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    Jan 16, 2021
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    Control of Ebola virus disease outbreaks: Comparison of health care worker-targeted and community vaccination strategies.

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    Robert et al - 2019 - Control ...
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    Authors
    Robert, A
    Camacho, A
    Edmunds, WJ
    Rosello A
    Baguelin, M
    Muyembe, JJT
    Eggo, RM
    Keita, S
    Issue Date
    2019-03-02
    Submitted date
    2019-05-10
    
    Metadata
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    Journal
    Epidemics
    Abstract
    Health care workers (HCW) are at risk of infection during Ebola virus disease outbreaks and therefore may be targeted for vaccination before or during outbreaks. The effect of these strategies depends on the role of HCW in transmission which is understudied. To evaluate the effect of HCW-targeted or community vaccination strategies, we used a transmission model to explore the relative contribution of HCW and the community to transmission. We calibrated the model to data from multiple Ebola outbreaks. We quantified the impact of ahead-of-time HCW-targeted strategies, and reactive HCW and community vaccination. We found that for some outbreaks (we call "type 1″) HCW amplified transmission both to other HCW and the community, and in these outbreaks prophylactic vaccination of HCW decreased outbreak size. Reactive vaccination strategies had little effect because type 1 outbreaks ended quickly. However, in outbreaks with longer time courses ("type 2 outbreaks"), reactive community vaccination decreased the number of cases, with or without prophylactic HCW-targeted vaccination. For both outbreak types, we found that ahead-of-time HCW-targeted strategies had an impact at coverage of 30%. The vaccine strategies tested had a different impact depending on the transmission dynamics and previous control measures. Although we will not know the characteristics of a new outbreak, ahead-of-time HCW-targeted vaccination can decrease the total outbreak size, even at low vaccine coverage.
    Publisher
    Elsevier
    URI
    http://hdl.handle.net/10144/619403
    DOI
    10.1016/j.epidem.2019.03.001
    PubMed ID
    30981563
    Language
    en
    ISSN
    1878-0067
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.epidem.2019.03.001
    Scopus Count
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