Efficacy of a bivalent killed whole-cell cholera vaccine over five years: a re-analysis of a cluster-randomized trial

BMC Infectious Diseases
Youyi FongDennis L Chao

Abstract

Oral cholera vaccine (OCV) is a feasible tool to prevent or mitigate cholera outbreaks. A better understanding of the vaccine's efficacy among different age groups and how rapidly its protection wanes could help guide vaccination policy. To estimate the level and duration of OCV efficacy, we re-analyzed data from a previously published cluster-randomized, double-blind, placebo controlled trial with five years of follow-up. We used a Cox proportional hazards model and modeled the potentially time-dependent effect of age categories on both vaccine efficacy and risk of infection in the placebo group. In addition, we investigated the impact of an outbreak period on model estimation. Vaccine efficacy was 38% (95% CI: -2%,62%) for those vaccinated from ages 1 to under 5 years old, 85% (95% CI: 67%,93%) for those 5 to under 15 years, and 69% (95% CI: 49%,81%) for those vaccinated at ages 15 years and older. Among adult vaccinees, efficacy did not appear to wane during the trial, but there was insufficient data to assess the waning of efficacy among child vaccinees. Through this re-analysis we were able to detect a statistically significant difference in OCV efficacy when the vaccine was administered to children under 5 years old vs. c...Continue Reading

References

May 22, 1998·American Journal of Epidemiology·L K DurhamM Rao
Mar 31, 2012·Bulletin of the World Health Organization·Mohammad AliJohn Clemens
May 30, 2014·The New England Journal of Medicine·Francisco J LuqueroRebecca F Grais
Sep 3, 2014·PLoS Medicine·Dang Duc AnhDavid A Sack
Jan 2, 2015·Bulletin of the World Health Organization·Stephen MartinDavid A Sack
Jun 5, 2015·PLoS Neglected Tropical Diseases·Mohammad AliDavid A Sack

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Citations

Sep 23, 2021·The Journal of Infectious Diseases·Dennis L Chao

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Clinical Trials Mentioned

NCT00289224

Software Mentioned

R Foundation for Statistical Computing
kyotil
R programming system
R

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