Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making
<i>Background</i>: age structured mathematical models have been used to evaluate the impact of rubella-containing vaccine (RCV) introduction into existing measles vaccination programs in several countries. South Africa has a well-established measles vaccination program and is considering...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-07-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/8/3/383 |
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| author | Nkengafac Villyen Motaze Ijeoma Edoka Charles S. Wiysonge C. Jessica E. Metcalf Amy K. Winter |
| author_facet | Nkengafac Villyen Motaze Ijeoma Edoka Charles S. Wiysonge C. Jessica E. Metcalf Amy K. Winter |
| author_sort | Nkengafac Villyen Motaze |
| collection | DOAJ |
| description | <i>Background</i>: age structured mathematical models have been used to evaluate the impact of rubella-containing vaccine (RCV) introduction into existing measles vaccination programs in several countries. South Africa has a well-established measles vaccination program and is considering RCV introduction. This study aimed to provide a comparison of different scenarios and their relative costs within the context of congenital rubella syndrome (CRS) reduction or elimination. <i>Methods</i>: we used a previously published age-structured deterministic discrete time rubella transmission model. We obtained estimates of vaccine costs from the South African medicines price registry and the World Health Organization. We simulated RCV introduction and extracted estimates of rubella incidence, CRS incidence and effective reproductive number over 30 years. <i>Results</i>: compared to scenarios without mass campaigns, scenarios including mass campaigns resulted in more rapid elimination of rubella and congenital rubella syndrome (CRS). Routine vaccination at 12 months of age coupled with vaccination of nine-year-old children was associated with the lowest RCV cost per CRS case averted for a similar percentage CRS reduction. <i>Conclusion</i>: At 80% RCV coverage, all vaccine introduction scenarios would achieve rubella and CRS elimination in South Africa. Any RCV introduction strategy should consider a combination of routine vaccination in the primary immunization series and additional vaccination of older children. |
| first_indexed | 2024-03-09T06:09:00Z |
| format | Article |
| id | doaj.art-025aedd80ed2419caeb0d664c13c851e |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-09T06:09:00Z |
| publishDate | 2020-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-025aedd80ed2419caeb0d664c13c851e2023-12-03T11:59:59ZengMDPI AGVaccines2076-393X2020-07-018338310.3390/vaccines8030383Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision MakingNkengafac Villyen Motaze0Ijeoma Edoka1Charles S. Wiysonge2C. Jessica E. Metcalf3Amy K. Winter4Centre for Vaccines and Immunology, National Institute for Communicable Diseases/National Health Laboratory Service, Johannesburg 2131, South AfricaSouth African Medical Research Council Centre for Health Economics and Decision Science-PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South AfricaDepartment of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South AfricaDepartment of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USADepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA<i>Background</i>: age structured mathematical models have been used to evaluate the impact of rubella-containing vaccine (RCV) introduction into existing measles vaccination programs in several countries. South Africa has a well-established measles vaccination program and is considering RCV introduction. This study aimed to provide a comparison of different scenarios and their relative costs within the context of congenital rubella syndrome (CRS) reduction or elimination. <i>Methods</i>: we used a previously published age-structured deterministic discrete time rubella transmission model. We obtained estimates of vaccine costs from the South African medicines price registry and the World Health Organization. We simulated RCV introduction and extracted estimates of rubella incidence, CRS incidence and effective reproductive number over 30 years. <i>Results</i>: compared to scenarios without mass campaigns, scenarios including mass campaigns resulted in more rapid elimination of rubella and congenital rubella syndrome (CRS). Routine vaccination at 12 months of age coupled with vaccination of nine-year-old children was associated with the lowest RCV cost per CRS case averted for a similar percentage CRS reduction. <i>Conclusion</i>: At 80% RCV coverage, all vaccine introduction scenarios would achieve rubella and CRS elimination in South Africa. Any RCV introduction strategy should consider a combination of routine vaccination in the primary immunization series and additional vaccination of older children.https://www.mdpi.com/2076-393X/8/3/383rubellacongenital rubella syndromerubella-containing vaccinevaccine introduction strategiesage-structured rubella transmission model |
| spellingShingle | Nkengafac Villyen Motaze Ijeoma Edoka Charles S. Wiysonge C. Jessica E. Metcalf Amy K. Winter Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making Vaccines rubella congenital rubella syndrome rubella-containing vaccine vaccine introduction strategies age-structured rubella transmission model |
| title | Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making |
| title_full | Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making |
| title_fullStr | Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making |
| title_full_unstemmed | Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making |
| title_short | Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making |
| title_sort | rubella vaccine introduction in the south african public vaccination schedule mathematical modelling for decision making |
| topic | rubella congenital rubella syndrome rubella-containing vaccine vaccine introduction strategies age-structured rubella transmission model |
| url | https://www.mdpi.com/2076-393X/8/3/383 |
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