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首页> 外文期刊>International Journal of Environmental Research and Public Health >Vaccination and Clinical Severity: Is the Effectiveness of Contact Tracing and Case Isolation Hampered by Past Vaccination?
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Vaccination and Clinical Severity: Is the Effectiveness of Contact Tracing and Case Isolation Hampered by Past Vaccination?

机译：疫苗接种和临床严重程度：过去的疫苗接种是否会影响接触者追踪和病例隔离的效果？

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While contact tracing and case isolation are considered as the first choice of interventions against a smallpox bioterrorist event, their effectiveness under vaccination is questioned, because not only susceptibility of host and infectiousness of case but also the risk of severe clinical manifestations among cases is known to be reduced by vaccine-induced immunity, thereby potentially delaying the diagnosis and increasing mobility among vaccinated cases. We employed a multi-type stochastic epidemic model, aiming to assess the feasibility of contact tracing and case isolation in a partially vaccinated population and identify data gaps. We computed four epidemiological outcome measures, i.e., (i) the threshold of a major epidemic under the interventions; (ii) the expected total number of cases; (iii) the probability of extinction, and (iv) the expected duration of an outbreak, demonstrating that all of these outcomes critically depend on the clinical impact of past vaccination on the diagnosis and movement of vaccinated cases. We discuss that, even in the absence of smallpox in the present day, one should consider the way to empirically quantify the delay in case detection and an increase in the frequency of contacts among previously vaccinated cases compared to unvaccinated during the early stage of an epidemic so that the feasibility of contact tracing and case isolation in a vaccinated population can be explicitly assessed.
机译：虽然接触者追踪和病例隔离被认为是预防天花生物恐怖事件的首选干预措施，但它们在疫苗接种下的有效性受到质疑，因为不仅已知宿主的易感性和病例的传染性，而且病例之间存在严重临床表现的风险疫苗诱导的免疫力会降低其免疫力，从而潜在地延迟诊断并增加接种病例之间的流动性。我们采用了多种类型的随机流行病模型，旨在评估在部分接种疫苗的人群中进行接触者追踪和病例隔离的可行性，并确定数据差距。我们计算了四种流行病学结果指标，即（i）干预措施下主要流行病的阈值; （ii）预期的案件总数; （iii）灭绝的可能性，以及（iv）爆发的预期持续时间，表明所有这些结果都主要取决于过去接种疫苗对接种病例的诊断和转移的临床影响。我们讨论了，即使在当前没有天花的情况下，也应该考虑一种方法，以经验的方式量化在流行病早期阶段与未接种疫苗的病例相比，先前接种疫苗的病例之间的病例发现延迟和接触频率的增加这样就可以明确评估在疫苗接种人群中进行接触者追踪和病例隔离的可行性。

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