World’s first vaccination campaign to control hepatitis E outbreak in Bentiu, South Sudan

Author(s): John Rumunu

Director General for Preventive Health Services, South Sudan Ministry of Health. 

Email: [email protected] 

Citation: Rumunu. World’s first vaccination campaign to control hepatitis E outbreak in Bentiu, South Sudan South Sudan Medical Journal 2022;15(4):126 © 2022 The Author (s) License: This is an open access article under CC BY-NC  DOI:

Nyekhan getting vaccinated against hepatits E at Bentiu, Rubkona County, Unity State, South Sudan. (© Peter Caton)

Hepatitis E is the most common cause of acute viral hepatitis, causing approximately 20 million infections and 44,000 deaths every year. It is transmitted through faecal contamination of food and water. The fatality rate is up to 25% among pregnant women, as well as increasing the risk of spontaneous abortions and stillbirths.

Outbreaks of hepatitis E have occurred since 2015 in Bentiu, the largest internally displaced persons camp in South Sudan. In the most recent outbreak 759 patients were confirmed with hepatitis E, 17 of whom died. 

In response to the outbreaks, the South Sudan Ministry of Health and Médecins Sans Frontières (MSF) jointly carried out a mass vaccination in Bentiu with the Hecolin Vaccine that has been developed and tested in China. The vaccination targeted a population aged 16 to 40 years that included pregnant women. Three rounds of vaccination were carried out in March, April and October 2022. A total of 39,764 doses were given as 1st dose, 26,110 as 2nd dose and 14,293 as 3rd dose. It is worthy to note that the 1st dose seems to be high compared to the rest due to the inclusion of new people who fitted the criteria, but they were not present during either the 2nd or 3rd rounds.

Although the World Health Organization (WHO) recommended as early as 2015 the use of the vaccine in Hepatitis E outbreaks, the campaign in Bentiu was the first time it had been used at scale in response to a public health emergency. WHO has called the campaign a “significant milestone” in the fight against hepatitis E.[1, 2]

Given the successful implementation and the community’s enthusiastic response, I hope that this innovative vaccination campaign can serve as an example and be replicated in similar settings in other countries managing hepatitis E outbreaks. While other outbreak control measures are also necessary, including improving water and sanitation services, I believe this vaccination campaign is an important step toward reducing the impact of hepatitis E in the future.

The Ministry of Health and MSF will continue to monitor and report on the results. 


  1. South Sudan – World’s First Vaccination Campaign to Control Hepatitis E Outbreak.  
  2. Hepatitis E: MSF carries out world’s first-ever ‘reactive’ vaccination campaign