Imperial College London
Alternate

ProfessorPeterWhite

Faculty of Medicine, School of Public Health

Professor of Public Health Modelling
 
 
 
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Contact

 

p.white Website

 
 
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Location

 

Praed StreetSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Whittles:2020:cid/ciz1241,
author = {Whittles, LK and White, PJ and Didelot, X},
doi = {cid/ciz1241},
journal = {Clinical Infectious Diseases},
pages = {1912--1919},
title = {Assessment of the potential of vaccination to combat antibiotic resistance in gonorrhea: a modeling analysis to determine preferred product characteristics},
url = {http://dx.doi.org/10.1093/cid/ciz1241},
volume = {71},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Gonorrhea incidence is increasing rapidly in many countries, whilst antibiotic resistance is making treatment more difficult. Combined with evidence that MeNZB and Bexsero meningococcal vaccines are likely partially-protective against gonorrhea, this has renewed interest in a gonococcal vaccine, and several candidates are in development. Key questions are how protective a vaccine needs to be, how long protection needs to last, and how should it be targeted. We assessed vaccination's potential impact, and the feasibility of achieving WHO's target 90% reduction in gonorrhea incidence 2016-2030, by comparing realistic vaccination strategies under a range of scenarios of vaccine efficacy and duration of protection, and emergence of extensively-resistant gonorrhea. METHODS: We developed a stochastic transmission-dynamic model, incorporating asymptomatic and symptomatic infection and heterogeneous sexual behavior in men-who-have-sex-with-men (MSM). We used data from England, which has a comprehensive, consistent nationwide surveillance system. Using particle Markov Chain Monte Carlo methods we fitted the model to gonorrhea incidence in 2008-17, and then used Bayesian forecasting to examine an extensive range of scenarios. RESULTS: Even in the worst-case scenario of untreatable infection emerging, the WHO target is achievable if all MSM attending sexual health clinics receive a vaccine offering ≥52% protection for ≥6 years. A vaccine conferring 31% protection (as estimated for MeNZB) for 2-4 years, could reduce incidence in 2030 by 45% in the worst-case scenario, and by 75% if >70% of resistant gonorrhea remains treatable. CONCLUSIONS: Even a partially-protective vaccine, delivered through a realistic targeting strategy, could substantially reduce gonorrhea incidence, despite antibiotic resistance.
AU  - Whittles,LK
AU  - White,PJ
AU  - Didelot,X
DO  - cid/ciz1241
EP  - 1919
PY  - 2020///
SN  - 1058-4838
SP  - 1912
TI  - Assessment of the potential of vaccination to combat antibiotic resistance in gonorrhea: a modeling analysis to determine preferred product characteristics
T2  - Clinical Infectious Diseases
UR  - http://dx.doi.org/10.1093/cid/ciz1241
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31905399
UR  - http://hdl.handle.net/10044/1/76994
VL  - 71
ER  -
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