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. 2023 Mar 9;192(8):1335–1340. doi: 10.1093/aje/kwad055

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© The Author(s) 2023. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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Simulation results illustrating the sensitivity of negative vaccine effectiveness () measurements to vaccine efficacy (VE) against infectiousness (), vaccine efficacy against susceptibility (), and the degree of higher contact between vaccinated individuals. The existence and degree of observed negative , measured using the relative risk, was influenced by (A), the % increase in contact between vaccinated individuals (i.e., vaccinated-contact heterogeneity bias) (B), and (A and B). Colors indicate the maximum negative measurement (the minimum ) observed for a given simulation with >0 indicating a nonnegative measurement. Similar patterns also emerge when measuring the effect of , , and the vaccinated-contact heterogeneity bias on underestimates (Web Figure 5).

Inline graphic — Simulation results illustrating the sensitivity of negative vaccine effectiveness () measurements to vaccine efficacy (VE) against infectiousness (), vaccine efficacy against susceptibility (), and the degree of higher contact between vaccinated individuals. The existence and degree of observed negative , measured using the relative risk, was influenced by (A), the % increase in contact between vaccinated individuals (i.e., vaccinated-contact heterogeneity bias) (B), and (A and B). Colors indicate the maximum negative measurement (the minimum ) observed for a given simulation with >0 indicating a nonnegative measurement. Similar patterns also emerge when measuring the effect of , , and the vaccinated-contact heterogeneity bias on underestimates (Web Figure 5).