Estimating the Health Impact of Vaccination Against 10 Pathogens in 98 Low and Middle Income Countries from 2000 to 2030

Li, Xiang; Mukandavire, Christinah; Cucunubá, Zulma M.; Abbas, Kaja; Clapham, Hannah E.; Jit, Mark; Johnson, Hope L.; Papadopoulos, Timos; Vynnycky, Emilia; Brisson, Marc; Carter, Emily D; Clark, Andrew; Villiers, Marietjie de; Eilertson, Kirsten; Ferrari, Matthew J.; Gamkrelidze, Ivane; Gaythorpe, Katy A. M.; Grassly, Nicholas C.; Hallett, Timothy B.; Hinsley, Wes; Jackson, Michael L.; Jean, Kévin; Karachaliou, Andromachi; Klepac, Petra; Lessler, Justin; Li, Xi; Moore, Sean M.; Nayagam, Shevanthi; Nguyen, Duy Manh; Razavi, Homie; Razavi‐Shearer, Devin; Resch, Stephen; Sanderson, Colin; Sweet, Steven; Sy, Stephen; Tam, Yvonne; Tanvir, Hira; Tran, Quan Minh; Trotter, Caroline; Truelove, Shaun; Zandvoort, Kevin van; Verguet, Stéphane; Walker, Neff; Winter, Amy; Woodruff, Kim; Ferguson, Neil; Garske, Tini

doi:10.2139/ssrn.3460657

Cited by 11 publications

(22 citation statements)

References 11 publications

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“…Vaccines have substantially improved health and reduced mortality, particularly among children in low-income countries. 1 - 3 World Health Organization (WHO) launched the Immunization Agenda 2030 strategy in 2020 to accelerate progress towards equitable access and use of vaccines over the new decade. 4 However, ensuring everyone has access to immunization services has been challenging, an additional challenge is posed by the COVID-19 pandemic, which has necessitated physical distancing measures to mitigate or delay the epidemic to avoid health-care systems being overwhelmed.…”

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confidence: 99%

Effects of the Coronavirus disease 2019 pandemic on routine pediatric immunization coverage rates at the main University Hospital in Saudi Arabia

Alrabiaah

Alshaer

Estrella

et al. 2020

SMJ

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Objectives: To investigate whether the coronavirus disease-2019 pandemic has had any effects on pediatric vaccination rates at the main university hospital in Saudi Arabia. Methods: A retrospective study conducted at King Saud University Medical City, Riyadh, Saudi Arabia using electronic health records. The vaccination statuses of all children who were scheduled for vaccinations at birth and at 2, 4, 6, 9, and 12 months during March, April and May between 2017 and 2020 were included in the study with total sample of 15,870 children, and comparisons between the cohorts were performed. Results: All vaccination visits during April and May 2020 were below the lower extremes except for the birth vaccinations. In March, April, and May 2020 there were respective drops in vaccination visits of 49.93%, 71.90% and 68.48% compared with the mean numbers of vaccination visits during the same months from 2017 to 2019. In comparisons of mean numbers of visits from March 2017 to May 2019 and March to May in 2020, the respective reductions in visits for birth and 2, 4, 6, 9 and 12-month vaccinations were 16.5%, 80.5%, 74.7%, 72.9%, 80.0% and 74.1%. Conclusions: The huge impact of the coronavirus disease-2019 pandemic on childhood vaccinations will require urgent vaccination recovery plans with innovative approaches and future action plans to maintain vaccination coverage during any subsequent pandemics.

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confidence: 99%

Effects of the Coronavirus disease 2019 pandemic on routine pediatric immunization coverage rates at the main University Hospital in Saudi Arabia

Alrabiaah

Alshaer

Estrella

et al. 2020

SMJ

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“…Previous quantifications of the outstanding health impact of vaccination activities have mainly focused on cases or deaths prevented, and have relied on mathematical models whose structures and assumptions may be difficult to understand by a non-expert audience, whether that be decision-makers or targeted populations [ 34 , 35 ]. Here we further document vaccination impact using an empirical, maybe more intuitive approach, thus allowing for a triangulation of methods to further document the beneficial impact of yellow fever vaccine campaigns.…”

Section: Discussionmentioning

confidence: 99%

Assessing the impact of preventive mass vaccination campaigns on yellow fever outbreaks in Africa: A population-level self-controlled case series study

et al. 2021

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Background The Eliminate Yellow fever Epidemics (EYE) strategy was launched in 2017 in response to the resurgence of yellow fever in Africa and the Americas. The strategy relies on several vaccination activities, including preventive mass vaccination campaigns (PMVCs). However, to what extent PMVCs are associated with a decreased risk of outbreak has not yet been quantified. Methods and findings We used the self-controlled case series (SCCS) method to assess the association between the occurrence of yellow fever outbreaks and the implementation of PMVCs at the province level in the African endemic region. As all time-invariant confounders are implicitly controlled for in the SCCS method, this method is an alternative to classical cohort or case–control study designs when the risk of residual confounding is high, in particular confounding by indication. The locations and dates of outbreaks were identified from international epidemiological records, and information on PMVCs was provided by coordinators of vaccination activities and international funders. The study sample consisted of provinces that were both affected by an outbreak and targeted for a PMVC between 2005 and 2018. We compared the incidence of outbreaks before and after the implementation of a PMVC. The sensitivity of our estimates to a range of assumptions was explored, and the results of the SCCS method were compared to those obtained through a retrospective cohort study design. We further derived the number of yellow fever outbreaks that have been prevented by PMVCs. The study sample consisted of 33 provinces from 11 African countries. Among these, the first outbreak occurred during the pre-PMVC period in 26 (79%) provinces, and during the post-PMVC period in 7 (21%) provinces. At the province level, the post-PMVC period was associated with an 86% reduction (95% CI 66% to 94%, p < 0.001) in the risk of outbreak as compared to the pre-PMVC period. This negative association between exposure to PMVCs and outbreak was robustly observed across a range of sensitivity analyses, especially when using quantitative estimates of vaccination coverage as an alternative exposure measure, or when varying the observation period. In contrast, the results of the cohort-style analyses were highly sensitive to the choice of covariates included in the model. Based on the SCCS results, we estimated that PMVCs were associated with a 34% (95% CI 22% to 45%) reduction in the number of outbreaks in Africa from 2005 to 2018. A limitation of our study is the fact that it does not account for potential time-varying confounders, such as changing environmental drivers of yellow fever and possibly improved disease surveillance. Conclusions In this study, we provide new empirical evidence of the high preventive impact of PMVCs on yellow fever outbreaks. This study illustrates that the SCCS method can be advantageously applied at the population level in order to evaluate a public health intervention.

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“…The spatial distribution of burden was also generally similar across serology scenarios. As such, different assumptions about the interpretation of serological data may be more consequential for decision making around the prioritization of investments across different vaccine-preventable diseases [25] than for decision making that is limited in scope to yellow fever.…”

Section: Discussionmentioning

confidence: 99%

Burden is in the eye of the beholder: Sensitivity of yellow fever disease burden estimates to modeling assumptions

Perkins

Huber

Tran

et al. 2021

Preprint

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Geographically stratified estimates of disease burden play an important role in setting priorities for the management of different diseases and for targeting interventions against a single disease. Such estimates involve numerous assumptions, which uncertainty about is not always well accounted for. We developed a framework for estimating the burden of yellow fever in Africa and evaluated its sensitivity to assumptions about the interpretation of serological data and choice of regression model. We addressed the latter with an ensemble approach, and we found that the former resulted in a nearly twentyfold difference in burden estimates (range of central estimates: 8.4×104-1.5×106 deaths in 2021-2030). Even so, statistical uncertainty made even greater contributions to variance in burden estimates (87%). Combined with estimates that most infections go unreported (range of 95% credible intervals: 99.65-99.99%), our results suggest that yellow fever’s burden will remain highly uncertain without major improvements in surveillance.

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Estimating the Health Impact of Vaccination Against 10 Pathogens in 98 Low and Middle Income Countries from 2000 to 2030

Cited by 11 publications

References 11 publications

Effects of the Coronavirus disease 2019 pandemic on routine pediatric immunization coverage rates at the main University Hospital in Saudi Arabia

Effects of the Coronavirus disease 2019 pandemic on routine pediatric immunization coverage rates at the main University Hospital in Saudi Arabia

Assessing the impact of preventive mass vaccination campaigns on yellow fever outbreaks in Africa: A population-level self-controlled case series study

Burden is in the eye of the beholder: Sensitivity of yellow fever disease burden estimates to modeling assumptions

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