Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children

Root, Elisabeth Dowling, Lucero, Marilla, Nohynek, Hanna, Anthamatten, Peter, Thomas, Deborah S. K., Tallo, Veronica, Tanskanen, Antti, Quiambao, Beatriz P., Puumalainen, Taneli, Lupisan, Socorro P., Ruutu, Petri, Ladesma, Erma, Williams, Gail M., Riley, Ian and Simoes, Eric A. F. (2014) Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children. Proceedings of the National Academy of Sciences of the United States of America, 111 9: 3520-3525. doi:10.1073/pnas.1313748111


Author Root, Elisabeth Dowling
Lucero, Marilla
Nohynek, Hanna
Anthamatten, Peter
Thomas, Deborah S. K.
Tallo, Veronica
Tanskanen, Antti
Quiambao, Beatriz P.
Puumalainen, Taneli
Lupisan, Socorro P.
Ruutu, Petri
Ladesma, Erma
Williams, Gail M.
Riley, Ian
Simoes, Eric A. F.
Title Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children
Journal name Proceedings of the National Academy of Sciences of the United States of America   Check publisher's open access policy
ISSN 0027-8424
1091-6490
Publication date 2014-03
Year available 2014
Sub-type Article (original research)
DOI 10.1073/pnas.1313748111
Open Access Status
Volume 111
Issue 9
Start page 3520
End page 3525
Total pages 6
Place of publication Washington, DC United States
Publisher National Academy of Sciences
Collection year 2015
Language eng
Formatted abstract
Pneumococcal conjugate vaccines (PCVs) have demonstrated efficacy against childhood pneumococcal disease in several regions globally. We demonstrate how spatial epidemiological analysis of a PCV trial can assist in developing vaccination strategies that target specific geographic subpopulations at greater risk for pneumococcal pneumonia. We conducted a secondary analysis of a randomized, placebo-controlled, double-blind vaccine trial that examined the efficacy of an 11-valent PCV among children less than 2 y of age in Bohol, Philippines. Trial data were linked to the residential location of each participant using a geographic information system. We use spatial interpolation methods to create smoothed surface maps of vaccination rates and local-level vaccine efficacy across the study area. We then measure the relationship between distance to the main study hospital and local-level vaccine efficacy, controlling for ecological factors, using spatial autoregressive models with spatial autoregressive disturbances. We find a significant amount of spatial variation in vaccination rates across the study area. For the primary study endpoint vaccine efficacy increased with distance from the main study hospital from −14% for children living less than 1.5 km from Bohol Regional Hospital (BRH) to 55% for children living greater than 8.5 km from BRH. Spatial regression models indicated that after adjustment for ecological factors, distance to the main study hospital was positively related to vaccine efficacy, increasing at a rate of 4.5% per kilometer distance. Because areas with poor access to care have significantly higher VE, targeted vaccination of children in these areas might allow for a more effective implementation of global programs.
Keyword Spatial epidemiology
Spatial analysis
Targeted intervention
Randomized controlled trial
Placebo controlled trial
Systematic Analysis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
 
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