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Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study

Xiang Li 1 Christinah Mukandavire 1 Zulma M Cucunubá 1 Susy Echeverría-Londoño 1 Kaja Abbas 2 Hannah E Clapham 3, 4, 5 Mark Jit 2, 6, 7 Hope L Johnson 8 Timos Papadopoulos 7, 9 Emilia Vynnycky 2, 7 Marc Brisson 10 Emily D Carter 11 Andrew Clark 2 Margaret J de Villiers 1 Kirsten Eilertson 12 Matthew J Ferrari 13 Ivane Gamkrelidze 14 Katy A M Gaythorpe 1 Nicholas C Grassly 1 Timothy B Hallett 1 Wes Hinsley 1 Michael L Jackson 15 Kévin Jean 1, 16, 17 Andromachi Karachaliou 18 Petra Klepac 2 Justin Lessler 11 Xi Li Sean M Moore 19 Shevanthi Nayagam 1 Duy Manh Nguyen 4, 20 Homie Razavi 14 Devin Razavi-Shearer 14 Stephen Resch 21 Colin Sanderson 2 Steven Sweet 21 Stephen Sy 21 Yvonne Tam 11 Hira Tanvir 2 Quan Minh Tran 4, 19 Caroline L Trotter 18 Shaun Truelove 11 Kevin van Zandvoort 2 Stéphane Verguet 21 Neff Walker 11 Amy Winter 11 Kim Woodruff 1 Neil M Ferguson 1, * Tini Garske 1 
Abstract : Background: The past two decades have seen expansion of childhood vaccination programmes in low-income and middle-income countries (LMICs). We quantify the health impact of these programmes by estimating the deaths and disability-adjusted life-years (DALYs) averted by vaccination against ten pathogens in 98 LMICs between 2000 and 2030. Methods: 16 independent research groups provided model-based disease burden estimates under a range of vaccination coverage scenarios for ten pathogens: hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, and yellow fever. Using standardised demographic data and vaccine coverage, the impact of vaccination programmes was determined by comparing model estimates from a no-vaccination counterfactual scenario with those from a reported and projected vaccination scenario. We present deaths and DALYs averted between 2000 and 2030 by calendar year and by annual birth cohort. Findings: We estimate that vaccination of the ten selected pathogens will have averted 69 million (95% credible interval 52–88) deaths between 2000 and 2030, of which 37 million (30–48) were averted between 2000 and 2019. From 2000 to 2019, this represents a 45% (36–58) reduction in deaths compared with the counterfactual scenario of no vaccination. Most of this impact is concentrated in a reduction in mortality among children younger than 5 years (57% reduction [52–66]), most notably from measles. Over the lifetime of birth cohorts born between 2000 and 2030, we predict that 120 million (93–150) deaths will be averted by vaccination, of which 58 million (39–76) are due to measles vaccination and 38 million (25–52) are due to hepatitis B vaccination. We estimate that increases in vaccine coverage and introductions of additional vaccines will result in a 72% (59–81) reduction in lifetime mortality in the 2019 birth cohort. Interpretation: Increases in vaccine coverage and the introduction of new vaccines into LMICs have had a major impact in reducing mortality. These public health gains are predicted to increase in coming decades if progress in increasing coverage is sustained.
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Submitted on : Thursday, November 3, 2022 - 2:00:59 PM
Last modification on : Saturday, November 5, 2022 - 3:58:46 AM


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Xiang Li, Christinah Mukandavire, Zulma M Cucunubá, Susy Echeverría-Londoño, Kaja Abbas, et al.. Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study. The Lancet, 2021, 397 (10272), pp.398-408. ⟨10.1016/s0140-6736(20)32657-x⟩. ⟨hal-03835387⟩



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