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At least 19 recordsLinked to original sources
PubMed2000

Herd immunity and herd effect: new insights and definitions.

The term herd immunity has been used by various authors to conform to different definitions. Earlier this situation had been identified but not corrected. We propose that it should have precise meaning for which purpose a new definition is offered: "the proportion of subjects with immunity in a given population". This definition dissociates herd immunity from the indirect protection observed in the unimmunised segment of a population in which a large proportion is immunised, for which the term 'herd effect' is proposed. It is defined as: "the reduction of infection or disease in the unimmunised segment as a result of immunising a proportion of the population". Herd immunity can be measured by testing a sample of the population for the presence of the chosen immune parameter. Herd effect can be measured by quantifying the decline in incidence in the unimmunised segment of a population in which an immunisation programme is instituted. Herd immunity applies to immunisation or infection, human to human transmitted or otherwise. On the other hand, herd effect applies to immunisation or other health interventions which reduce the probability of transmission, confined to infections transmitted human to human, directly or via vector. The induced herd immunity of a given vaccine exhibits geographic variation as it depends upon coverage and efficacy of the vaccine, both of which can vary geographically. Herd effect is determined by herd immunity as well as the force of transmission of the corresponding infection. Clear understanding of these phenomena and their relationships will help improve the design of effective and efficient immunisation programmes aimed at control, elimination or eradication of vaccine preventable infectious diseases.

Adult↗
PubMed2007

The economics of routine childhood hepatitis A immunization in the United States: the impact of herd immunity.

OBJECTIVES: Because of the herd-immunity phenomenon, the benefits of immunization against hepatitis A extend beyond those received by those who are vaccinated. This analysis estimates the impact of herd immunity on the cost-effectiveness of routine hepatitis A immunization among US children. PATIENTS AND METHODS: In an economic model, the costs and benefits of hepatitis A immunization were estimated for immunizing all US children at age 1 year over a 10-year period starting in 2005. The future burden of disease from hepatitis A was also estimated with this model, and the fraction that would be prevented by herd immunity was modeled by using a previously published analysis of the relationship between hepatitis A vaccination coverage and declines in hepatitis A incidence. RESULTS: Without accounting for herd-immunity effects, the costs of routine immunization would average 32,000 dollars per quality-adjusted life-year gained for the first 10 cohorts immunized starting with the 2005 birth cohort. Herd-immunity effects would be expected to produce substantial additional benefits, lowering the cost of the immunization program to 1000 dollars per quality-adjusted life-year gained for the first 10 cohorts. Herd-immunity benefits would be greatest for the first few cohorts, more than doubling the benefits of immunization, and would decline over time. In a univariate sensitivity analysis, estimates were most sensitive to vaccination costs but remained below 20,000 dollars per quality-adjusted life-year under all of the assumptions. CONCLUSIONS: Herd-immunity effects more than double the savings from hepatitis A immunization during the first 10 years of the program. After accounting for these effects, immunization is close to cost-neutral on a cost-per-quality-adjusted-life-year basis.

Child, Preschool↗
PubMed2005

Role of herd immunity in determining the effect of vaccines against sexually transmitted disease.

BACKGROUND: Vaccination programs provide both direct protection to those immunized and herd immunity, which is indirect protection of those who remain susceptible, owing to a reduced prevalence of infections. METHODS: The well-understood impact of vaccination against ubiquitous childhood infections is compared with that of vaccination against sexually transmitted infections (STIs), and theoretical insights are derived from a review of mathematical modeling studies. RESULTS: Typically, a large fraction of cases of STIs are acquired by those with modest risk, and these cases could be prevented by low-efficacy vaccines. If coverage is good, vaccination of only one sex can protect the other sex. Candidate vaccines against human papillomavirus (HPV) and genital herpes are in the final stages of testing. The former is likely to be highly efficacious for a limited number of disease-causing HPV types, and the latter has provided protection against disease in women who initially were seronegative for both herpes simplex virus (HSV) type 1 and HSV-2, with 73% efficacy. In models, this vaccine had a substantial impact when infectiousness was assumed to be reduced along with incidence of disease. CONCLUSION: With such vaccines on the horizon, the requirements for vaccine delivery need to be considered, particularly who should be vaccinated and at what age.

AIDS Vaccines↗
PubMed1991

Herd immunity and the HIV epidemic.

Background. Herd immunity describes the collective immunocompetence of a population and its ability to resist disease. The diseases of mycobacteria, salmonella, hepatitis A, cryptosporidia, syphilis, measles, influenza, and numerous others recently have been seen in epidemic proportions in the United States. An association between these superimposed secondary infections and the human immunodeficiency virus (HIV) epidemic can be made since the HIV's imposition on individual immunity has ramifications on a population level through a decline in herd immunity. Conclusion. Exploring these epidemic phenomena as consequential to a reduction in herd immunity can provide a unifying hypothesis to explain existing and predict future infectious disease epidemic dynamics. The benefits of acting upon these implications has advantages for both the HIV infected and the uninfected.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Economic evaluation of vaccination programs: the impact of herd-immunity.

The unique characteristic of vaccination is that it not only reduces the incidence of disease in those immunized but also indirectly protects nonvaccinated susceptibles against infection (produces herd-immunity). The bulk of economic evaluations of vaccination programs continue to use models that cannot take into account the indirect effects produced by herd-immunity. Here, the authors illustrate the importance of incorporating herd-immunity externalities when assessing the cost-effectiveness of vaccination progams. To do this, they compare 2 methods of estimating the benefits of routine mass vaccination: one that includes herd-immunity (dynamic approach) and one that does not (static approach). Finally, they use the results to clarify a number of misconceptions that are common in the literature concerning herd-immunity and dynamical effects produced by models.

Adolescent↗
PubMed1997

Simulation analysis of the effect of herd immunity and age structure on infection of a cattle herd with bluetongue viruses in Queensland, Australia.

A state-transition model based on Leslie matrix formulation was used to investigate the effects of herd immunity and age structure on the infection of a simulated cattle herd with bluetongue viruses under Australian climatic conditions. Increasing duration of immunity decreased the prevalence of infection. A duration of immunity of 33 months was consistent with prevalence estimates made from previous serological studies of bluetongue virus. Herd prevalence displayed slowly dampening cyclical variation over time (most pronounced when a short duration of immunity was simulated). Increasing calving and mortality risk rates in the simulated herd increased prevalence, whereas increasing age at first calving decreased prevalence. Manipulation of calving rates had the greatest effect on the predicted prevalence of infection in the herd. Simulation of a number of herd-management scenarios suggested that management systems in which cattle are bred early and where high calving rates are achieved are likely to contribute to high levels of infection with bluetongue viruses. Results confirm the importance of management factors in influencing the prevalence of infectious diseases in animal populations.

Aging↗
PubMed2001

Herd immunity after vaccination: how to quantify it and how to use it to halt disease.

In comparison to unvaccinated individuals, vaccinated individuals have fewer clinical symptoms, reduced susceptibility and reduced infectivity. The first two effects of vaccination can mean that each vaccinated individual is protected against clinical symptoms. From experiments and field trials, the extent of individual protection can be determined by a statistical analysis of the resulting data. In addition, there is an effect of the vaccination on the populations in which one or more individuals are vaccinated. This effect on the population is due to the effects of vaccination on susceptibility and infectivity of the vaccinated individuals. The population effect is called herd immunity and is observed as a reduction in chance of becoming infected when being part of a population with some of the individuals vaccinated. Note that the protection by herd immunity applies to vaccinated individuals as well as to unvaccinated individuals. Thus, protection against disease can be achieved not only by vaccinating the individuals that have to be protected but also by vaccinating other individuals in the same population. Such an application of herd immunity is especially important in protecting farm animals. To plan and evaluate vaccination at the population level, the herd immunity needs to be quantified. It will be illustrated that it is possible, not only theoretically but also practically, to quantify herd immunity among farm animals with data from small-scale experiments as well as with data from field trials.

Animal Diseases↗
PubMed2005

Herd immunity in adults against influenza-related illnesses with use of the trivalent-live attenuated influenza vaccine (CAIV-T) in children.

Highest attack rates for influenza occur in children. Immunization of schoolchildren with inactivated influenza vaccine in Michigan and Japan was associated with decreased morbidity and mortality, respectively, in older community contacts. An open-labeled, non-randomized, community-based trial in children with the cold adapted influenza vaccine, trivalent (CAIV-T) was initiated to determine the coverage necessary to reduce spread of influenza in the community. Age-specific baseline rates of medically attended acute respiratory illness (MAARI) for Scott and White Health Plan (SWHP) members at intervention (Temple and Belton) and comparison communities (Waco, Bryan, and College Station) were obtained in 1997-1998. During three subsequent vaccination years, 4298, 5251 and 5150 children received one dose per season of CAIV-T. Vaccinees represented 20-25% of the age-eligible children. Age-specific MAARI rates were compared for SWHP members in the intervention and comparison sites during the influenza outbreaks. Baseline age-specific MAARI rates per 100 persons for the influenza season were comparable between the intervention and comparison communities. In the subsequent three influenza seasons, the age groups 35-44, 45-54, 55-65 and >64 years experienced reductions in MAARI rates in the intervention communities. In adults > or =35 years of age, significant reductions in MAARI of 0.08 (95% CI: 0.04, 0.13), 0.18 (95% CI: 0.14, 0.22) and 0.15 (95% CI: 0.12, 0.19), were observed in the influenza seasons for vaccination years 1, 2 and 3, respectively. No consistent reduction in MAARI rates was detected in the younger age groups. Vaccination of approximately 20-25% of children, 1.5-18 years of age in the intervention communities resulted in an indirect protection of 8-18% against MAARI in adults > or =35 years of age.

Adolescent↗
PubMed2006

Network frailty and the geometry of herd immunity.

The spread of infectious disease through communities depends fundamentally on the underlying patterns of contacts between individuals. Generally, the more contacts one individual has, the more vulnerable they are to infection during an epidemic. Thus, outbreaks disproportionately impact the most highly connected demographics. Epidemics can then lead, through immunization or removal of individuals, to sparser networks that are more resistant to future transmission of a given disease. Using several classes of contact networks-Poisson, scale-free and small-world-we characterize the structural evolution of a network due to an epidemic in terms of frailty (the degree to which highly connected individuals are more vulnerable to infection) and interference (the extent to which the epidemic cuts off connectivity among the susceptible population that remains following an epidemic). The evolution of the susceptible network over the course of an epidemic differs among the classes of networks; frailty, relative to interference, accounts for an increasing component of network evolution on networks with greater variance in contacts. The result is that immunization due to prior epidemics can provide greater community protection than random vaccination on networks with heterogeneous contact patterns, while the reverse is true for highly structured populations.

Animal Diseases↗
PubMedDate not supplied

[Status of herd immunity to poliomyelitis in children in the Moscow region].

The paper presents the results of 3-year observations of the status of herd immunity to poliomyelitis in 7 towns of the Moscow region. In individual years antibody for poliomyelitis virus of 3 types was found in 63-74% of the examined children and from 2.7 to 7.5% of children were triple-negative. Insufficient levels of herd immunity to poliovirus types I and III were found. Some factors are analysed which could have some influence on the decline of herd immunity.

Adolescent↗