ArticleScientific reports2019
Limited available evidence supports theoretical predictions of reduced vaccine efficacy at higher exposure dose.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed.
- Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19.The New England journal of medicine · 2021Trial
- Article
- Orally delivered chitosan-basedFrontiers in immunology · 2026Article
- The Impact of Exposure Dosage and Host Genetics on the Shedding Kinetics of Flavobacterium psychrophilum in Rainbow Trout.Journal of fish diseases · 2025Article
- Vaccine failure mode determines population-level impact of vaccination campaigns during epidemics.Journal of the Royal Society, Interface · 2025Article
- Protective efficacy of inactivated FHV-1 vaccine in cats following challenge with the Chinese field strains.Frontiers in veterinary science · 2025Article
- Short-term effectiveness of single-dose intranasal spray COVID-19 vaccine against symptomatic SARS-CoV-2 Omicron infection in healthcare workers: a prospective cohort study.EClinicalMedicine · 2024Article
- Background malaria incidence and parasitemia during the three-dose RTS,S/AS01 vaccination series do not reduce magnitude of antibody response nor efficacy against the first case of malaria.BMC infectious diseases · 2023Article
- Evidence of leaky protection following COVID-19 vaccination and SARS-CoV-2 infection in an incarcerated population.Nature communications · 2023Article
- Relationships Between Social Vulnerability and Coronavirus Disease 2019 Vaccination Coverage and Vaccine Effectiveness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Article
- Estimation of mRNA COVID-19 Vaccination Effectiveness in Tokyo for Omicron Variants BA.2 and BA.5: Effect of Social Behavior.Vaccines · 2022Article
- Breakthrough infections after COVID-19 vaccination: Insights, perspectives and challenges.Metabolism open · 2022Article
- Vaccination for the Prevention of Infection among Immunocompromised Patients: A Concise Review of Recent Systematic Reviews.Vaccines · 2022Review
- Protection Generated by Prior Exposure to Pathogens Depends on both Priming and Challenge Dose.Infection and immunity · 2022Article
- SARS-CoV-2 breakthrough infections in vaccinated individuals: measurement, causes and impact.Nature reviews. Immunology · 2022Review
- Prioritizing second-generation SARS-CoV-2 vaccines through low-dosage challenge studies.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Article
- Seroepidemiology of bovine brucellosis in Colombia's preeminent dairy region, and its potential public health impact.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2020Article
- Impact of Vaccination and Pathogen Exposure Dosage on Shedding Kinetics of Infectious Hematopoietic Necrosis Virus (IHNV) in Rainbow Trout.Journal of aquatic animal health · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Understanding the causes of vaccine failure is important for predicting disease dynamics in vaccinated populations and planning disease interventions. Pathogen exposure dose and heterogeneity in host susceptibility have both been implicated as important factors that may reduce overall vaccine efficacy and cause vaccine failure. Here, we explore the effect of pathogen dose and heterogeneity in host susceptibility in reducing efficacy of vaccines. Using simulation-based methods, we find that increases in pathogen exposure dose decrease vaccine efficacy, but this effect is modified by heterogeneity in host susceptibility. In populations where the mode of vaccine action is highly polarized, vaccine efficacy decreases more slowly with exposure dose than in populations with less variable protection. We compared these theoretical results to empirical estimates from a systematic literature review of vaccines tested over multiple exposure doses. We found that few studies (nine of 5,389) tested vaccine protection against infection over multiple pathogen challenge doses, with seven studies demonstrating a decrease in vaccine efficacy with increasing exposure dose. Our research demonstrates that pathogen dose has potential to be an important determinant of vaccine failure, although the limited empirical data highlight a need for additional studies to test theoretical predictions on the plausibility of reduced host susceptibility and high pathogen dose as mechanisms responsible for reduced vaccine efficacy in high transmission settings.
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