMed
Anderson, R. M. & May, R. M. (1983 a). Vaccination against rubella and measles: quantitative investigations of different policies. Journal of Hygiene 90. 259–325.CrossRefGoogle ScholarPubMed
Anderson, R. M. & May, R. M. (1983 b). Two-stage vaccination programme against rubella. Lancet ii, 1416–1417.CrossRefGoogle Scholar
Anderson, R. M. & May, R. M. (1984). Spatial, temporal and genetic heterogeneity in host populations and the design of immunization programmes. IMA Journal of Mathematics Applied in Medicine and Biology 1. 233–266.CrossRefGoogle ScholarPubMed
Anderson, R. M. & May, R. M. (1985). Age-related changes in the rate of disease transmission: implications for the design of vaccination programmes. Journal of Hygiene 94. 365–436.CrossRefGoogle ScholarPubMed
Benenson, A. S. (1975). Control of Communicable Diseases in Man, 12th ed.Washington, D.C.: American Public Health Association.Google Scholar
Black, F. L. (1959). Measles antibodies in the population of New Haven, Connecticut. Journal of Immunology 83, 74–83.CrossRefGoogle ScholarPubMed
Collins, S. D. (1929). Age incidence of the common communicable diseases of children. United States Public Health Reports 44, 763–828.CrossRefGoogle Scholar
Dietz, K. (1975). The incidence of infectious diseases under the influence of seasonal fluctuations. Lecture Notes in Biomathematics 11, 1–15.Google Scholar
Fales, W. T. (1928). The age distribution of whooping cough, measles, chicken pox, scarlet fever and diphtheria in various areas of the United States. American Journal of Hygiene 8, 758–799.Google Scholar
Field, A. M. (1967). The occurrence of neutralizing and complement fixing antibiotics in rubella. Journal of Hygiene 65, 409–421.CrossRefGoogle Scholar
Fine, P. E. M. & Clarkson, J. A. (1982 a). Measles in England and Wales. I. An analysis of factors underlying seasonal patterns. International Journal of Epidemiology 11, 5–14.CrossRefGoogle ScholarPubMed
Fine, P. E. M. & Clarkson, J. A. (1982 b). Measles in England and Wales. II. The impact of the measles vaccination programme on the distribution of immunity in the population. International Journal of Epidemiology 11, 15–25.CrossRefGoogle ScholarPubMed
Fine, P. E. M. & Clarkson, J. A. (1984). Distribution of immunity to pertussis in the population of England and Wales. Journal of Hygiene 92, 21–36.CrossRefGoogle ScholarPubMed
Gregg, N. M. (1941). Congenital cataract following German measles in the mother. Transactions of the Ophthalmic Society of Australia 3, 35.Google Scholar
Grenfell, B. T. & Anderson, R. M. (1985). The estimation of age-related rates of infection from case notifications and serological data. Journal of Hygiene 95, 419–436.CrossRefGoogle ScholarPubMed
Griffiths, D. A. (1974). A catalytic model of infection for measles. Applied Statistics 23, 330–339.CrossRefGoogle Scholar
Hanshaw, J. B. & Dudgeon, J. A. (1978). Viral Diseases of the Foetus and Newborn. London: W. B. Saunders Company.Google Scholar
Hethcote, H. W. (1983). Measles and rubella in the United States. American Journal of Epidemiology 117, 2–13.CrossRefGoogle ScholarPubMed
Knox, E. G. (1980). Strategy for rubella vaccination. International Journal of Epidemiology 9, 13–23.CrossRefGoogle ScholarPubMed
Miller, C. L., Miller, E., Sequeira, P. J. L., Craddock-Watson, J. E., Langson, M. & Wiseberg, E. C. (1985). Effect of selective vaccination on rubella susceptibility and infection in pregnancy. British Medical Journal (In the Press.)Google Scholar
Miller, E., Craddock-Watson, J. E. & Pollock, T. M. (1982). Consequences of confirmed maternal rubella at successive stages of pregnancy. Lancet ii, 781–784.Google Scholar
MMWR (1984). Annual Summary 1983. U.S. Department of Health and Human Services.Google Scholar
Nokes, J., Anderson, R. M. & Anderson, M. J. (1985). Rubella transmission in South East England: a horizontal seroepidemiological study. Journal of Hygiene 96, 291—304.Google Scholar
O'Shea, S., Best, J. M., Banatvala, J. E., Marshall, W. C. & Dudgeon, J. A. (1982). Rubella vaccination: persistence of antibodies for up to 16 years. British Medical Journal 285, 253–255.CrossRefGoogle ScholarPubMed
O'Shea, S., Best, J. M., Banatvala, J. E., Marshall, W. C. & Dudgeon, J. A. (1984). Persistence of rubella antibody 8–28 years after vaccination. British Medical Journal 288, 1043.CrossRefGoogle Scholar
O'Shea, S., Best, J. M., Banatvala, J. E. & Shepherd, W. M. (1985). Development and persistence of class-specific antibodies in serum and nasopharyngeal washings of rubella vaccines. Journal of Infectious Diseases (In the Press.)CrossRefGoogle Scholar
Schenle, D. (1984). An Age-structured Model of Pre-and Post-vaccination Measles Transmission. IMA Journal of Mathematics Applied in Medicine and Biology 1, 169–192.CrossRefGoogle Scholar
South, M. A. & Sever, J. L. (1985). Teratogen update: the congenital rubella syndrome. Teratology 31, 297–307.CrossRefGoogle ScholarPubMed
Sydenstricker, E. & Hedrich, A. W. (1929). Completeness of reporting of measles, whooping cough and chicken pox in different ages. United States Public Health Reports 44, 1537–1543.Google Scholar