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dc.contributor.authorMarinelli, I.
dc.contributor.authorvan Lier, A.
dc.contributor.authorde Melker, H.
dc.contributor.authorPugliese, A. 
dc.contributor.authorvan Boven, M.
dc.date.accessioned2017-01-20T11:03:36Z
dc.date.available2017-01-20T11:03:36Z
dc.date.issued2016-12-31
dc.identifier.issn1755-4365
dc.identifier.urihttp://hdl.handle.net/20.500.11824/355
dc.description.abstractStudies into the impact of vaccination against the varicella zoster virus (VZV) have increasingly focused on herpes zoster (HZ), which is believed to be increasing in vaccinated populations with decreasing infection pressure. This idea can be traced back to Hope-Simpson's hypothesis, in which a person's immune status determines the likelihood that he/she will develop HZ. Immunity decreases over time, and can be boosted by contact with a person experiencing varicella (exogenous boosting) or by a reactivation attempt of the virus (endogenous boosting). Here we use transmission models to estimate age-specific rates of reactivation and immune boosting, exogenous as well as endogenous, using zoster incidence data from the Netherlands (2002–2011, n = 7026). The boosting and reactivation rates are estimated with splines, enabling these quantities to be optimally informed by the data. The analyses show that models with high levels of exogenous boosting and estimated or zero endogenous boosting, constant rate of loss of immunity, and reactivation rate increasing with age (to more than 5% per year in the elderly) give the best fit to the data. Estimates of the rates of immune boosting and reactivation are strongly correlated. This has important implications as these parameters determine the fraction of the population with waned immunity. We conclude that independent evidence on rates of immune boosting and reactivation in persons with waned immunity are needed to robustly predict the impact of varicella vaccination on the incidence of HZ.en_US
dc.description.sponsorshipPIENTER2 serological studyen_US
dc.formatapplication/pdfen_US
dc.language.isoengen_US
dc.rightsReconocimiento-NoComercial-CompartirIgual 3.0 Españaen_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/es/en_US
dc.subjectVaricellaen_US
dc.subjectZosteren_US
dc.subjectTransmission modelen_US
dc.subjectStatistical inferenceen_US
dc.subjectVaccinationen_US
dc.titleEstimation of age-specific rates of reactivation and immune boosting of the varicella zoster virusen_US
dc.typeinfo:eu-repo/semantics/articleen_US
dc.identifier.doi10.1016/j.epidem.2016.11.001
dc.relation.publisherversionhttp://dx.doi.org/10.1016/j.epidem.2016.11.001en_US
dc.relation.projectIDES/1PE/SEV-2013-0323en_US
dc.relation.projectIDEUS/BERC/BERC.2014-2017en_US
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessen_US
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersionen_US
dc.journal.titleEpidemicsen_US


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Reconocimiento-NoComercial-CompartirIgual 3.0 España
Except where otherwise noted, this item's license is described as Reconocimiento-NoComercial-CompartirIgual 3.0 España