Abstract
Zika virus (ZIKV) is a mosquito-borne flavivirus. In 2016, Managua, the capital city of Nicaragua experienced a Zika virus outbreak. Amongst confirmed cases, seropositivity increased with age and >50% of the adult population had ZIKV antibodies. The duration of immunity to ZIKV remains unclear. We used an agent-based model in a Bayesian framework to describe the dynamics of immunity to ZIKV, and predict the future age-specific risk of ZIKV infection in the population of Managua. We also investigated the potential impact of a ZIKV vaccine under different assumptions about the persistence of immunity. Assuming lifelong immunity, the risk of a ZIKV outbreak will remain low until 2035 and rise above 50% in 2047. Young women of reproductive age will be at highest risk of infection during the next ZIKV outbreak. ZIKV vaccine development and licensure are urgent, to attain the maximum benefit in reducing the population-level risk of infection and the risk of adverse congenital outcomes.
