Cost-effectiveness evaluation of gender-based vaccination programs against sexually transmitted infections
Bibliographic record
Abstract
The ultimate goal of a vaccination program is to interrupt pathogen transmission so as to eradicate the disease from the population in the future, and/or to decrease morbidity and mortality due to the disease in the short term. For sexually transmitted infections (STI) the determination of an optimal vaccination program is not straightforward since (1) the transmission probabilities between two different sexes are normally unequal (weighted to a greater probability from males to females than vice versa), (2) demographic parameters between the two sexes are unequal, (3) the prevalence of disease in one sex may have a greater impact on the morbidity and mortality of the next generation (transmission to the neonate) and, (4) the existence of pathogens closely related to the STI in question (i.e. herpes - HSV-1 vs. HSV-2, different strains of Chlamydia trachomatis, different strains of Neisseria which cause Gonorrhea, and others) may induce immunity in individuals that render a vaccine ineffective. We have developed two models of sexually transmitted infections (with and without age structure) to evaluate the cost-efficacy of gender-based vaccination programs in the context of STI control. The first model ignores age structure for qualitative analysis of points (1-3), while the second refined one incorporatesthe age structure, reflecting the effects of immunity gained from infection of closely related strains (point 4), which is important for HSV-2 vaccination strategies. For both models, we find that the stability of the system and ultimate eradication of the disease depends explicitly on the corresponding reproduction number. We also find that vaccinating females is more cost-effective, providing a greater reduction in disease prevalence in the population and number of infected females of childbearing age. This result is counter-intuitive since vaccinating super-transmitters (males) over sub-transmitters (females) usually has the greatest impact on disease prevalence. Sensitivity analysis is implemented to investigate how the parameters affect the control reproduction numbers and infectious population sizes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".