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Open AccessArticle

Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making

1
Centre for Vaccines and Immunology, National Institute for Communicable Diseases/National Health Laboratory Service, Johannesburg 2131, South Africa
2
Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa
3
South 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 Africa
4
Cochrane South Africa, South African Medical Research Council, Cape Town 7505, South Africa
5
School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
6
Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA
7
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
*
Author to whom correspondence should be addressed.
Vaccines 2020, 8(3), 383; https://doi.org/10.3390/vaccines8030383
Received: 1 June 2020 / Revised: 23 June 2020 / Accepted: 24 June 2020 / Published: 13 July 2020
(This article belongs to the Section Epidemiology)
Background: 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. Methods: 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. Results: 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. Conclusion: 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. View Full-Text
Keywords: rubella; congenital rubella syndrome; rubella-containing vaccine; vaccine introduction strategies; age-structured rubella transmission model rubella; congenital rubella syndrome; rubella-containing vaccine; vaccine introduction strategies; age-structured rubella transmission model
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MDPI and ACS Style

Motaze, N.V.; Edoka, I.; Wiysonge, C.S.; Metcalf, C.J.E.; Winter, A.K. Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making. Vaccines 2020, 8, 383. https://doi.org/10.3390/vaccines8030383

AMA Style

Motaze NV, Edoka I, Wiysonge CS, Metcalf CJE, Winter AK. Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making. Vaccines. 2020; 8(3):383. https://doi.org/10.3390/vaccines8030383

Chicago/Turabian Style

Motaze, Nkengafac V.; Edoka, Ijeoma; Wiysonge, Charles S.; Metcalf, C. J.E.; Winter, Amy K. 2020. "Rubella Vaccine Introduction in the South African Public Vaccination Schedule: Mathematical Modelling for Decision Making" Vaccines 8, no. 3: 383. https://doi.org/10.3390/vaccines8030383

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