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Should yellow fever vaccine be included in the expanded program of immunization in Africa?

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Should yellow fever vaccine be included in the expanded program of immunization in Africa?

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The cost-effectiveness of preventive yellow fever vaccination versus emergency mass vaccination campaigns for epidemic control remains a matter of controversy. Until recently, Nigeria and other anglophone countries in West Africa most severely afflicted by yellow fever epidemics have followed a policy of emergency control. The effects of including yellow fever 17D vaccine in the Expanded Program of Immunization (EPI) on the immune status of the Nigerian population was studied under conservative assumptions of vaccine coverage and efficacy. The model defined the age-specific prevalence of immunity resulting from vaccination of infants and from natural endemic infection beginning in 1991 and extending over a time horizon of 35 years. The data were used to predict the number of cases and deaths during hypothetical epidemics in 2006 and 2026, representing the historic periodicity of epidemics. A second model was used to demonstrate that a > or = 60% prevalence of immunity would preclude ep

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