Modeling the Impact of Maternal Immunization Programs in a Low Income Setting Public

Guterman, L. Beryl (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/6h440t404?locale=fr
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Abstract

The WHO recommends that countries implementing seasonal influenza vaccination give the highest priority to pregnant women because they are at a higher risk for adverse outcomes attributable to influenza infection. Additionally, maternal immunization has shown to have an impact on the protection of their new born infants. We developed a preliminary deterministic ordinary differential equation model to simulate seasonal influenza transmission. Our model utilizes previously published demographic, seasonality and social mixing data for Kenya to assess the impact of a maternal immunization program in a low-income setting. Approximately six months following the introduction of vaccination, a smaller secondary peak in incidence and prevalence took place in both the maternal and infant populations. In addition, these secondary peaks appear to increase in amplitude as vaccination coverage increases. The model shows a linear increase in cases averted in both the pregnant and infant populations as maternal immunization coverage increases and vaccination modeled continuously throughout the year. Several elements of this model need further development, specifically in its parameterization. Due to limited available data, elements of the model structure and several parameters do not accurately simulate the interplay of population dynamics and influenza transmission in low income settings. Therefore, further development and data collection is needed for this model.

Table of Contents

Table of Contents

I. Introduction…………………………………………………………………...1

II. Methods……………………………………………………………………….3

Demographic parameters………………………………………………………3

Disease transmission parameters……………………………………………….4

The Model……………………………………………………………………...8

Vaccination…………………………………………………………………….8

Uncertainty Analysis……………………………………………………………8

III. Results………………………………………………………………………...10

Model Fitting …………………………………………………………………10

Vaccination Impact …………………………………………………………...10

IV. Discussion…………………………………………………………………….12

Discussion of results………………………………………………………….12

Limitations……………………………………………………………………13

Future Directions……………………………………………………………...14

V. Figures………………………………………………………………………...16

VI. Tables ………………………………………………………………………...23

VII. References…………………………………………………………………….28

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