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Fig. 1 | BMC Medicine

Fig. 1

From: Short- and long-term impact of vaccination against cytomegalovirus: a modeling study

Fig. 1

Schematic of the transmission model. Shown are epidemiological transitions in the transmission model without vaccination. Seronegative persons (susceptible, S) acquire primary infection (I1) either vertically from their seropositive mothers (with probability q) or horizontally (with the force of infection λ) via contact with acutely infected persons in three infectious classes (I1, I2, I3). After primary infection (duration 1/γ year), persons become latently infected with low antibody concentrations (latent, L). In this class, re-infection occurs at a rate zλ, where z is the reduction in susceptibility to re-infection in latently infected persons compared to seronegative persons, and reactivation occurs at a rate ρ. After reactivation/re-infection (duration 1/γ year), persons transit to the latent class with high antibody concentrations (boosted, B) with probability pLB, where further re-infection and reactivation events can occur (I3). Note that vertical transmission from mother to child includes both congenital and postnatal transmission via breastfeeding. The population is stratified by sex and age, and the forces of infection and reactivation rates are age- and sex-specific (not shown). Figure S1 and Figure S2 give schematics of the full model with vaccination

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