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research article

Identification of Vaccine Effects When Exposure Status Is Unknown

Stensrud, Mats Julius  
•
Smith, Louisa
2023
Epidemiology

Results from randomized controlled trials (RCTs) help determine vaccination strategies and related public health policies. However, defining and identifying estimands that can guide policies in infectious disease settings is difficult, even in an RCT. The effects of vaccination critically depend on characteristics of the population of interest, such as the prevalence of infection, the number of vaccinated, and social behaviors. To mitigate the dependence on such characteristics, estimands, and study designs, that require conditioning or intervening on exposure to the infectious agent have been advocated. But a fundamental problem for both RCTs and observational studies is that exposure status is often unavailable or difficult to measure, which has made it impossible to apply existing methodology to study vaccine effects that account for exposure status. In this study, we present new results on this type of vaccine effects. Under plausible conditions, we show that point identification of certain relative effects is possible even when the exposure status is unknown. Furthermore, we derive sharp bounds on the corresponding absolute effects. We apply these results to estimate the effects of the ChAdOx1 nCoV-19 vaccine on SARS-CoV-2 disease (COVID-19) conditional on postvaccine exposure to the virus, using data from a large RCT......

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Type
research article
DOI
10.1097/EDE.0000000000001573
Author(s)
Stensrud, Mats Julius  
Smith, Louisa
Date Issued

2023

Published in
Epidemiology
Volume

34

Issue

2

Start page

216

End page

224

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
BIOSTAT  
Available on Infoscience
March 30, 2023
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/196631
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