{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:55:35Z","timestamp":1790920535102,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>Despite high administrative immunization coverage across Sub-Saharan Africa, unexpected infectious disease outbreaks pose significant public health challenges. Traditional tracking relies heavily on logistical inputs and reactive surveillance, leaving an unmonitored biological gap in real-world host immunity. This paper presents a novel systems-design conceptual framework for Population-Level Immunologic Monitoring (PLIM) as a core operational tool of Public Health Pharmacology (PHP) to systematically bridge this gap. PLIM operates across three interconnected pillars: (1) biological sentinel surveillance using field-stabilized samples, (2) risk stratification mapping the climatic-biological nexus, and (3) near-real-time policy feedback via digital health infrastructure. To demonstrate operational plausibility, we describe a prospective \u201cPathfinder Pilot\u201d validation roadmap in Rwanda. This theoretical proof-of-concept model details a logistics blueprint utilizing Dried Blood Spot (DBS) sampling paired with quantitative ELISAs and T-cell Activation Assays (TASA) integrated into existing DHIS2 software to monitor population cohorts against the Population Immunologic Threshold (PIT)\u2014a composite metric linking individual correlates of protection to herd immunity thresholds. Crucially, PLIM complements existing administrative tracking, pharmacovigilance, and epidemiological outbreak investigations. By isolating biological host factors, the framework provides an intermediate biological audit layer. This empowers public health managers to detect waning immunity and map \u201cbiological cold spots\u201d before outbreaks occur, advancing immunologic equity across resource-limited settings.<\/jats:p>","DOI":"10.3389\/fpubh.2026.1965936","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:36:26Z","timestamp":1790919386000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Public Health Pharmacology: a framework for population-level immunologic monitoring (PLIM) to optimize vaccine performance in Africa"],"prefix":"10.3389","volume":"14","author":[{"given":"Ahmed Adebowale","family":"Adedeji","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Toxicology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda","place":["Butare, Rwanda"]},{"name":"Foresight Institute of Research and Translation, Gikondo","place":["Kigali, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminah Adeola","family":"Adedeji","sequence":"additional","affiliation":[{"name":"Foresight Institute of Research and Translation, Gikondo","place":["Kigali, Rwanda"]},{"name":"Department of Epidemiology, Lagos State Ministry of Health","place":["Lagos, Nigeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einas","family":"Mohammed ElHabibi Adam","sequence":"additional","affiliation":[{"name":"Equator University of Science and Technology","place":["Masaka, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taofeek Tope","family":"Adegboyega","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda","place":["Butare, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issa Muritala","family":"Bale","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda","place":["Butare, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasheed Omotayo","family":"Adeyemo","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda","place":["Butare, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojeed Akorede","family":"Gbadamosi","sequence":"additional","affiliation":[{"name":"Department of Primary Care-Palliative Care and Community Health, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda","place":["Butare, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Sibomana","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Immunization, Rwanda Ministry of Health","place":["Kigali, Rwanda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasim Sakran","family":"Abass","sequence":"additional","affiliation":[{"name":"Department of Physiology, Biochemistry, and Pharmacology, College of Veterinary Medicine, University of Kirkuk","place":["Kirkuk, Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drissa Makan","family":"Toure","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health, University of Minnesota","place":["Minneapolis, MN, United 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