Impact of targeted tuberculosis vaccination among Amining population in South Africa: A model-based study

Sourya Shrestha, Violet Chihota, Richard G. White, Alison D. Grant, Gavin J. Churchyard, David W. Dowdy

Research output: Contribution to journalArticlepeer-review

Abstract

Optimizing the use of new tools, such as vaccines, may play a crucial role in reaching global targets for tuberculosis (TB) control. Some of the most promising candidate vaccines target adults, although high-coverage mass vaccinations may be logistically more challenging among this population than among children. Vaccine-delivery strategies that target high-risk groups or settings might yield proportionally greater impact than do those that target the general population. We developed an individual-based TB transmission model representing a hypothetical population consisting of people who worked in South African gold mines or lived in associated labor-sending communities. We simulated the implementation of a post infection adult vaccine with 60% efficacy and a mean effect duration of 10 years. We then compared the impact of a mine-targeted vaccination strategy, in which miners were vaccinated while in the mines, with that of a community-targeted strategy, in which random individuals within the labor-sending communities were vaccinated. Mine-targeted vaccination averted an estimated 0.37 TB cases per vaccine dose compared with 0.25 for community-targeted vaccination, for a relative efficacy of 1.46 (95% range, 1.13-1.91). The added benefit of mine targeted vaccination primarily reflected the disproportionate demographic burden of TB among the population of adult males as a whole. As novel vaccines for TB are developed, venue-based vaccine delivery that targets high-risk demographic groups may improve both vaccine feasibility and the impact on transmission.

Original languageEnglish (US)
Pages (from-to)1362-1369
Number of pages8
JournalAmerican journal of epidemiology
Volume186
Issue number12
DOIs
StatePublished - Dec 15 2017

Keywords

  • Mathematical modeling
  • South African gold mines
  • TB vaccine
  • Targeted vaccination
  • Tuberculosis

ASJC Scopus subject areas

  • Epidemiology

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