Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo

Background: Rubella vaccine has yet to be introduced into the national immunization schedule of the Democratic Republic of the Congo (DRC); the current burden of congenital rubella syndrome (CRS) is unknown and likely to be high. An important consideration prior to introducing rubella containing vac...

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Autores principales:	Alvan Cheng, Kurt Frey, Guillaume Ngoie Mwamba, Kevin A. McCarthy, Nicole A. Hoff, Anne W. Rimoin
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Rubella Congenital rubella syndrome Vaccine introduction Agent-based model Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/ee0b8d2e3f08441cadfb379fb07178dd
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spelling	oai:doaj.org-article:ee0b8d2e3f08441cadfb379fb07178dd2021-11-22T04:29:36ZExamination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo2590-136210.1016/j.jvacx.2021.100127https://doaj.org/article/ee0b8d2e3f08441cadfb379fb07178dd2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2590136221000449https://doaj.org/toc/2590-1362Background: Rubella vaccine has yet to be introduced into the national immunization schedule of the Democratic Republic of the Congo (DRC); the current burden of congenital rubella syndrome (CRS) is unknown and likely to be high. An important consideration prior to introducing rubella containing vaccine (RCV) is the potential inverse relationship between RCV coverage and CRS incidence. Increasing RCV coverage will also increase in the average age of infection. Cumulative infections across all age groups will decrease, but the number of infections in age groups vulnerable to CRS may increase. Methods: Rubella transmission dynamics in the DRC were simulated using a stochastic agent-based model of transmission. Input parameter values for known properties, demographic variables, and interventions were fixed; infectivity was inferred from seropositivity profiles in survey data. Results: Our simulations of RCV introduction for the DRC demonstrate that an increase in CRS burden is unlikely. Continued endemic transmission is only plausible when routine immunization coverage is less than 40% and follow-up supplemental immunization activities have poor coverage for decades. Conclusion: Increased vaccination coverage tends to increase the annual variability of CRS burden. Simulations examining low vaccination coverage and high mean CRS burden are outbreak prone, with multiple years of reduced burden followed by acute outbreaks. These outcomes contrast simulations with no vaccination coverage and high mean CRS burden, which have more consistent burden from year to year.Alvan ChengKurt FreyGuillaume Ngoie MwambaKevin A. McCarthyNicole A. HoffAnne W. RimoinElsevierarticleRubellaCongenital rubella syndromeVaccine introductionAgent-based modelImmunologic diseases. AllergyRC581-607ENVaccine: X, Vol 9, Iss , Pp 100127- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Rubella Congenital rubella syndrome Vaccine introduction Agent-based model Immunologic diseases. Allergy RC581-607
spellingShingle	Rubella Congenital rubella syndrome Vaccine introduction Agent-based model Immunologic diseases. Allergy RC581-607 Alvan Cheng Kurt Frey Guillaume Ngoie Mwamba Kevin A. McCarthy Nicole A. Hoff Anne W. Rimoin Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
description	Background: Rubella vaccine has yet to be introduced into the national immunization schedule of the Democratic Republic of the Congo (DRC); the current burden of congenital rubella syndrome (CRS) is unknown and likely to be high. An important consideration prior to introducing rubella containing vaccine (RCV) is the potential inverse relationship between RCV coverage and CRS incidence. Increasing RCV coverage will also increase in the average age of infection. Cumulative infections across all age groups will decrease, but the number of infections in age groups vulnerable to CRS may increase. Methods: Rubella transmission dynamics in the DRC were simulated using a stochastic agent-based model of transmission. Input parameter values for known properties, demographic variables, and interventions were fixed; infectivity was inferred from seropositivity profiles in survey data. Results: Our simulations of RCV introduction for the DRC demonstrate that an increase in CRS burden is unlikely. Continued endemic transmission is only plausible when routine immunization coverage is less than 40% and follow-up supplemental immunization activities have poor coverage for decades. Conclusion: Increased vaccination coverage tends to increase the annual variability of CRS burden. Simulations examining low vaccination coverage and high mean CRS burden are outbreak prone, with multiple years of reduced burden followed by acute outbreaks. These outcomes contrast simulations with no vaccination coverage and high mean CRS burden, which have more consistent burden from year to year.
format	article
author	Alvan Cheng Kurt Frey Guillaume Ngoie Mwamba Kevin A. McCarthy Nicole A. Hoff Anne W. Rimoin
author_facet	Alvan Cheng Kurt Frey Guillaume Ngoie Mwamba Kevin A. McCarthy Nicole A. Hoff Anne W. Rimoin
author_sort	Alvan Cheng
title	Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
title_short	Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
title_full	Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
title_fullStr	Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
title_full_unstemmed	Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo
title_sort	examination of scenarios introducing rubella vaccine in the democratic republic of the congo
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/ee0b8d2e3f08441cadfb379fb07178dd
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Examination of scenarios introducing rubella vaccine in the Democratic Republic of the Congo

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