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dc.contributor.authorFong, Youyi
dc.contributor.authorHalloran, M Elizabeth
dc.contributor.authorPark, Jin Kyung
dc.contributor.authorMarks, Florian
dc.contributor.authorClemens, John D
dc.contributor.authorChao, Dennis L
dc.date.accessioned2018-11-13T00:30:42Z
dc.date.available2018-11-13T00:30:42Z
dc.date.issued2018-02-20
dc.identifier.issn1471-2334
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/284960
dc.description.abstractBACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. children 5 years and older. The estimated efficacies are more similar to the previously published analysis based on the first two years of follow-up than the analysis based on all five years. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00289224.
dc.format.mediumElectronic
dc.languageeng
dc.publisherSpringer Science and Business Media LLC
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectCholera
dc.subjectCholera Vaccines
dc.subjectTreatment Outcome
dc.subjectAdministration, Oral
dc.subjectProportional Hazards Models
dc.subjectRisk Factors
dc.subjectFollow-Up Studies
dc.subjectDouble-Blind Method
dc.subjectPlacebo Effect
dc.subjectAdolescent
dc.subjectAdult
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectInfant
dc.subjectFemale
dc.subjectMale
dc.titleEfficacy of a bivalent killed whole-cell cholera vaccine over five years: a re-analysis of a cluster-randomized trial.
dc.typeArticle
prism.issueIdentifier1
prism.publicationDate2018
prism.publicationNameBMC Infect Dis
prism.startingPage84
prism.volume18
dc.identifier.doi10.17863/CAM.32331
dcterms.dateAccepted2018-01-29
rioxxterms.versionofrecord10.1186/s12879-018-2981-4
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-02-20
dc.contributor.orcidMarks, Florian [0000-0002-6043-7170]
dc.contributor.orcidChao, Dennis L [0000-0002-8253-6321]
dc.identifier.eissn1471-2334
rioxxterms.typeJournal Article/Review
cam.issuedOnline2018-02-20


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International