The Potential Public Health Impact of Imperfect HIV-1 Vaccines
Roy Anderson and Stanley Plotkin
from: AIDS Vaccine Development: Challenges and Opportunities (Edited by: Wayne Koff, Patricia Kahn and Ian D. Gust). Caister Academic Press, U.K. (2007)
Abstract
The many biological uncertainties regarding vaccination against HIV make it likely that the first available vaccines will be only partly effective. The most likely scenario is that these vaccines may not prevent the establishment of infection, but instead might work by reducing viral load and transmission to sexual partners. Mathematical models indicate that such partially effective vaccines will be valuable only if protection is long-lasting and risk behaviour amongst vaccinees does not increase greatly. Therefore, once efficacy is demonstrated in a controlled trial, long- term follow-up will be necessary to determine vaccine effectiveness. Another issue is the effect of vaccination on viral load if vaccinees become infected, with current data suggesting that decreasing viral load would delay the onset of disease and greatly reduce transmission. Despite some caveats, suboptimal vaccines that give persistent sterile immunity or that slow disease progression and diminish transmission could have major public health benefits if properly used, particularly in mass vaccination campaigns read more ...
