Vaccine Efficacy Estimands Implied by Common Estimators Used in Individual Randomized Field Trials

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Autori principali: Fay, Michael P., Follmann, Dean, Swihart, Bruce J., Dang, Lauren E.
Natura: Preprint
Pubblicazione: 2026
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author Fay, Michael P.
Follmann, Dean
Swihart, Bruce J.
Dang, Lauren E.
author_facet Fay, Michael P.
Follmann, Dean
Swihart, Bruce J.
Dang, Lauren E.
contents We review vaccine efficacy (VE) estimands for susceptibility in individual randomized trials with natural (unmeasured) exposure, where individual responses are measured as time from vaccination until an event (e.g., disease from the infectious agent). Common VE estimands are written as $1-θ$, where $θ$ is some ratio effect measure (e.g., ratio of incidence rates, cumulative incidences, hazards, or odds) comparing outcomes under vaccination versus control. Although the ratio effects are approximately equal with low control event rates, we explore the quality of that approximation using a nonparametric formulation. Traditionally, the primary endpoint VE estimands are full immunization (or biological) estimands that represent a subset of the intent-to-treat population, excluding those that have the event before the vaccine has been able to ramp-up to its full effect, requiring care for proper causal interpretation. Besides these primary VE estimands that summarize an effect of the vaccine over the full course of the study, we also consider local VE estimands that measure the effect at particular time points. We discuss interpretational difficulties of local VE estimands (e.g., depletion of susceptibles bias), and using frailty models as sensitivity analyses for the individual-level causal effects over time.
format Preprint
id arxiv_https___arxiv_org_abs_2601_18587
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Vaccine Efficacy Estimands Implied by Common Estimators Used in Individual Randomized Field Trials
Fay, Michael P.
Follmann, Dean
Swihart, Bruce J.
Dang, Lauren E.
Methodology
Applications
62-02, 62P10
We review vaccine efficacy (VE) estimands for susceptibility in individual randomized trials with natural (unmeasured) exposure, where individual responses are measured as time from vaccination until an event (e.g., disease from the infectious agent). Common VE estimands are written as $1-θ$, where $θ$ is some ratio effect measure (e.g., ratio of incidence rates, cumulative incidences, hazards, or odds) comparing outcomes under vaccination versus control. Although the ratio effects are approximately equal with low control event rates, we explore the quality of that approximation using a nonparametric formulation. Traditionally, the primary endpoint VE estimands are full immunization (or biological) estimands that represent a subset of the intent-to-treat population, excluding those that have the event before the vaccine has been able to ramp-up to its full effect, requiring care for proper causal interpretation. Besides these primary VE estimands that summarize an effect of the vaccine over the full course of the study, we also consider local VE estimands that measure the effect at particular time points. We discuss interpretational difficulties of local VE estimands (e.g., depletion of susceptibles bias), and using frailty models as sensitivity analyses for the individual-level causal effects over time.
title Vaccine Efficacy Estimands Implied by Common Estimators Used in Individual Randomized Field Trials
topic Methodology
Applications
62-02, 62P10
url https://arxiv.org/abs/2601.18587