Developing a seasonal influenza vaccine recommendation in Kenya: Process and challenges faced by the National Immunization Technical Advisory Group (NITAG)

Dawa, Jeanette; Chaves, Sandra S.; Nguz, Antoinette Ba; Kalani, Rosalia; Anyango, Edwina; Mutie, Dominic; Muthoka, Philip; Tabu, Collins; Maritim, Marybeth; Amukoye, Evans; Were, Fred

doi:10.1016/j.vaccine.2018.11.062

Cited by 25 publications

(20 citation statements)

References 14 publications

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“…Most pregnant women in this study reported a willingness to receive influenza vaccine, which is not currently in routine use in Kenya, but was recommended by the Kenya National Immunization Technical Advisory Group in 2016, pending availability of local data on burden of influenza in pregnancy. 42 Contrarily, 27.0% felt that new vaccines are riskier than old vaccines, and 50.8% reported that "experimental" vaccines should not be used on pregnant women. Also, 16.7% of participants reported they would only accept one vaccine during pregnancy, and 11.9% would accept up to two vaccines.…”

Section: Discussionmentioning

confidence: 99%

Drivers and barriers of vaccine acceptance among pregnant women in Kenya

Otieno

Otiato

Nyawanda

et al. 2020

Human Vaccines & Immunotherapeutics

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Maternal vaccination coverage remains suboptimal globally and is lowest in low-and middle-income countries. Attitudes toward maternal vaccines have been characterized in middle-high income settings, however data from African countries are limited. We assessed drivers and barriers of vaccine acceptance among pregnant women in Kenya. We conducted a cross-sectional survey among pregnant women aged 15-49 y. We enrolled a convenience sample of women presenting for antenatal care at seven health-care facilities in four diverse counties (Nairobi, Mombasa, Marsabit, Siaya) of Kenya and from the community in two counties (Nairobi, Siaya). We described frequencies of socio-demographic characteristics of participants and their knowledge, attitudes, and beliefs regarding maternal vaccination. We enrolled 604 pregnant women with a median age of 26.5 y, of whom 48.2% had primary education or less. More than 95% agreed that maternal vaccines are "important for my health" and that getting vaccinated is "a good way to protect myself from disease". The most commonly cited reason in favor of maternal vaccination was disease prevention (53.2%). Fear of side effects to mother/baby (15.1%) was the most frequently reported potential barrier. Influenza vaccine is not in routine use in Kenya; however, 77.8% reported willingness to accept influenza vaccination during pregnancy. Maternal vaccination is well accepted among Kenyan pregnant women. We identified the provision of adequate vaccine information and addressing safety concerns as opportunities to improve maternal vaccine uptake. The expressed willingness to receive a vaccine not currently in routine use bodes well for implementation of new maternal vaccines in Kenya.

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Section: Discussionmentioning

confidence: 99%

Drivers and barriers of vaccine acceptance among pregnant women in Kenya

Otieno

Otiato

Nyawanda

et al. 2020

Human Vaccines & Immunotherapeutics

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“…Currently, there is no influenza vaccination policy in Kenya, and the number of influenza vaccine doses distributed in the private sector is very limited and based on the Southern Hemisphere vaccine formulations. However, ongoing discussions about introduction of an influenza vaccine recommendation in the government may lead to a formal policy in the near future . The genetic analysis, as demonstrated in this study, can assist with monitoring the evolution of seasonal influenza viruses.…”

Section: Discussionmentioning

confidence: 91%

“…Currently, the government of Kenya is considering recommending annual influenza vaccine for young children. 21 As an influenza vaccination program is implemented, there will be a need to establish genetic and antigenic viral surveillance which could be used to assess how well the vaccine performs and inform public health decisions on vaccination strategies. 7 We characterized the genetic changes in A(H3N2) viruses circulating in coastal Kenya using full-length HA sequences generated through next-generation sequencing (NGS) from respiratory specimens collected from inpatient and outpatient sentinel surveillance sites in coastal Kenya from 2009 to 2017.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, the government of Kenya is considering recommending annual influenza vaccine for young children . As an influenza vaccination program is implemented, there will be a need to establish genetic and antigenic viral surveillance which could be used to assess how well the vaccine performs and inform public health decisions on vaccination strategies …”

Section: Introductionmentioning

confidence: 99%

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Genetic characterization of influenza A(H3N2) viruses circulating in coastal Kenya, 2009‐2017

Owuor

Ngoi

Otieno

et al. 2020

Influenza Resp Viruses

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Background: Influenza viruses evolve rapidly and undergo immune driven selection, especially in the hemagglutinin (HA) protein. We report amino acid changes affecting antigenic epitopes and receptor-binding sites of A(H3N2) viruses circulating in Kilifi, Kenya, from 2009 to 2017. Methods: Next-generation sequencing (NGS) was used to generate A(H3N2) virus genomic data from influenza-positive specimens collected from hospital admissions and health facility outpatients presenting with acute respiratory illness to health facilities within the Kilifi Health and Demographic Surveillance System. Full-length HA sequences were utilized to characterize A(H3N2) virus genetic and antigenic changes.

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“…KENITAG further recommended pilot projects to generate additional local data to inform implementation of a nationwide influenza vaccination policy. In particular, KENITAG requested that local evidence be generated on influenza vaccine cost-effectiveness, because their recommendation largely relied on studies in non-African countries [ 4 – 6 ]. Given the cost implications of a nationwide programme, local economic evaluation data are needed to inform policy on the design and benefits of influenza vaccination in Kenya.…”

Section: Introductionmentioning

confidence: 99%

Seasonal influenza vaccination in Kenya: an economic evaluation using dynamic transmission modelling

Dawa

Emukule

Barasa

et al. 2020

BMC Med

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Background: There is substantial burden of seasonal influenza in Kenya, which led the government to consider introducing a national influenza vaccination programme. Given the cost implications of a nationwide programme, local economic evaluation data are needed to inform policy on the design and benefits of influenza vaccination. We set out to estimate the cost-effectiveness of seasonal influenza vaccination in Kenya. Methods: We fitted an age-stratified dynamic transmission model to active surveillance data from patients with influenza from 2010 to 2018. Using a societal perspective, we developed a decision tree cost-effectiveness model and estimated the incremental cost-effectiveness ratio (ICER) per disability-adjusted life year (DALY) averted for three vaccine target groups: children 6-23 months (strategy I), 2-5 years (strategy II) and 6-14 years (strategy III) with either the Southern Hemisphere influenza vaccine (Strategy A) or Northern Hemisphere vaccine (Strategy B) or both (Strategy C: twice yearly vaccination campaigns, or Strategy D: year-round vaccination campaigns). We assessed cost-effectiveness by calculating incremental net monetary benefits (INMB) using a willingness-to-pay (WTP) threshold of 1-51% of the annual gross domestic product per capita ($17-$872). Results: The mean number of infections across all ages was 2-15 million per year. When vaccination was well timed to influenza activity, the annual mean ICER per DALY averted for vaccinating children 6-23 months ranged between $749

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Developing a seasonal influenza vaccine recommendation in Kenya: Process and challenges faced by the National Immunization Technical Advisory Group (NITAG)

Cited by 25 publications

References 14 publications

Drivers and barriers of vaccine acceptance among pregnant women in Kenya

Drivers and barriers of vaccine acceptance among pregnant women in Kenya

Genetic characterization of influenza A(H3N2) viruses circulating in coastal Kenya, 2009‐2017

Seasonal influenza vaccination in Kenya: an economic evaluation using dynamic transmission modelling

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