Modelling the long-term persistence of neutralizing antibody in adults after one dose of live attenuated Japanese encephalitis chimeric virus vaccine.

ABSTRACT

In a study conducted in a non-endemic area, a live attenuated Japanese encephalitis chimeric virus vaccine (JE-CV) was found to provide 97% seroprotection at 6 months in JE-naive adults after 1 dose, and 87% of those protected at 6 months were still protected at 5 years. Because long-term seroprotection data are essential for decision-making on the need and timing of boosters, we applied statistical models to this dataset to predict individuals' neutralizing antibody titres and seroprotection up to 25 years post-vaccination. Three types of statistical model (linear, piecewise linear and exponential-type) with fixed and random effects were constructed to model antibody decline from the observed peak in antibody levels measured 28 days after vaccination. Individual seroprotection was based on the accepted threshold of 110 dilution units (antibody titre ≥10). The piecewise linear mixed model provided best fit amongst all tested models and identified 2 periods of antibody decline an initial period of rapid decline followed by a period of much slower decline (50 times) starting on average 3.2 months (5th to 95th percentile range 1.4-7.3) after vaccination. Predicted median antibody titres at 10 years were 38 (<10-174) and the corresponding seroprotection rate was 85.5% (72.7-94.9). The estimated median duration of seroprotection was 21.4 years (5th to 95th percentile range 7.3-34.0). This analysis suggests that one dose of JE-CV confers to most adults a high level of protection against Japanese encephalitis for at least 10 years.