Med Decis Making - Prevalence of antibodies associated with herd immunity: a new indicator to evaluate the establishment of herd immunity and to decide immunization strategies.

Tópicos

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Resumo

JECTIVE: To develop a method to estimate the critical prevalence of antibodies associated with herd immunity (p(c)) and to assess the establishment of herd immunity against measles, mumps, rubella, varicella, and pertussis in Catalonia (Spain) using this method.METHODS: The herd immunity is established when the prevalence of antibodies (positive serological results) is higher than p(c) = I(c) Se/PV, where I(c) is the prevalence of protected individuals necessary to block the transmission of an infection in the population, Se is the sensitivity of the serological test, and PV is the predictive value of a positive serological result. The establishment of herd immunity was assessed comparing the age-group specific p(c) with the prevalence of antibodies (p) observed in Catalonia in 2002 in schoolchildren (6-9 years) and individuals aged 14 to 29 years and 45 to 54 years.RESULTS: The herd immunity was not established (p < p(c)) against measles, mumps, and varicella in schoolchildren aged 6 to 9 years, against measles in individuals aged 15 to 24 years, and against pertussis in all age groups. Based on these results, the measles-mumps-rubella (MMR) vaccine should be given to schoolchildren and individuals aged 15 to 24 years, the varicella vaccine to schoolchildren aged 6 to 9 years, and the diphtheria-tetanus-pertussis (DTaP/dTaP) vaccine to all age groups in order to establish the necessary herd immunity in the population.CONCLUSION: Serological surveys and the critical prevalence of antibodies can be used to assess the establishment of herd immunity for vaccine-preventable diseases in different population groups, indicating to which of them immunization activities should be prioritized.

Resumo Limpo

jectiv develop method estim critic preval antibodi associ herd immun pc assess establish herd immun measl mump rubella varicella pertussi catalonia spain use methodmethod herd immun establish preval antibodi posit serolog result higher pc ic sepv ic preval protect individu necessari block transmiss infect popul se sensit serolog test pv predict valu posit serolog result establish herd immun assess compar agegroup specif pc preval antibodi p observ catalonia schoolchildren year individu age year yearsresult herd immun establish p pc measl mump varicella schoolchildren age year measl individu age year pertussi age group base result measlesmumpsrubella mmr vaccin given schoolchildren individu age year varicella vaccin schoolchildren age year diphtheriatetanuspertussi dtapdtap vaccin age group order establish necessari herd immun populationconclus serolog survey critic preval antibodi can use assess establish herd immun vaccineprevent diseas differ popul group indic immun activ priorit

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