Evidence map›Paper›PMID 39586191›Full record

ArticleVaccine2025

Poor vaccine responders mask the true trend in vaccine effectiveness against progression to severe disease.

Natalie E Dean, M Elizabeth Halloran, Veronika I Zarnitsyna

Abstract read
In one paragraph

Article in Vaccine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Natalie E DeanDepartment of Biostatistics & Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America. Electronic address: nataliedean@emory.edu.
M Elizabeth HalloranBiostatistics, Bioinformatics, and Epidemiology Program, Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center, Seattle, WA, United States of America; Department of Biostatistics, University of Washington, Seattle, WA, United States of America.
Veronika I ZarnitsynaDepartment of Microbiology & Immunology, School of Medicine, Emory University, Atlanta, GA, United States of America. Electronic address: vizarni@emory.edu.

Funding

VACCINE INDUCED IMMUNITY IN THE YOUNG AND AGEDU19AI057266 · NIAID · EMORY UNIVERSITY · PI Rafi Ahmed · 2003 to 2026
$81.7M
DYNAMICS AND EVOLUTION OF IMMUNE RESPONSES TO INFLUENZA VIRUSESU01AI150747 · NIAID · EMORY UNIVERSITY · PI AHMED, RAFI, ANTIA, RUSTOM NOSHIR · 2020 to 2024
$5.9M
Design and Analysis of Vaccine Trials for Emerging Infectious Disease ThreatsR01AI139761 · NIAID · UNIVERSITY OF FLORIDA · PI DEAN, NATALIE EXNER · 2018 to 2022
$3.6M
CDC HHS NU38FT000001NIAID NIH HHS R01 AI139761NIAID NIH HHS U01 AI150747NIAID NIH HHS U19 AI057266
6 · The paper itself

Abstract

Vaccines can reduce an individual's risk of infection and their risk of progression to severe disease given infection. The latter effect is less commonly estimated but is relevant for vaccine impact modeling and cost-effectiveness calculations. Using a motivating example from the COVID-19 literature, we note how vaccine effectiveness against progression to severe disease can appear to increase from below 0 % to over 70 % within 8 months. With true biological strengthening of this magnitude being unlikely, we use a mathematical modeling framework to identify parameter combinations where this phenomenon can occur. Fundamental features are an immunocompetent population with high initial protection against infection, contrasted with a vulnerable subpopulation with poor vaccine response against infection and progression. As a result, the earliest infections are among those with the weakest protection against severe disease. This work highlights methodological challenges in isolating a vaccine's effect on progression to severe disease after infection, and it signals the need for refined analytical methods to adjust for differences between the vaccinated infected and the unvaccinated infected populations.

Indexed as

COVID-19COVID-19 VaccinesDisease ProgressionSARS-CoV-2Vaccine EfficacyHumansModels, TheoreticalVaccinationCOVID-19 VaccinesProgression to severe diseaseProtection against infectionVaccine waning

Identifiers

PMID39586191
PMCPMC11822770

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.