Epidemiology and modelling to support the routine infant immunisation programme in England.

The routine infant immunization programme in England has been instrumental in reducing morbidity and mortality associated with vaccine-preventable diseases. This thesis explores the use of epidemiological and mathematical modelling to inform vaccination policy, focusing on two critical aspects: the impact of changes to the meningococcal vaccination schedule and the potential introduction of a universal varicella vaccine. Two dynamic transmission models were developed and applied to evaluate these issues. The first model assessed the consequences of withdrawing the Hib/MenC vaccine from the infant schedule, revealing that teenage MenACWY vaccination provides sufficient indirect protection to mitigate the need for an infant MenC dose. The second model examined the epidemiological and economic implications of introducing a varicella vaccine. The findings indicated that routine varicella vaccination would dramatically reduce varicella incidence and be cost-effective, despite a modest rise in zoster cases. The thesis also investigated the influence of structural choices in vaccination modelling on disease dynamics and outcomes, highlighting the importance of robust model assumptions and sensitivity analyses. These findings underscore the value of mathematical modelling in adapting vaccination policies. This work provides insights to policymakers, recommending the streamlining of the meningococcal schedule and the introduction of a varicella vaccine. It also emphasizes the need for ongoing investment in data-driven modelling approaches to enhance the effectiveness and sustainability of immunization programmes in England.

Name dc:type.qualificationname

Doctor of Philosophy (PhD)

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

University of Cambridge

Year dc:date.issued

2024

Author dc:creator

• Adams, Lauren

Advisor dc:contributor.advisor

• Trotter, Caroline

• Vaccination
• transmission modelling
• infant immunisation
• varicella
• meningitis
• epidemiology

Licence

• https://www.repository.cam.ac.uk/bitstreams/c9a19e1c-74fa-4095-92b2-d2c09d033126/download
• http://purl.org/NET/rdflicense/allrightsreserved

Author Identifier

0009-0001-6585-9145

OAI identifier oai:identifier

oai:www.repository.cam.ac.uk:1810/385253