Fig. 3 Anticipated transmission dynamics under scenarios of vaccine escape and vaccine waning. Anticipated transmission dynamics under scenarios of vaccine.

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Fig. 3 Anticipated transmission dynamics under scenarios of vaccine escape and vaccine waning. Anticipated transmission dynamics under scenarios of vaccine escape and vaccine waning. Here, we use a stochastic simulation model to predict the epidemiology of mumps outbreaks under the scenario of mumps virus escaping vaccine-induced immune pressure and the scenario of waning vaccine-derived immunity. (A) A stochastic model of an emerging vaccine-escape strain of mumps virus in a vaccinated population predicts excess incidence in young age groups, in keeping with their higher historical burden of mumps. (B) In contrast, the fit of a model incorporating waning vaccine-derived immunity matches the observed age distribution. (C) Higher overall incidence rates and (D) a younger age distribution of cases are predicted when immune responses to the vaccine offer minimal cross-protection against the circulating strain, as compared to the fit of the model with waning vaccine immunity. (E) Whereas the model with a viral-escape (VE) strain can reproduce the age distribution of cases at low degrees of immunological mismatch, (F) lower-than-reported incidence is expected under this scenario, again in contrast to the fit of a model with waning vaccine immunity. Lines in (E) and (F) signify 95% CIs. Joseph A. Lewnard and Yonatan H. Grad Sci Transl Med 2018;10:eaao5945 Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works