# data[].attributes.body
哈哈哈哈哈

# data[].attributes.body
7504 confirmed measles cases in England between 2010 and 2019 collected by Public Health England including the date of symptom onset, region of residence,

age, and vaccine status of each individual

# data[].attributes.body
did increased measles cases observed in England between 2010 and 2019 were due to a waning of vaccine-induced immunity?

# data[].attributes.body
Input data - vaccination data from

COVER

CPRD

# data[].attributes.body
Lots of data from multiple sources are required for ID modelling

# data[].attributes.body
The proportion of measles cases that are two-dose recipients is increasing faster in the data than in all simulated scenarios, so waning dynamics might be more complex than what we tested.

# data[].attributes.body
Thorough documentation of the entire process is key to allowing readers to understand, interpret and critique the chosen approach

# data[].attributes.body
three scenarios: (1): without the waning of immunity (ie, transmission between the vaccinated and the exposed compartments is only possible in the case of primary vaccine failure) (2): with the waning of immunity increasing with each year of age from 5 years, and with the waning of immunity increasing with each year of age from 5 years and from the year 2000. (3): individuals vaccinated before 2000 had full protection until 2000, when the waning of immunity is then linked to the low rates of transmission observed since 2000 in England.

# data[].attributes.body
In all modelled scenarios, the R0 was estimated between 16 and 18 (scenarios without waning: 16·6 [95% credible interval (CrI): 16·2–17·0]; scenarios with waning: 17·2 [16·9–17·6]; scenarios with waning starting in 2000: 17·1 [16·8–17·4]; figure 5A; appendix p 18), which is within the typical range for measles (between 12 and 18).

# data[].attributes.body
Reference analysis assumed that only infection-induced immunity (ie, providing full non-waning protection) was possible in the 30-39 year age group due to difficulties estimating the vaccination status for these individauls due to routine vaccination only starting in 1968, and the presence of catch-up vaccination campaigns

# data[].attributes.body
Migration of inhabitants is not considered in the model. Instead, a spatial kernel was included to quantify the rate of transmission from one region to another

# data[].attributes.body
Contact pattern between age groups is quantified by a contact matrix, computed from the POLYMOD study

# data[].attributes.body
sensitivity analyses: to assess whether the effect of waning of immunity was robust to changes in assumptions, including:

(1) the addition of a constant risk of secondary vaccine failure but is not waning over time

(2) using the COVER data without adjustment for under-ascertainment, and using the CPRD data to compute the proportion of newly vaccinated individuals at the age of 3 years and 4 years

(3) estimating the proportion of individuals aged 30–39 years in 2010 who received one dose of the vaccine

(4) fixing the cross-regional transmission rate to test different transmission patterns between regions

(5) setting the start of waning to 1995 in a scenario where waning depends on both age and time since end of endemicity

# data[].attributes.body
in ref analysis, it assumes that only infection-induced immunity for individuals born before and in 1970s

# data[].attributes.body
to generate stochastic simulations where transitions between compartments were treated as a stochastic process. The stochastic simulations showed the set of dynamics the parameter estimates could generate, with a higher variance than the deterministic fits. Fitting a stochastic version of the model was not computationally feasible given the number of compartments and stratum.

# data[].attributes.body
Waning of vaccine-induced immunity follows a step-wise function (in predefined basket of ages)

# data[].attributes.body
Measles case dynamics in England were consistent with scenarios assuming the waning of vaccine-induced immunity. While most transmissions were connected to people who are unvaccinated, breakthrough infections are increasingly frequent for individuals who have been vaccinated twice. While the vaccine remains highly protective against measles infections, slow waning leads to a heightened burden in outbreaks, increasing the number of measles cases in people who are both vaccinated and unvaccinated

# data[].attributes.body
Waning of vaccine-induced immunity assumed to be linear

# data[].attributes.body
All double-vaccinated individuals are vaccinated by 5 years old, hence late-vaccinees were not considered, and immunity wanes at the same rate in all vaccinated individuals.

# data[].attributes.body
In waning scenarios, waning starts at age of 5

# data[].attributes.body
Input parameters:

Duration of latent and infectious period

Timing and duration of outbreak

Seasonality of importations

Number of importations by region

# data[].attributes.body
risk of infection being the same for all individuals in a given age group

# data[].attributes.body
the number of daily cases per age group, region, and vaccine status in England between 2010 and 2019.

# data[].attributes.body
Vaccine efficacy wanes at the same rate for one-dose and two-dose recipients

# data[].attributes.body
SEIR model would represent the transmission dynamics of measles well

# data[].attributes.body
vaccination status of some individual (n=143) were classified as one-dose recipients on the basis that a) no other individuals were classified as one-dose between 2014-2019 (whereas n=152 classified as two-doses) and 19/143 were 3 years old and younger, younger than the recommended age for the 2nd dose of vaccine

# data[].attributes.body
Unknown vaccination status was set as unvaccinated

# data[].attributes.body
Which of the three scenarios is the measles transmission dynamics most consistent with?

# data[].attributes.body
the authors want to evaluate whether measles dynamics observed in England

between 2010 and 2019 were in line with a waning of vaccine-induced immunity.

# data[].attributes.body
scenario analysis: without the waning of immunity, waning of immunity increasing with each year of age from 5 years, the waning of immunity increasing with each year of age from 5 years and from the year 2000

# data[].attributes.body
vaccination data from COVER and CPRD, first and second dose coverage from UKHSA

# data[].attributes.body
To evaluate whether measles dynamics observed in England between 2010 and 2019 were in line with a waning of vaccine-induced immunity.

# data[].attributes.body
From the sound of the title, it's something about measles.