Author: Wu, Joseph T.; Peak, Corey M.; Leung, Gabriel M.; Lipsitch, Marc
Title: Fractional Dosing of Yellow Fever Vaccine to Extend Supply: A Modeling Study Document date: 2016_11_10
ID: 02pjdufw_35
Snippet: Given the global shortage of YF vaccines, an additional benefit of fractionated dosing is to extend coverage to a wider geographic area, covering more populations with vaccine than could be achieved with standard dosing. Indeed, part of the WHO plan is to vaccinate border areas between Angola and Congo 25 , providing benefit to that population as well as an "immune buffer" to slow movement of disease toward Kinshasa. 26 We conclude that dose frac.....
Document: Given the global shortage of YF vaccines, an additional benefit of fractionated dosing is to extend coverage to a wider geographic area, covering more populations with vaccine than could be achieved with standard dosing. Indeed, part of the WHO plan is to vaccinate border areas between Angola and Congo 25 , providing benefit to that population as well as an "immune buffer" to slow movement of disease toward Kinshasa. 26 We conclude that dose fractionation could be a very effective strategy for improving coverage of YF vaccines and reducing infection attack rate in populations --possibly by a large absolute and relative margin --if high to moderate efficacy is maintained by reduceddose formulations. For vaccines whose standard formulations exceed WHO minimum concentration of viral particles, 10 this dose fractionation could be accomplished without changing the WHO recommendations. In particular, the WHO plan to use fractional dosing to extend the coverage of vaccination within Kinshasa and in surrounding areas is robust in the sense that it is expected to provide greater benefit than the use of full dosages, even if, counter to current evidence, efficacy of fractionated doses is substantially lower than that of standard doses.
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