Vaccine efficacy or vaccine effectiveness is the percentage reduction of disease cases in a vaccinated group of people compared to an unvaccinated group. For example, a vaccine efficacy or effectiveness of 80% indicates an 80% decrease in the number of disease cases among a group of vaccinated people compared to a group in which nobody was vaccinated. When a study is carried out using the most favorable, ideal or perfectly controlled conditions, such as those in a clinical trial, the term vaccine efficacy is used. On the other hand, when a study is carried out to show how well a vaccine works when they are used in a bigger, typical population under less-than-perfectly controlled conditions, the term vaccine effectiveness is used.
Vaccine efficacy was designed and calculated by Greenwood and Yule in 1915 for the cholera and typhoid vaccines. It is best measured using double-blind, randomized, clinical controlled trials, such that it is studied under "best case scenarios."
Vaccine efficacy studies are used to measure several important and critical outcomes of interest such as disease attack rates, hospitalizations due to the disease, deaths due to the disease, asymptomatic infection, serious adverse events due to vaccination, vaccine reactogenicity, and cost effectiveness of the vaccine. Vaccine efficacy is calculated on a set population (and therefore is not a constant value when counting in other populations), and may be misappropriated to be how efficacious a vaccine is in all populations.
Relative risk reduction
The outcome data (vaccine efficacy) generally are expressed as a proportionate reduction in disease attack rate (AR) between the unvaccinated (ARU) and vaccinated (ARV), or can be calculated from the relative risk (RR) of disease among the vaccinated group.
The basic formula is written as:with
= Vaccine efficacy,
= Attack rate of unvaccinated people,
= Attack rate of vaccinated people.
An alternative, equivalent formulation of vaccine efficacy is: where is the relative risk of developing the disease for vaccinated people compared to unvaccinated people.
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