20. Vaccine–Preventable Diseases
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Editors/Authors: Logan Brenzel, Lara J. Wolfson, Julia Fox–Rushby, Mark Miller, and Neal A. Halsey
Disease / Condition
Adolescent & Childhood Diseases
Integrated Management of Childhood Illness
Maternal & Neonatal Conditions
Sexually Transmitted Infections
Because vaccination has had a significant effect on reducing mortality and morbidity from childhood diseases, it is one of the key strategies for achieving the child health Millennium Development Goals endorsed by the United Nations. The World Health Organization's Expanded Program on Immunization is one of the most cost–effective public health programs, focusing on tuberculosis, diphtheria, pertussis (whooping cough), tetanus, polio, measles, hepatitis B, and yellow fever. More recently, a consortium of major international development partners, private philanthropies, nongovernmental organizations, and the vaccine industry has helped increase access to new and underused vaccines in the world's poorest countries, improve access to basic immunization services, and accelerate research and development into new drugs and technologies.
The epidemiology and burden of vaccine–preventable diseases vary by country and region for numerous reasons, including differences in vaccine uptake, geography, seasonal patterns, nutritional status, and travel to and from other countries. The greatest burden of disease occurs in Sub–Saharan Africa, where immunization programs have been least successful. Governments in developing countries as well as their development partners are challenged to find ways to finance and sustain immunization programs, especially as they seek to achieve higher coverage levels and introduce new vaccines.
In the short term, policy makers can explore ways to improve the cost–effectiveness of vaccination over other interventions. For example, immunization program costs can be lowered by using the most efficient mix of delivery strategies, reducing vaccine waste, and reducing the number of doses required to achieve immunity. Targeted approaches also could yield high returns, especially in those regions with poor control of vaccine–preventable diseases. In some countries, however, the challenge will be to sustain high immunization coverage in the face of community perception that vaccine–preventable diseases no longer constitute a major public health threat.
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- Causes and Epidemiology of Diseases Prevented by Vaccines Used in National Immunization Programs
- Estimates of the Current Burden of Vaccine-Preventable Diseases and of the Burden Averted by Vaccination
- Expanded Program on Immunization
- Costs and Cost-Effectiveness of Existing Vaccination Programs
- Cost-Effectiveness of Increasing Immunization Coverage for the Traditional EPI
- Costs and Cost-Effectiveness of Adding New Antigens to the Current Immunization Schedule
- Financial Sustainability of Immunization Programs
- Improving the Costs and Cost-Effectiveness of Immunization Programs
- Research Agenda
- 20.1 Marginal Costs of Immunization Services in India
- 20.2 An Immunization Costing Study of Adding New Vaccines to the EPI in Peru
- 20.1 Selected Vaccine-preventable Diseases and Vaccines
- 20.2 Estimated Number of Deaths in the Absence of Vaccination, Deaths from Vaccine-preventable Diseases, and Deaths Averted by Vaccination, All Ages, by Region and Vaccine, 2001 (thousands)
- 20.3 DALYs Lost from Vaccine-preventable Diseases, All Ages By Region, 2001 (thousands)
- 20.4 Estimates of the Population-weighted Annual Cost for the Traditional Vaccines per FIC, by Immunization Strategy and Region, 2001 (2001 US$)
- 20.5 Average Cost per FIC, Total Immunization Cost, Cost per Death Averted and Cost per DALY for the Traditional Immunization Program by Region
- 20.6 Average Cost per Person Vaccinated and per Death Averted for Scaling Up Immunization Coverage and Adding in Selected New Vaccines in a Hypothetical Population of 1 million for 2002-11 (2001 US$, current vaccine prices)