A dynamic transmission model with age-dependent infectiousness and reactivation for cytomegalovirus in the United States: Potential impact of vaccination strategies on congenital infection

Figures & data

Figure 1. Illustration of best-fit model-projected age-stratified CMV seroprevalence in the US population vs. the corresponding nationally-representative NHANES III CMV seroprevalence data (A). Model-based force of infection (FOI: per susceptible risk of infection per year) as a function of age corresponding to best model-data fit in (A) (B).

Table 1. Vaccine scenarios

		Routine vaccination (Yes/No; age)		Catch-up (Yes/No; age)		Booster (Yes/No; age)
		Seronegative	Seropositive	Seronegative	Seropositive	Seronegative	Seropositive
Adolescent female vaccination	Scenario 1	Yes; 10 y old	No	Yes; 10–17 y old	No	No	No
	Scenario 2	Yes; 10 y old	Yes; 10 y old	Yes; 10–17 y old	Yes; 10–17 y old	No	No
	Scenario 3	Yes; 10 y old	No	Yes; 10–17 y old	No	Yes	No
	Scenario 4	Yes; 10 y old	Yes; 10 y old	Yes; 10–17 y old	Yes; 10–17 y old	Yes	Yes
Male and female infant vaccination	Scenario 5	Yes; <1 y old	Yes; <1 y old	No	No	No	No
	Scenario 6	Yes; <1 y old	Yes; <1 y old	No	No	Yes; 10 y old	Yes; 10 y old
	Scenario 7	Yes; <1 y old	Yes; <1 y old	Yes; 10–17 y old	Yes; 10–17 y old	No	No
	Scenario 8	Yes; <1 y old	Yes; <1 y old	Yes; 10–17 y old	Yes; 10–17 y old	Yes; 10 y old	Yes; 10 y old

^a Similar vaccine coverage and efficacy assumed in routine (primary and booster) and catch-up vaccination. Only a one-time catch-up at the start-up of the vaccination program considered.

^b Routine booster platform here considered based on assumed vaccine protection waning: if mean duration of protection was 10 y, then routine booster was offered at 20 y of age. If mean duration of vaccine protection was 20 y, then routine booster was offered at 30 y of age.

Figure 2. Model-projected congenital CMV infection birth prevalence over time post-vaccination of seronegative adolescent females without booster, with one-time catch-up in 10–17 y old at start-up, under scenario 1 in the base-case vaccination framework (no vaccine impact on reactivation).

Figure 3. Model-projected congenital CMV infection birth prevalence over time post-vaccination of seronegative adolescent females with booster, one-time catch-up in 10–17 y old at start-up, under scenario 3 in the base-case vaccination framework (no vaccine impact on reactivation).

Figure 4. Model-projected congenital CMV infection birth prevalence over time post-vaccination of both seronegative and seropositive adolescent females without booster, one-time catch-up in 10–17 y old at start-up, under scenario 2 in the optimistic vaccination framework (with vaccine impact on reactivation).

Figure 5. Model-projected congenital CMV infection birth prevalence over time post-vaccination of both seronegative and seropositive adolescent females with booster, one-time catch-up in 10–17 y old at start-up, under scenario 4 in the optimistic vaccination framework (with vaccine impact on reactivation).

Figure 6. Model-projected congenital CMV infection birth prevalence over time post-vaccination of infants, without booster and without catch-up, under scenario 5 in the base-case vaccination framework (no vaccine impact on reactivation).

Figure 7. Model structure with compartments, states and flows. Details are given in the accompanying table below the figure.