Vaccination greatly reduces disease, disability, death and inequity worldwide

Fe, André; Booy, Robert; Bock, H.L.; Clemens, John D.; Datta, SK; John, Thomas; Bw, Lee; Lolekha, Somsak; Peltola, Heikki; Ruff, TA; Santosham, Mathuram; Hj, Schmitt

doi:10.2471/blt.07.040089

Cited by 1,007 publications

(774 citation statements)

References 58 publications

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“…Twelve of these were included in previous studies (Table A3) for their well-documented effects on child mortality and health [12,16–18]. We added five additional interventions that have demonstrated a significant impact on child health and have available data in DHS and MICS: access to improved water, access to improved sanitation, BCG immunization, polio immunization, and care seeking for diarrhea [9,26–31]. …”

Section: Methodsmentioning

confidence: 99%

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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Background: Reducing child mortality was one of the Millennium Development Goals. In the current Sustainable Development Goals era, achieving equity is prioritized as a major aim. Objective: This study aims to provide a comprehensive and updated picture of inequalities in child health intervention coverage and child health outcomes by wealth status, as well as their trends between 2000 and 2014. Methods: Using data from Demographic Health Surveys and Multiple Indicator Cluster Surveys, we adopted three measures of inequality, including one absolute inequality indicator and two relative inequality indicators, to estimate the level and trends of inequalities in three child health outcome variables and 17 intervention coverages in 88 developing countries. Results: While improvements in child health outcomes and coverage of interventions have been observed between 2000 and 2014, large inequalities remain. There was a high level of variation between countries’ progress toward reducing child health inequalities, with some countries significantly improving, some deteriorating, and some remaining statistically unchanged. Among child health interventions, the least equitable one was access to improved sanitation (The absolute difference in coverages between the richest quintile and the poorest quintile reached 49.5% [42.7, 56.2]), followed by access to improved water (34.1% [29.5, 38.6]), and skilled birth attendant (SBA) (34.1% [28.8, 39.4]). The most equitable intervention coverage was insecticide-treated bed net for children (1.0% [−3.9, 5.9]), followed by oral rehydration therapy for diarrhea ((8.0% [5.2, 10.8]), and vitamin A supplement (8.4% [5.1, 11.7]). These findings were robust to various inequality measurements. Conclusions: Although child health outcomes and coverage of interventions have improved largely over the study period for almost all wealth quintiles, insufficient progress was made in reducing child health inequalities between the poorest and richest wealth quintiles. Future efforts should focus on reaching the poorest children by increasing investments toward expanding the coverage of interventions in resource-limited settings.

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Section: Methodsmentioning

confidence: 99%

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Subramanian

et al. 2017

Global Health Action

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“…Childhood vaccination has contributed to major global reductions in morbidity and mortality [1,2] and is considered to be the most successful public health intervention in terms of number of deaths averted per year [3,4]. However, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) estimate that 1.5 million children worldwide continue to die from vaccine-preventable diseases every year because of sub-optimal vaccination coverage [5].…”

Section: Introductionmentioning

confidence: 99%

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Kagoné

Yé

Nebié

et al. 2017

Global Health Action

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Background: Vaccination is an important tool for reducing infectious disease morbidity and mortality. In the past, less than 80% of children 12–23 months of age were fully immunized in Burkina Faso. Objectives: To describe coverage and assess factors associated with adherence to the vaccination schedule in rural area Burkina Faso. Methods: The study population was extracted from the Nouna Health and Demographic surveillance system cohort. Data from four rounds of interviews conducted between November 2012 and June 2014 were considered. This study included 4016 children aged 12–23 months. We assessed the effects of several background factors, including sex, factors reflecting access to health care (residence, place of birth), and maternal factors (age, education, marital status), on being fully immunized defined as having received Bacillus Calmette–Guérin (BCG), three doses of diphtheria–tetanus–pertussis and oral polio vaccine, and measles vaccine by 12 months of age. The associations were studied using binomial regression to derive prevalence ratios (PRs) in univariate and multivariate regression models. Results: The full vaccination coverage increased significantly over time (72% in 2012, 79% in 2013, and 81% in 2014, p = 0.003), and the coverage was significantly lower in urban than in rural areas (PR 0.84; 0.80–0.89). Vaccination coverage was neither influenced by sex nor influenced by place of birth or by maternal factors. Conclusion: The study documented a further improvement in full vaccination coverage in Burkina Faso in recent years and better vaccination coverage in rural than in urban areas. The organization of healthcare systems with systematic outreach activities in the rural areas may explain the difference between rural and urban areas.

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“…The vaccine might operate over a long timescale, providing protection for years into the future [11]. Vaccination programmes are therefore considered public health initiatives because they actively target an entire at-risk population, rather than passively waiting for patients who already have symptomatic disease to present for treatment [12]. Attempts have been made to develop a clearer inventory of the different types of vaccine benefits (short-term, long-term) that goes beyond the narrow vision of reduction of specific disease burden and consequential improved production (Table 1).…”

Section: Total Value Measurementmentioning

confidence: 99%

3. How comprehensive can we be in the economic assessment of vaccines?

Standaert

Rappuoli²

2017

Journal of Market Access & Health Policy

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In two previous papers we argued on current vaccines economic assessment not fully comprehensive when using the incremental cost-utility analysis normally applied for treatments. Many differences exist between vaccines and drug treatments making vaccines economic evaluation more cumbersome. Four challenges overwhelmingly present in vaccines assessment are less important for treatments: requirements for population, societal perspectives, budget impact evaluation, and time focused objectives (control or elimination). Based on this, economic analysis of vaccines may need to be presented to many different stakeholders with various evaluation preferences, in addition to the current stakeholders involved for drugs treatment assessment. Then, we may need a tool making the inventory of the different vaccines health economic assessment programmes more comprehensive. The cauliflower value toolbox has been developed with that aim, and its use is illustrated here with rotavirus vaccine. Given the broader perspectives for vaccine assessment, it provides better value and cost evaluations. Cost-benefit analysis may be the preferred economic assessment method when considering substitution from treatment to active medical prevention. Other economic evaluation methods can be selected (i.e. optimisation modelling, return on investment) when project prioritisation is the main focus considered and when stakeholders would like to influence the development of the healthcare programme.

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Vaccination greatly reduces disease, disability, death and inequity worldwide

Cited by 1,007 publications

References 58 publications

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Assessing levels and trends of child health inequality in 88 developing countries: from 2000 to 2014

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

3. How comprehensive can we be in the economic assessment of vaccines?

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