Vaccine dose fractionation in Africa: A systematic review | ||
| Microbes and Infectious Diseases | ||
| Volume 6, Issue 4, November 2025, Pages 6175-6188 PDF (763.6 K) | ||
| Document Type: Systematic review or meta-analysis | ||
| DOI: 10.21608/mid.2024.298537.2021 | ||
| Authors | ||
| Abdourahamane Yacouba* 1, 2; Souleymane Brah1, 2; Mamane Daou1, 2; Abdoul Kader Andia1, 2; Alkassoum Ibrahim1, 2; Lamine Mahaman Moustapha2, 3; Daouda Alhousseini1, 2; Mahamadou Doutchi1, 2; Ousmane Guindo4; Issaka Soumana4; Matthew E Coldiron5; Saidou Mamadou1, 2; Eric Adehossi1, 2; Rebecca Grais5 | ||
| 1Université Abdou Moumouni, Niamey, Niger ; PB 10896, Niamey, Niger. | ||
| 2Centre de Formation et de Recherche en Médecine Tropicale (CFRMT), Niamey, Niger ; PB 10896, Niamey, Niger | ||
| 3Université André Salifou, LEG2S, Zinder, Niger ; PB 656, KM 5 Route d’AgadezZinder, Niger. | ||
| 4Epicentre, Maradi, Niger ; PB : 13330, Maradi, Niger | ||
| 5Epicentre, 14-34 Avenue Jean Jaurès, Paris, France | ||
| Abstract | ||
| Background: The major challenges of vaccination programs are notably coverage in the target population, vaccine hesitancy and cost-effectiveness. Aim: This study aimed to review the literature on administering fractional vaccine doses in Africa. Methods: A systematic search of PubMed and Google Scholar was conducted to identify articles published up till March 31, 2024. Keywords used for the search were “fractional dosing”, “Vaccines”, and “Africa”. Results: Findings from eleven eligible studies were analyzed. Studies were from the Democratic Republic of the Congo, Gambia, Ghana, Kenya, South Africa, and Uganda. They covered five vaccines including the yellow fever vaccine (n=3; 27.3%), inactivated poliovirus vaccine (n=3; 27.3%), meningococcal A/C/Y/W135 vaccine (n=2; 18.2%), Haemophilus influenzae type b vaccine (n=2; 18.2%), and malaria vaccine (n=1; 9.1%). Fractionated doses used most often consist of one-fifth of the standard dose (n=8; 72.7%). Regarding immunogenicity/efficacity, eight of ten studies that addressed immunogenicity suggest that immune responses to the fractional dose vaccines were comparable to that of the standard dose vaccines and resulted in higher antibody titers. Regarding safety, all of the eight studies that addressed the safety of fractional doses in Africa, suggest that safety and tolerability data of fractional dosing were favorable compared to full dose regimen. Conclusion: Fractional dosing may be considered to address the availability and acceptability of certain vaccines while maintaining protection. Contribution: Although efforts are currently underway to increase the possibility of vaccine manufacturing on the African continent, fractional dosing strategies may also be needed in the future and potentially offer other benefits. | ||
| Keywords | ||
| vaccine coverage; vaccine hesitancy; fractional doses; Africa | ||
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