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The number needed to vaccinate (NNV) is a metric commonly used to evaluate the public health impact of a vaccine as it represents the number of individuals that must be vaccinated to prevent one case of disease. Traditional calculations may underestimate vaccine benefits by neglecting indirect effects and duration of protection (DOP), resulting in NNV overestimation. This study evaluated the NNV for the pediatric 20-valent pneumococcal conjugate (PCV20) US immunization program, as compared to PCV13, with a unique approach to NNV. A multi-cohort, population-based Markov model accounting for indirect effects was employed to calculate the NNV of PCV20 to avert a case of pneumococcal disease, invasive pneumococcal disease (IPD), hospitalized non-bacteremic pneumonia (NBP), ambulatory NBP, and otitis media (OM), as well as to prevent antibiotic-resistant cases and antibiotic prescriptions. The mean NNV over a 25-year time horizon to prevent one case of pneumococcal disease was 6, with NNVs of 854 for IPD, 106 for hospitalized NBP, 25 for outpatient NBP, and 9 for OM, 11 for a course of antibiotic, and 4 for resistant disease. The mean NNV per year decreased over time, reflecting the DOP and increasing indirect effects over time. This study presents a novel approach to NNVs and shows that relatively few vaccinations are required to prevent disease. The decrease in NNV over time highlights the necessity of including DOP and indirect effects in NNV calculations, ensuring a more realistic assessment of a vaccine's impact.
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http://dx.doi.org/10.3390/vaccines13080805 | DOI Listing |
JMIR Public Health Surveill
September 2025
Center of Indigenous Health Care, Department of Community Health, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.
Background: The COVID-19 pandemic has devastated economies and strained health care systems worldwide. Vaccination is crucial for outbreak control, but disparities persist between and within countries. In Taiwan, certain indigenous regions show lower vaccination rates, prompting comprehensive inquiries.
View Article and Find Full Text PDFPhys Rev Lett
August 2025
Los Alamos National Laboratory, Theoretical Division, Los Alamos, New Mexico 87545, USA.
At the extreme densities in neutron stars, a phase transition to deconfined quark matter is anticipated. Yet masses, radii, and tidal deformabilities offer only indirect measures of a first-order phase transition, requiring many detections to resolve or being ineffective observables if the discontinuity exists at lower densities. We report on a smoking-gun gravitational-wave signature of a first-order transition: the resonant tidal excitation of an interface mode.
View Article and Find Full Text PDFAm J Physiol Regul Integr Comp Physiol
September 2025
Department of Pediatrics, Ribeirao Preto Medical School - University of Sao Paulo, Brazil.
The differential diagnosis within polyuria-polydipsia syndrome, especially in the pediatric population, remains challenging. Despite its limited accuracy, the water deprivation test (WDT) is the reference test in pediatrics. We retrospectively analyzed performed in 65 pediatric patients (mean age 8.
View Article and Find Full Text PDFBioinformatics
September 2025
Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania United States.
Summary: Causal mediation analysis investigates the role of mediators in the relationship between exposure and outcome. In the analysis of omics or imaging data, mediators are often high-dimensional, presenting challenges such as multicollinearity and interpretability. Existing methods either compromise interpretability or fail to effectively prioritize mediators.
View Article and Find Full Text PDFPLoS One
September 2025
Methodology and Analysis, Statistics Denmark, Copenhagen, Denmark.
Background: Previous studies have found paternal occupation, childhood intelligence, and educational attainment to be important predictors of socioeconomic status (SES) later in life. However, these factors only explain part of the variance in SES and thus, it is important to identify other predictors of SES and trajectories of influence from early childhood to adulthood.
Objectives: To analyze predictors of SES attainment during the life course from early childhood to midlife with special emphasis on identifying direct and indirect effects on midlife SES of early childhood, late childhood and young adult characteristics.