Estimating the Epidemiologic Impact of TB Vaccines using Mathematical Models

使用数学模型估计结核疫苗的流行病学影响

• 批准号: 10525044
• 负责人: Kristin Nicole Bratton Nelson
• 金额: $ 13.11万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-18 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10525044
• 关键词: Accounting; Address; Adolescent; Adult; BCG Vaccine; Behavior; Biological; Birth; Cause of Death; Cessation of life; Communicable Diseases; Country; Data; Development; Disease; Disease Surveillance; Disease model; Epidemic; Epidemiology; Foundations; Future; Goals; Guatemala; HIV/TB; Health; Herd Immunity; Home; Household; Human; Human Resources; Immunization Programs; Incidence; India; Infection; Infection prevention; International; Interview; Lead; Location; Mentors; Modeling; Morbidity - disease rate; Mozambique; Pakistan; Participant; Pattern; Persons; Phase; Phase II Clinical Trials; Policies; Population; Prevalence; Recommendation; Reporting; Research; Research Personnel; Resources; Risk; Schools; Social Mobility; Source; Structure; Subunit Vaccines; Surveys; Testing; Time; Training; Tuberculosis; Tuberculosis Vaccines; United States National Institutes of Health; Universities; Vaccination; Vaccine Research; Vaccinee; Vaccines; Variant; Work; Workplace; World Health Organization; career; co-infection; community transmission; design; disease transmission; disorder prevention; epidemiologic data; evidence base; high risk; high risk population; implementation barriers; low and middle-income countries; mathematical model; mortality; novel vaccines; particle; prevent; programs; role model; skills; social contact; surveillance data; tool; transmission process; unvaccinated; vaccination schedule; vaccination strategy; vaccine distribution; vaccine trial

PROJECT SUMMARY/ABSTRACT Tuberculosis (TB) is a major cause of ill health and was the leading infectious cause of death in 2019, a burden felt disproportionately in low- and middle-income countries. To accelerate progress towards the World Health Organization’s ambitious goal to cut TB deaths by 95% and cases by 90% by 2035, new tools to prevent TB are essential. New and repurposed vaccines against TB hold promise to fill this gap: after decades of research, two TB vaccines have emerged from Phase II clinical trials with positive efficacy results. The existing BCG vaccine, currently given at birth, is being reconsidered for use (‘revaccination’) in adults after a Phase IIb trial showed 50% efficacy in preventing TB infection in adolescents. In a separate Phase IIb trial, subunit vaccine M72-AS01e was shown to be 50% efficacious in preventing TB disease in adults. The overarching objectives of this K01 are to (1) estimate the potential epidemiologic impact of new and repurposed TB vaccines; and (2) identify and assess potential vaccination strategies targeting high-risk groups. We will do this using data from the GlobalMix study, which will provide detailed country-specific social contact and mobility data from four countries – Mozambique, Guatemala, India, and Pakistan – with diverse TB epidemic profiles. Understanding potential differences in vaccine impact across countries can guide the design of further vaccine trials and inform strategies for introducing new and repurposed TB vaccines into immunization programs. This K01 project will provide Dr. Nelson with skills in conducting international field work as well as building, fitting, and analyzing TB transmission models to address questions with practical implications for TB vaccine policy and implementation. The mentoring team, Drs. Ben Lopman (Primary Mentor), Neel Gandhi (co-Mentor), Ted Cohen (co-Mentor), and Rob Breiman (co-Mentor), will provide Dr. Nelson with training in how to build and analyze models of TB transmission to estimate vaccine impact, the design and conduct of vaccine trials, and the role of modeling in development of evidence-based national and global vaccine policy. Home to the Emory Vaccine Center and the Center for TB Research, Emory University offers abundant resources for young investigators engaged in TB vaccine research, providing an ideal setting to carry out the proposed work. The TB vaccine modeling framework developed in this K01 will form the basis of a future NIH R01 proposal aiming to quantify country-level vaccine impact and develop country-specific recommendations for TB vaccine implementation in conjunction with TB vaccine experts and policymakers. The skills Dr. Nelson will develop have broad applicability to other infectious diseases, building a foundation for a career in infectious disease dynamics which will address vaccine implementation challenges for emerging and endemic infections.

项目摘要/摘要 结核病（TB）是疾病不良的主要原因，是2019年的主要感染原因，这是一个负担 在低收入和中等收入国家中，感觉不成比例。加速前进到世界健康 组织的雄心勃勃的目标是将结核病死亡人数减少95％，到2035年将案例减少90％，这是防止结核病的新工具 是必不可少的。针对结核病的新疫苗有望填补这一空白：经过数十年的研究， 从II期临床试验中出现了两种结核病疫苗，结果有效。现有的BCG 目前在出生时服用的疫苗正在重新考虑以供成年人使用后使用（“重新接种”） 显示了50％的效率，以防止青少年的结核病感染。在单独的IIB期试验中，亚基疫苗 M72-AS01E在预防成年人的结核病疾病方面效率为50％。总体目标 该K01是（1）估计新的和重新利用的结核病疫苗的潜在流行病学影响； （2） 识别并评估针对高风险群体的潜在疫苗策略。我们将使用来自 GlobalMix研究将提供四个国家的特定国家 /地区的社会联系和流动数据 国家 - 莫桑比克，危地马拉，印度和巴基斯坦 - 潜水员结核病流行概况。理解 各国疫苗影响的潜在差异可以指导进一步疫苗试验的设计， 告知将新的和重新利用的结核病疫苗引入免疫计划的策略。这个K01 项目将为尼尔森博士提供进行国际现场工作以及建筑，配件和 分析结核病传输模型，以解决对结核病疫苗政策和 执行。指导团队，博士。 Ben Lopman（主要导师），Neel Gandhi（联合学），TED 科恩（Cohen（Co-​​Incertor）和Rob Breiman（Co-​​Incermor），将为尼尔森博士提供有关如何建立和建造的培训 分析结核病传播模型以估计疫苗影响，疫苗试验的设计和行为以及 建模在循证国家和全球疫苗政策的发展中的作用。埃默里的故乡 埃默里大学疫苗中心和结核病研究中心为年轻人提供丰富的资源 从事结核病疫苗研究的研究人员提供了一个理想的环境来进行拟议的工作。 在本K01中开发的结核病疫苗建模框架将构成未来的NIH R01提案的基础 量化国家级疫苗影响并开发针对TB疫苗的特定国家 /地区建议 结合结核病疫苗专家和决策者的实施。纳尔逊博士将发展技能 对其他传染病有广泛的适用性，为传染病的职业奠定了基础 将针对新兴和内在感染的疫苗实施挑战的动态。