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Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa

Hepatitis A is a vaccine preventable disease caused by the Hepatitis A Virus (HAV). Currently, South Africa is classified by the World Health Organization (WHO) as a high hepatitis A endemic region where 90% of children are assumed to be “naturally immunised” following HAV exposure before the age of...

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Main Author: Patterson, Jenna
Other Authors: Kagina, Benjamin
Format: Thesis
Language:English
Published: Department of Public Health and Family Medicine 2023
Subjects:
Epidemiology &amp
Biostatistics
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access_status_str Open Access
author Patterson, Jenna
author2 Kagina, Benjamin
author_browse Kagina, Benjamin
Patterson, Jenna
author_facet Kagina, Benjamin
Patterson, Jenna
author_sort Patterson, Jenna
collection Thesis
description Hepatitis A is a vaccine preventable disease caused by the Hepatitis A Virus (HAV). Currently, South Africa is classified by the World Health Organization (WHO) as a high hepatitis A endemic region where 90% of children are assumed to be “naturally immunised” following HAV exposure before the age of 10 years old. In high hepatitis A endemic settings, routine vaccination against HAV is not necessary due to high rates of “natural immunization”. Recent data suggest a possible shift from high to intermediate HAV endemicity may be occurring in South Africa. Countries with intermediate HAV endemicity and no routine hepatitis A vaccination program have a high risk of experiencing hepatitis A outbreaks and high costs associated with care. Currently, there is no routine vaccination program against HAV in South Africa. The aim of this PhD was to generate evidence for decision making on whether a routine vaccination program against HAV should be considered for introduction into the South African Expanded Program on Immunizations (EPI-SA). The objectives included gathering context-specific evidence on the epidemiologic features of hepatitis A, clinical characteristics of the disease, hepatitis A vaccine characteristics and cost of case management. Using this evidence, the PhD estimated the future epidemiology of hepatitis A and impacts of routine hepatitis A vaccination scenarios in the country. The PhD's overall methods were informed by the principles of Evidence-Based Vaccinology for developing vaccine recommendations. The project included a mixed-methods approach: systematic reviews, a retrospective clinical folder review, mathematical modelling, and economic evaluation. A dynamic transmission model was built to forecast the future epidemiology of hepatitis A and to simulate the impacts of several different childhood hepatitis A vaccination strategies in South Africa. Selected findings have been published in relevant peer-reviewed journals. In addition, a technical dossier was prepared to submit to the South African National Advisory Group on Immunization (NAGI) on behalf of the Hepatitis A Working Group for considerations of introducing hepatitis A vaccination into the South African EPI.
format Thesis
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:48:14.378Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2023
publishDateRange 2023
publishDateSort 2023
publisher Department of Public Health and Family Medicine
publisherStr Department of Public Health and Family Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/38124 Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa Patterson, Jenna Kagina, Benjamin Cleary Susan Muloiwa, Rudzani Hussey, Gregory Silal, Sheetal Epidemiology &amp Biostatistics Hepatitis A is a vaccine preventable disease caused by the Hepatitis A Virus (HAV). Currently, South Africa is classified by the World Health Organization (WHO) as a high hepatitis A endemic region where 90% of children are assumed to be “naturally immunised” following HAV exposure before the age of 10 years old. In high hepatitis A endemic settings, routine vaccination against HAV is not necessary due to high rates of “natural immunization”. Recent data suggest a possible shift from high to intermediate HAV endemicity may be occurring in South Africa. Countries with intermediate HAV endemicity and no routine hepatitis A vaccination program have a high risk of experiencing hepatitis A outbreaks and high costs associated with care. Currently, there is no routine vaccination program against HAV in South Africa. The aim of this PhD was to generate evidence for decision making on whether a routine vaccination program against HAV should be considered for introduction into the South African Expanded Program on Immunizations (EPI-SA). The objectives included gathering context-specific evidence on the epidemiologic features of hepatitis A, clinical characteristics of the disease, hepatitis A vaccine characteristics and cost of case management. Using this evidence, the PhD estimated the future epidemiology of hepatitis A and impacts of routine hepatitis A vaccination scenarios in the country. The PhD's overall methods were informed by the principles of Evidence-Based Vaccinology for developing vaccine recommendations. The project included a mixed-methods approach: systematic reviews, a retrospective clinical folder review, mathematical modelling, and economic evaluation. A dynamic transmission model was built to forecast the future epidemiology of hepatitis A and to simulate the impacts of several different childhood hepatitis A vaccination strategies in South Africa. Selected findings have been published in relevant peer-reviewed journals. In addition, a technical dossier was prepared to submit to the South African National Advisory Group on Immunization (NAGI) on behalf of the Hepatitis A Working Group for considerations of introducing hepatitis A vaccination into the South African EPI. 2023-07-17T12:46:28Z 2023-07-17T12:46:28Z 2023 2023-07-17T12:46:16Z Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/38124 eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences
spellingShingle Epidemiology &amp
Biostatistics
Patterson, Jenna
Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
thesis_degree_str Doctoral
title Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
title_full Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
title_fullStr Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
title_full_unstemmed Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
title_short Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
title_sort evidence based vaccinology supporting evidence informed considerations to introduce routine hepatitis a immunization in south africa
topic Epidemiology &amp
Biostatistics
url http://hdl.handle.net/11427/38124
work_keys_str_mv AT pattersonjenna evidencebasedvaccinologysupportingevidenceinformedconsiderationstointroduceroutinehepatitisaimmunizationinsouthafrica

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