{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:59:19Z","timestamp":1787788759290,"version":"build-2784847793"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T00:00:00Z","timestamp":1570665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Theme-based Research Scheme","award":["T11-705\/14N"],"award-info":[{"award-number":["T11-705\/14N"]}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54 GM088558"],"award-info":[{"award-number":["U54 GM088558"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>There is increasing attention to the need to identify new immune markers for the evaluation of existing and new influenza vaccines. Immune markers that could predict individual protection against infection and disease, commonly called correlates of protection (CoPs), play an important role in vaccine development and licensing. Here, we discuss the epidemiologic considerations when evaluating immune markers as potential CoPs for influenza vaccines and emphasize the distinction between correlation and causation. While an immune marker that correlates well with protection from infection can be used as a predictor of vaccine efficacy, it should be distinguished from an immune marker that plays a mechanistic role in conferring protection against a clinical endpoint\u2014the latter might be a more reliable predictor of vaccine efficacy and a more appropriate target for rational vaccine design. To clearly distinguish mechanistic and nonmechanistic CoPs, we suggest using the term \u201ccorrelates of protection\u201d for nonmechanistic CoPs, and \u2018\u2018mediators of protection\u2019\u2019 for mechanistic CoPs. Furthermore, because the interactions among and relative importance of correlates or mediators of protection can vary according to age or prior vaccine experience, the effect sizes and thresholds for protective effects for CoPs could also vary in different segments of the population.<\/jats:p>","DOI":"10.1093\/aje\/kwz227","type":"journal-article","created":{"date-parts":[[2019,10,2]],"date-time":"2019-10-02T11:14:58Z","timestamp":1570014898000},"page":"185-192","source":"Crossref","is-referenced-by-count":17,"title":["Distinguishing Causation from Correlation in the Use of Correlates of Protection to Evaluate and Develop Influenza Vaccines"],"prefix":"10.1093","volume":"189","author":[{"given":"Wey Wen","family":"Lim","sequence":"first","affiliation":[{"name":"World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, the University of Hong Kong, Hong Kong SAR, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy H L","family":"Leung","sequence":"first","affiliation":[{"name":"World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, the University of Hong Kong, Hong Kong SAR, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheena G","family":"Sullivan","sequence":"first","affiliation":[{"name":"World Health Organization Collaborating Centre for Reference and Research on Influenza at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"},{"name":"Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J","family":"Tchetgen Tchetgen","sequence":"first","affiliation":[{"name":"Statistics Department, the Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J","family":"Cowling","sequence":"first","affiliation":[{"name":"World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, the University of Hong Kong, Hong Kong SAR, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,10]]},"reference":[{"key":"2020051409075735200_ref1","author":"World Health Organization","year":"2013"},{"issue":"7","key":"2020051409075735200_ref2","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.4161\/hv.28639","article-title":"Fast vaccine design and development based on 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