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American Journal of Epidemiology Vol. 147, No. 10: 948-959
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health

other

Estimation of Vaccine Efficacy in the Presence of Waning: Application to Cholera Vaccines

L. Kathryn Durham1 3, Ira M. Longini, Jr.1,, M. Elizabeth Halloran1, John D. Clemens2, Nizam Azhar1 and Malla Rao2

1 Department of Biostatistics, The Rollins School of Public Health, Emory University Atlanta, GA.
2Division of Epidemiology, Statistics, and Prevention, National Institute of Child Health and Human Development, National Institutes of Health Bethesda, MD.

Reprint requests to Dr. Ira M. Longini, Jr., Department of Biotistics, The Rollins School of Public Health, Emory University, Atlanta, GA 30322.

The authors present a nonparametric method for estimating vaccine efficacy as a smooth function of time from vaccine trials. Use of the method requires a minimum of assumptions. Estimation is based on the smoothed case hazard rate ratio comparing the vaccinated with the unvaccinated. The estimation procedure allows investigators to assess time-varying changes in vaccine-induced protection, such as those produced by waning and boosting. The authors use the method to reanalyze data from a vaccine trial of two cholera vaccines in rural Bangladesh. This analysis reveals the differential protection and waning effects for the vaccines as a function of biotype and age. Am J Epidemiol 1998; 147: 948–59.

cholera; communicable diseases; epidemiologic methods; statistics; survival analysis; vaccines

3Current address: Genetic Epidemiology Laboratory, Imperial Cancer Research Fund, St. James' University Hospital, Leeds, United Kingdom.


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