Article type
Year
Abstract
Background: Hepatitis A is a vaccine preventable disease caused by the hepatitis A virus (HAV). Currently, South Africa is classified by the World Health Organisation (WHO) as a high hepatitis A endemic region where ≥ 90% of children are assumed to be “naturally immunized” following HAV exposure before the age of 10 years old. In high hepatitis A endemic settings, routine vaccination against HAV is not necessarily due to high rates of “natural immunization”. Recent anecdotal evidence as well as clinical observations, however, 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 epidemics and high costs associated with care. Currently, there is no routine vaccination program against HAV in South Africa.
Objectives: The aim of this body of work is to generate evidence for decision making on whether a routine vaccination program against HAV should be introduced into the South African Expanded Program on Immunizations. The objectives of this project include 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. The project will also estimate the future epidemiology of hepatitis A and potential epidemiological and economic impacts of routine hepatitis A vaccination in the country.
Methods: The project’s overall methods are informed by the principles of evidence-based vaccinology for developing vaccine recommendations. The project includes a mixed-methods approach: systematic reviews, a retrospective clinical folder review, costing and epidemiologic-economic modelling. A Cochrane review entitled "Hepatitis A immunisation in persons not previously exposed to hepatitis A" was conducted as a part of this work to assess the beneficial and harmful effects of pre-exposure hepatitis A vaccines (inactivated and live-attenuated) administered to adults and children versus no intervention, placebo, or any other vaccine. The results from the Cochrane review were used to shape potential vaccination strategies in South Africa and to parameterize the epidemiologic-economic model.
Results: The findings and the dossier are to be shared with the relevant vaccine policy stakeholders in the country such as the National Advisory Group on Immunization (NAGI). To our knowledge, this is the first time a formalized, transparent framework will be applied to the development of a national vaccination policy in the country.
Conclusions: Along with the development of an EBV recommendation on routine use of hepatitis A vaccines in South Africa, this work will explore the applicability of Cochrane review findings in the EBV process and to to highlight potential pro’s and con’s of conducting Cochrane reviews in the EBV process.
Patient or healthcare consumer involvement: No patients were directly included in this study.
Objectives: The aim of this body of work is to generate evidence for decision making on whether a routine vaccination program against HAV should be introduced into the South African Expanded Program on Immunizations. The objectives of this project include 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. The project will also estimate the future epidemiology of hepatitis A and potential epidemiological and economic impacts of routine hepatitis A vaccination in the country.
Methods: The project’s overall methods are informed by the principles of evidence-based vaccinology for developing vaccine recommendations. The project includes a mixed-methods approach: systematic reviews, a retrospective clinical folder review, costing and epidemiologic-economic modelling. A Cochrane review entitled "Hepatitis A immunisation in persons not previously exposed to hepatitis A" was conducted as a part of this work to assess the beneficial and harmful effects of pre-exposure hepatitis A vaccines (inactivated and live-attenuated) administered to adults and children versus no intervention, placebo, or any other vaccine. The results from the Cochrane review were used to shape potential vaccination strategies in South Africa and to parameterize the epidemiologic-economic model.
Results: The findings and the dossier are to be shared with the relevant vaccine policy stakeholders in the country such as the National Advisory Group on Immunization (NAGI). To our knowledge, this is the first time a formalized, transparent framework will be applied to the development of a national vaccination policy in the country.
Conclusions: Along with the development of an EBV recommendation on routine use of hepatitis A vaccines in South Africa, this work will explore the applicability of Cochrane review findings in the EBV process and to to highlight potential pro’s and con’s of conducting Cochrane reviews in the EBV process.
Patient or healthcare consumer involvement: No patients were directly included in this study.