Herd immunity conferred by killed oral cholera vaccines in Bangladesh: A reanalysis

Mohammad Ali, Michael Emch, Lorenz Von Seidlein, Mohammad Yunus, David Allen Sack, Malla Rao, Jan Holmgren, John D. Clemens

Research output: Contribution to journalArticle

Abstract

Background: Decisions about the use of killed oral cholera vaccines, which confer moderate levels of direct protection to vaccinees, can depend on whether the vaccines also provide indirect (herd) protection when high levels of vaccine coverage are attained. We reanalysed data from a field trial in Bangladesh to ascertain whether there is evidence of indirect protection from killed oral cholera vaccines. Methods: We analysed the first year of surveillance data from a placebo-controlled trial of B subunit-killed whole-cell and killed whole-cell-only oral cholera vaccines in children and adult women in Bangladesh. We calculated whether there was an inverse, monotonic trend for the relation between the level of vaccine coverage in a residential cluster and the incidence of cholera in individual vaccine recipients or placebo recipients residing in the cluster after controlling for potential confounding variables. Findings: Vaccine coverage of the targeted population ranged from 4% to 65%. Incidence rates of cholera among placebo recipients were inversely related to levels of vaccine coverage (7·01 cases per 1000 in the lowest quintile of coverage vs 1·47 cases per 1000 in the highest quintile; p

Original languageEnglish (US)
Pages (from-to)44-49
Number of pages6
JournalThe Lancet
Volume366
Issue number9479
DOIs
StatePublished - Jul 2 2005

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Cholera Vaccines
Herd Immunity
Bangladesh
Vaccines
Cholera
Placebos
Confounding Factors (Epidemiology)
Incidence
Population

ASJC Scopus subject areas

  • Medicine(all)

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Herd immunity conferred by killed oral cholera vaccines in Bangladesh : A reanalysis. / Ali, Mohammad; Emch, Michael; Von Seidlein, Lorenz; Yunus, Mohammad; Sack, David Allen; Rao, Malla; Holmgren, Jan; Clemens, John D.

In: The Lancet, Vol. 366, No. 9479, 02.07.2005, p. 44-49.

Research output: Contribution to journalArticle

Ali, M, Emch, M, Von Seidlein, L, Yunus, M, Sack, DA, Rao, M, Holmgren, J & Clemens, JD 2005, 'Herd immunity conferred by killed oral cholera vaccines in Bangladesh: A reanalysis', The Lancet, vol. 366, no. 9479, pp. 44-49. https://doi.org/10.1016/S0140-6736(05)66550-6
Ali, Mohammad ; Emch, Michael ; Von Seidlein, Lorenz ; Yunus, Mohammad ; Sack, David Allen ; Rao, Malla ; Holmgren, Jan ; Clemens, John D. / Herd immunity conferred by killed oral cholera vaccines in Bangladesh : A reanalysis. In: The Lancet. 2005 ; Vol. 366, No. 9479. pp. 44-49.
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