The future of a partially effective HIV vaccine: assessing limitations at the population level

Christian Selinger (), Dobromir T. Dimitrov (), Philip A. Welkhoff () and Anna Bershteyn ()
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Christian Selinger: Institute for Disease Modeling
Dobromir T. Dimitrov: Fred Hutchinson Cancer Research Center
Philip A. Welkhoff: Institute for Disease Modeling
Anna Bershteyn: Institute for Disease Modeling

International Journal of Public Health, 2019, vol. 64, issue 6, No 14, 957-964

Abstract: Abstract Objectives Mathematical models have unanimously predicted that a first-generation HIV vaccine would be useful and cost-effective to roll out, but that its overall impact would be insufficient to reverse the epidemic. Here, we explore what factors contribute most to limiting the impact of such a vaccine. Methods Ranging from a theoretical ideal to a more realistic regimen, mirroring the one used in the currently ongoing trial in South Africa (HVTN 702), we model a nested hierarchy of vaccine attributes such as speed of scale-up, efficacy, durability, and return rates for booster doses. Results The predominant reasons leading to a substantial loss of vaccine impact on the HIV epidemic are the time required to scale up mass vaccination, limited durability, and waning of efficacy. Conclusions A first-generation partially effective vaccine would primarily serve as an intermediate milestone, furnishing correlates of immunity and platforms that could serve to accelerate future development of a highly effective, durable, and scalable next-generation vaccine capable of reversing the HIV epidemic.

Keywords: HIV vaccine; Epidemiological modeling; South Africa; Product development (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s00038-019-01234-z

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