TY - JOUR
T1 - The impact of sub-national heterogeneities in demography and epidemiology on the introduction of rubella vaccination programs in Nigeria
AU - Nakase, Taishi
AU - Brownwright, Tenley
AU - Okunromade, Oyeladun
AU - Egwuenu, Abiodun
AU - Ogunbode, Oladipo
AU - Lawal, Bola
AU - Akanbi, Kayode
AU - Grant, Gavin
AU - Bassey, Orji O.
AU - Coughlin, Melissa M.
AU - Bankamp, Bettina
AU - Adetifa, Ifedayo
AU - Metcalf, C. Jessica E.
AU - Ferrari, Matthew
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/8/13
Y1 - 2024/8/13
N2 - Rubella infection during pregnancy can result in miscarriage or infants with a constellation of birth defects known as congenital rubella syndrome (CRS). When coverage is inadequate, rubella vaccination can increase CRS cases by increasing the average age of infection. Thus, the World Health Organisation recommends that countries introducing rubella vaccine be able to vaccinate at least 80% of each birth cohort. Previous studies have focused on national-level analyses and have overlooked sub-national variation in introduction risk. We characterised the sub-national heterogeneity in rubella transmission within Nigeria and modelled local rubella vaccine introduction under different scenarios to refine the set of conditions and strategies required for safe rubella vaccine use. Across Nigeria, the basic reproduction number ranged from 2.6 to 6.2. Consequently, the conditions for safe vaccination varied across states with low-risk areas requiring coverage levels well below 80 %. In high-risk settings, inadequate routine coverage needed to be supplemented by campaigns that allowed for gradual improvements in vaccination coverage over time. Understanding local heterogeneities in both short-term and long-term epidemic dynamics can permit earlier nationwide introduction of rubella vaccination and identify sub-national areas suitable for program monitoring, program improvement and campaign support.
AB - Rubella infection during pregnancy can result in miscarriage or infants with a constellation of birth defects known as congenital rubella syndrome (CRS). When coverage is inadequate, rubella vaccination can increase CRS cases by increasing the average age of infection. Thus, the World Health Organisation recommends that countries introducing rubella vaccine be able to vaccinate at least 80% of each birth cohort. Previous studies have focused on national-level analyses and have overlooked sub-national variation in introduction risk. We characterised the sub-national heterogeneity in rubella transmission within Nigeria and modelled local rubella vaccine introduction under different scenarios to refine the set of conditions and strategies required for safe rubella vaccine use. Across Nigeria, the basic reproduction number ranged from 2.6 to 6.2. Consequently, the conditions for safe vaccination varied across states with low-risk areas requiring coverage levels well below 80 %. In high-risk settings, inadequate routine coverage needed to be supplemented by campaigns that allowed for gradual improvements in vaccination coverage over time. Understanding local heterogeneities in both short-term and long-term epidemic dynamics can permit earlier nationwide introduction of rubella vaccination and identify sub-national areas suitable for program monitoring, program improvement and campaign support.
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U2 - 10.1016/j.vaccine.2024.05.030
DO - 10.1016/j.vaccine.2024.05.030
M3 - Article
C2 - 38811269
AN - SCOPUS:85194495055
SN - 0264-410X
VL - 42
JO - Vaccine
JF - Vaccine
IS - 20
M1 - 125982
ER -