posts: 28383

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    "id": "wp-28383",
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                "text": [
                    {
                        "text": "Progress against vaccine-preventable diseases in the US",
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                        "text": "The visualization here shows the reduction in cases and deaths from vaccine-preventable diseases in the United States after the introduction of each vaccine. This data was published by Roush and Murphy (2007){ref}Roush and Murphy (2007) \u2013 Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. In the Journal of the American Medical Association, 298, 18, 2155\u20132163. ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pubmed/18000199",
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                                "text": "here",
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                        "text": "{/ref} and the data can be viewed in a table ",
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                        "url": "https://ourworldindata.org/roush-and-murphy-2007-data/",
                        "children": [
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                                "text": "here",
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                        "text": ".",
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                        "text": "For several diseases the US has achieved a 100% reduction of cases and deaths and for many other diseases the reduction is often very substantial as well.",
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                "text": [
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                        "text": "Reduction of cases and deaths of vaccine-preventable diseases in the United States after the introduction of the vaccine.{ref}These data are taken from the research paper Roush and Murphy (2007) \u2013 Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States. In the Journal of the American Medical Association, 298, 18, 2155\u20132163 ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pubmed/18000199",
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                                "text": "here",
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                        "text": ".",
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                        "text": "\nThe vaccines against the diseases up till \u2018Tetanus\u2019 were vaccines licensed or recommended before 1980. The vaccines against the last 5 diseases were only licensed or recommended between 1980 and 2005.{/ref}",
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                "filename": "Vaccine_Reduction-of-Cases-and-Deaths.png",
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                "text": [
                    {
                        "text": "The development of the vaccine against measles and the history of measles in the US",
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                        "text": "The introduction of a vaccine was not the only reason for progress against these diseases, as the visualization shows. The case-fatality rates of measles was falling in high income countries such as the US prior to the introduction of the vaccine in 1960 \u2013 this is best seen by switching from the linear to the logarithmic axis. Improved living conditions, nutrition, and medical advancements meant that contracting measles was less and less likely to be fatal.",
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                        "text": "The rate of cases however was virtually unchanged until after the measles vaccine was introduced \u2013 as our visualization shows.{ref}See also 'Graphical proof that vaccines work (with sources)' in ",
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                        "children": [
                            {
                                "text": "Medium",
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                        "text": " online ",
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                        "url": "https://medium.com/@visualvaccines/graphic-proof-that-vaccines-work-with-sources-61c199429c8c",
                        "children": [
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                                "text": "here",
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                        "text": ".",
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                        "text": "To account for such long-term changes, Roush and Murphy (2007) report data from the period shortly before the introduction of the respective vaccine. ",
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                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pubmed/18000199",
                        "children": [
                            {
                                "text": "here",
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                        "text": "{/ref}",
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                        "text": "A visualization showing the total number of cases and deaths can be seen ",
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                    },
                    {
                        "url": "https://ourworldindata.org/grapher/measles-cases-and-death",
                        "children": [
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                                "text": "here",
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                        "text": ".",
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                "url": "https://ourworldindata.org/grapher/measles-cases-and-death-rate",
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                "text": [
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                        "text": "Global decline in vaccine-preventable diseases",
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                        "children": [
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                                "text": "The WHO estimates that ",
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                        "url": "http://www.who.int/mediacentre/news/releases/2017/infants-worldwide-vaccinations/en/",
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                                        "text": "2 to 3 million deaths",
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                        "children": [
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                                "text": " are prevented every year through immunization against diphtheria, tetanus, whooping cough, and measles.",
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                        ],
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                        "text": "{ref}In our graphics and visualizations we rely on the ",
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                    {
                        "children": [
                            {
                                "text": "Institute for Health Metrics",
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                    {
                        "text": " (IHME) \u2018",
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                    {
                        "url": "http://ghdx.healthdata.org/gbd-results-tool",
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                                "text": "Global Burden of Disease Study 2016",
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                        "text": "\u2019 estimates of child death rates from individual VPDs (compared with other causes), TB death rates across countries, and death rates from individual VPDs; this dataset extends back to 1990 and therefore provides a longer-term perspective on these changes over time. However, lack of estimates from the IHME on the role of vaccination in the prevention of deaths means we rely on WHO data for the number of deaths prevented each year through vaccination and the total amount of deaths VPDs are responsible for.",
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                        "text": "The rates reported by the WHO and IHME are in a similar range but do differ slightly. WHO data on individual disease death rates can be found here: ",
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                        "url": "http://www.who.int/gho/mortality_burden_disease/en/",
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                                "text": "http://www.who.int/gho/mortality_burden_disease/en/",
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                        "text": "{/ref}",
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                                "text": "Nonetheless, the WHO also estimates that VPDs are still responsible for ",
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                        "url": "http://www.who.int/mediacentre/commentaries/vaccine-preventable-diseases/en/",
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                                "children": [
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                                        "text": "1.5 million deaths",
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                        "children": [
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                                "text": " each year. ",
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                                "text": "In the chart we see the global number of deaths of children younger than 5 years per year from 1990 to 2017. The number of deaths which are wholly or partially preventable by vaccines are shown in color.{ref}Note that, as discussed later in this post, the role of vaccines in prevention varies between these causes of death. Measles, for example, has the capacity to be eliminated through vaccination. Diarrheal deaths, in contrast, cannot be eliminated through vaccination alone; hygiene, water services, and nutrition must also be prioritised.{/ref} The chart shows that the reductions in child deaths over this 25-year period were primarily achieved by a reduction of the number of deaths from vaccine-preventable diseases: The decline in causes which are not vaccine preventable has been modest, while the number of child deaths caused by diseases for which vaccines are available declined from 5.1 million deaths in 1990 to 1.8 million deaths 27 years later.",
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                "filename": "Reduction-of-child-deaths-due-to-vaccine-preventable-diseases-2019.png",
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                                "text": "Two vaccines are responsible for saving millions each year: \u2018DTP\u2019 against diphtheria, tetanus, and pertussis (whooping cough) and \u2018MMR\u2019 against measles, mumps, and rubella.{ref}Some countries only give measles vaccines combined with rubella (MR) or with varicella in addition (MMRV).{/ref} Before the measles vaccine was introduced in 1963, measles caused a large number of deaths globally, estimated at ",
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                        "url": "http://www.who.int/mediacentre/factsheets/fs286/en/",
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                                        "text": "2.6 million each year",
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                        "children": [
                            {
                                "text": ". \u00a0Because about 86% of the ",
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                        "url": "http://www.who.int/mediacentre/factsheets/fs378/en/",
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                                "children": [
                                    {
                                        "text": "world population is immunized today,",
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                                "text": " the number of people killed by measles have been cut dramatically to an estimated 95,000 deaths in 2017. Tetanus and pertussis were also previously much bigger killers, with pertussis affecting\u00a0especially children younger than 5 years and tetanus striking newborns (",
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                        "url": "http://www.who.int/immunization/diseases/tetanus/en/",
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                                        "text": "killing an estimated 787,000 newborns",
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                        "children": [
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                                "text": " in 1988, compared with 49,000 in 2013",
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                        "children": [
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                                "text": ").",
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                "text": [
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                        "text": "The way ahead",
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                                "text": "However, the gains in global vaccination coverage have slowed down slightly in the last few years. The WHO estimates that\u00a0",
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                        "url": "http://www.who.int/mediacentre/factsheets/fs378/en/",
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                                        "text": "19.5 million infants",
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                                "text": " worldwide are still at risk of VPDs because they miss out on basic vaccines.",
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                    {
                        "text": "{ref}Highlighted are 10 countries ",
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                        "url": "http://www.who.int/mediacentre/factsheets/fs378/en/",
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                                "text": "where approximately 60%",
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                        "text": " of these infants live in: Angola, Brazil, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Iraq, Nigeria, Pakistan, and South Africa.{/ref}",
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                                "text": "In addition, all the recommended doses of a vaccine need to be received for it to be most effective. In the case of measles three vaccine doses are recommended. Even though an estimated ",
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                                "text": "85% of children receive their first dose of the vaccine, ",
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                                "url": "http://www.who.int/mediacentre/factsheets/fs378/en/",
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                                        "text": "this drops to 64%",
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                            {
                                "text": " for the second dose.",
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                                "text": "Therefore, it is not only lack of vaccination that is a problem, but it is under-vaccination that leads to deaths from VPDs.",
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                                "text": "What then are the most deadly VPDs? Which diseases continue to kill the most people? ",
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                        "text": "The most deadly diseases",
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                        "children": [
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                                "text": "Tuberculosis:",
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                                "text": " Determining which are the most deadly VPDs requires acknowledging that some vaccinations are more effective than others. While most vaccines included in national routine schedules are highly effective, a better vaccine for tuberculosis (TB) is desperately needed. It is Sub-Saharan Africa and parts of Asia in particular that ",
                                "spanType": "span-simple-text"
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                                "url": "https://ourworldindata.org/grapher/tuberculosis-death-rates",
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                                        "text": "are affected by TB",
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                            {
                                "text": ", as the world map shows.",
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                                "text": "The vaccine for TB \u2013 Bacillus Calmette\u2013Gu\u00e9rin (BCG) \u2013 has been in use for nearly 100 years. It protects against severe forms of TB but is ",
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                        "url": "https://wellcome.ac.uk/news/world-immunisation-week-seven-vaccine-challenges",
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                                "children": [
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                                        "text": "not effective against pulmonary TB",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-fallback"
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                        "children": [
                            {
                                "text": " (in the lungs) and has variable effectiveness against TB in adults.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-fallback"
                    },
                    {
                        "text": "{ref}Zwerling A, Behr MA, Verma A, Brewer TF, Menzies D, Pai M. The BCG World Atlas: A Database of Global BCG Vaccination Policies and Practices. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "PLoS Medicine",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ". 2011;8(3):e1001012. doi:10.1371/journal.pmed.1001012. Available ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001012",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".{/ref}",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": ",",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-superscript"
                    },
                    {
                        "text": "{ref}For a detailed commentary on why we do not yet have an effective TB vaccine see: Davenne T, McShane H. Why don\u2019t we have an effective tuberculosis vaccine yet?",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": " Expert Review of Vaccines",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ". 2016;15(8):1009-1013. doi:10.1586/14760584.2016.1170599. Available ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4950406/",
                        "children": [
                            {
                                "text": "here.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "{/ref}",
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                        "text": "Furthermore, resistance of antibiotics used to treat TB is increasing, meaning some people can no longer be cured by drugs. The estimated number of people in 2016 with ",
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                        "url": "http://www.who.int/features/qa/79/en/",
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                                        "text": "multi-drug resistant TB was 490,000",
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                        "children": [
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                                "text": ". ",
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                                "text": "The fact that there is not a fully effective vaccine and that antibiotic treatment is facing serious difficulties makes TB the most deadly VPD.",
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                        "children": [
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                                "text": "Meningococcal meningitis and hepatitis B are also deadly VPDs. ",
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                        "children": [
                            {
                                "text": "Meningococcal Meningitis: ",
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                            }
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                        "spanType": "span-bold"
                    },
                    {
                        "children": [
                            {
                                "text": "Despite the introduction of ",
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                            },
                            {
                                "children": [
                                    {
                                        "text": "MenAfriVac",
                                        "spanType": "span-simple-text"
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                                "text": " in 2010, an effective vaccine against the most common type of meningitis in that region, meningococcal meningitis killed almost 130,000 people in 2016. Many cases occur in the so-called \u2018meningitis belt\u2019 of sub-Saharan Africa, crossing from Senegal to Ethiopia. Not all the countries in the meningitis belt have implemented mass vaccination campaigns for ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "children": [
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                                        "text": "MenAfriVac",
                                        "spanType": "span-simple-text"
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                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " and also do not benefit from the expensive ",
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                            },
                            {
                                "children": [
                                    {
                                        "text": "MenACWY",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-italic"
                            },
                            {
                                "text": " vaccine introduced into richer countries to protect against other types of meningococcal meningitis.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-fallback"
                    },
                    {
                        "text": "{ref}An affordable ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "MenACWYX",
                                "spanType": "span-simple-text"
                            }
                        ],
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                    },
                    {
                        "text": " vaccine is being developed to cover all the types of meningococcal disease (with the exception of meningitis B, which is available through a separate vaccine) and will also have the ability to be transported at higher temperatures. It is currently in phase 1 clinical trial, with the hope that it will be available for use in 2020\u20132022.{/ref}",
                        "spanType": "span-simple-text"
                    },
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                        "children": [
                            {
                                "text": ",",
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                            }
                        ],
                        "spanType": "span-superscript"
                    },
                    {
                        "text": "{ref}See Meningococcal disease in the Middle East and Africa: Findings and updates from the Global Meningococcal Initiative, Borrow, Ray et al. ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "Journal of Infection",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", Volume 75 , Issue 1 , 1 - 11. Available ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "http://www.journalofinfection.com/article/S0163-4453(17)30114-7/abstract",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
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                    {
                        "text": ".{/ref}",
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                        "children": [
                            {
                                "text": "Hepatitis B:",
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                            }
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                    },
                    {
                        "children": [
                            {
                                "text": " The vaccine against hepatitis B is also very effective (",
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                            }
                        ],
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                    },
                    {
                        "url": "http://www.who.int/mediacentre/factsheets/fs141/en/",
                        "children": [
                            {
                                "children": [
                                    {
                                        "text": "an estimated 95% effectiveness",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-fallback"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "children": [
                            {
                                "text": " in preventing disease), meaning increased vaccination could lead to a significant reduction in deaths. Still, global coverage of the hepatitis B vaccine is lagging. In 2015, while ",
                                "spanType": "span-simple-text"
                            },
                            {
                                "url": "http://www.who.int/mediacentre/factsheets/fs141/en/",
                                "children": [
                                    {
                                        "text": "84% coverage was reached",
                                        "spanType": "span-simple-text"
                                    }
                                ],
                                "spanType": "span-link"
                            },
                            {
                                "text": " for the third dose of the vaccine, the coverage for the birth dose was only 39%. Estimates from mathematical models have shown that if infant coverage would reach 90%, and the first dose administered at birth, 84% of global hepatitis B-related deaths could be prevented.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-fallback"
                    },
                    {
                        "text": "{ref}Susan T Goldstein, Fangjun Zhou, Stephen C Hadler, Beth P Bell, Eric E Mast, Harold S Margolis; A mathematical model to estimate global hepatitis B disease burden and vaccination impact, ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "International Journal of Epidemiology",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", Volume 34, Issue 6, 1 December 2005, Pages 1329\u20131339, ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://doi.org/10.1093/ije/dyi206",
                        "children": [
                            {
                                "text": "https://doi.org/10.1093/ije/dyi206",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ". Available ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pubmed/16249217",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".{/ref}",
                        "spanType": "span-simple-text"
                    }
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        ],
        "type": "article",
        "title": "Progress against vaccine-preventable diseases",
        "authors": [
            null
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        "dateline": "November 25, 2019",
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    "createdAt": "2019-11-25T14:12:55.000Z",
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    "updatedAt": "2021-03-23T06:09:19.000Z",
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