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

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dc.contributor.advisorKagina, Benjamin
dc.contributor.advisorCleary Susan
dc.contributor.advisorMuloiwa, Rudzani
dc.contributor.advisorHussey, Gregory
dc.contributor.advisorSilal, Sheetal
dc.contributor.authorPatterson, Jenna
dc.date.accessioned2023-07-17T12:46:28Z
dc.date.available2023-07-17T12:46:28Z
dc.date.issued2023
dc.date.updated2023-07-17T12:46:16Z
dc.description.abstractHepatitis 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.
dc.identifier.apacitationPatterson, J. (2023). <i>Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/38124en_ZA
dc.identifier.chicagocitationPatterson, Jenna. <i>"Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2023. http://hdl.handle.net/11427/38124en_ZA
dc.identifier.citationPatterson, J. 2023. Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/38124en_ZA
dc.identifier.ris TY - Doctoral Thesis AU - Patterson, Jenna AB - 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. DA - 2023_ DB - OpenUCT DP - University of Cape Town KW - Epidemiology &amp KW - Biostatistics LK - https://open.uct.ac.za PY - 2023 T1 - Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa TI - Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa UR - http://hdl.handle.net/11427/38124 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/38124
dc.identifier.vancouvercitationPatterson J. Evidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/38124en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectEpidemiology &amp
dc.subjectBiostatistics
dc.titleEvidence-based vaccinology: supporting evidence-informed considerations to introduce routine hepatitis A immunization in South Africa
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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