Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the United States.

CONTEXT National vaccine recommendations in the United States target an increasing number of vaccine-preventable diseases for reduction, elimination, or eradication. OBJECTIVE To compare morbidity and mortality before and after widespread implementation of national vaccine recommendations for 13 vaccine-preventable diseases for which recommendations were in place prior to 2005. DESIGN, SETTING, AND PARTICIPANTS For the United States, prevaccine baselines were assessed based on representative historical data from primary sources and were compared to the most recent morbidity (2006) and mortality (2004) data for diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, rubella (including congenital rubella syndrome), invasive Haemophilus influenzae type b (Hib), acute hepatitis B, hepatitis A, varicella, Streptococcus pneumoniae, and smallpox. MAIN OUTCOME MEASURES Number of cases, deaths, and hospitalizations for 13 vaccine-preventable diseases. Estimates of the percent reductions from baseline to recent were made without adjustment for factors that could affect vaccine-preventable disease morbidity, mortality, or reporting. RESULTS A greater than 92% decline in cases and a 99% or greater decline in deaths due to diseases prevented by vaccines recommended before 1980 were shown for diphtheria, mumps, pertussis, and tetanus. Endemic transmission of poliovirus and measles and rubella viruses has been eliminated in the United States; smallpox has been eradicated worldwide. Declines were 80% or greater for cases and deaths of most vaccine-preventable diseases targeted since 1980 including hepatitis A, acute hepatitis B, Hib, and varicella. Declines in cases and deaths of invasive S pneumoniae were 34% and 25%, respectively. CONCLUSIONS The number of cases of most vaccine-preventable diseases is at an all-time low; hospitalizations and deaths have also shown striking decreases.

[1]  Diphtheria.  Division of Bacterial and Mycotic Diseases , 2006 .

[2]  Walter A Orenstein,et al.  Measles elimination in the United States. , 2004, The Journal of infectious diseases.

[3]  R. Holman,et al.  Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002. , 2005, JAMA.

[4]  Vaccine preventable deaths and the Global Immunization Vision and Strategy, 2006-2015. , 2006, MMWR. Morbidity and mortality weekly report.

[5]  H. L. Dunn,et al.  Vital statistics rates in the United States 1900-1940 , 1944 .

[6]  I. Ortega-Sánchez,et al.  Nosocomial pertussis: costs of an outbreak and benefits of vaccinating health care workers. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  R. Strikas,et al.  Influenza Vaccination of Healthcare Workers in the United States, 1989-2002 , 2006, Infection Control & Hospital Epidemiology.

[8]  Keiji Fukuda,et al.  Mortality associated with influenza and respiratory syncytial virus in the United States. , 2003, JAMA.

[9]  Malbea A Lapete,et al.  Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices ( ACIP ) , 2004 .

[10]  Robert T. Chen,et al.  Morbidity and Mortality Weekly Report , 2002 .

[11]  T. Wilson,et al.  The impact of a school entry law on adolescent immunization rates. , 2005, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[12]  Weigong Zhou,et al.  Data Mining in the US using the Vaccine Adverse Event Reporting System , 2006, Drug safety.

[13]  Immunization of adolescents: recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. American Academy of Pediatrics Committee on Infectious Diseases. , 1997, Pediatrics.

[14]  L. Rodewald,et al.  Use of standing orders programs to increase adult vaccination rates. , 2000, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[15]  W. Bellini,et al.  Genetic analysis of measles viruses isolated in the united states between 1989 and 2001: absence of an endemic genotype since 1994. , 2004, The Journal of infectious diseases.

[16]  H. Margolis,et al.  Childhood hepatitis B virus infections in the United States before hepatitis B immunization. , 2001, Pediatrics.

[17]  W. Schaffner,et al.  Estimating Influenza Hospitalizations among Children , 2006, Emerging infectious diseases.

[18]  A. Shefer,et al.  Impact of varicella vaccination on health care utilization. , 2005, JAMA.

[19]  L. Mascola,et al.  Varicella disease after introduction of varicella vaccine in the United States, 1995-2000. , 2002, JAMA.

[20]  Progress toward elimination of Haemophilus influenzae type b invasive disease among infants and children--United States, 1998-2000. , 2002, MMWR. Morbidity and mortality weekly report.

[21]  H. Margolis,et al.  A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) part 1: immunization of infants, children, and adolescents. , 2005, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[22]  Matthew M Davis,et al.  Associations of daycare and school entry vaccination requirements with varicella immunization rates. , 2005, Vaccine.

[23]  A. W. Hedrich.  Vital Statistics Rates in the United States: 1900-1940 , 1944 .

[24]  S. Redd,et al.  Preventable measles among U.S. residents, 2001-2004. , 2005 .

[25]  J Gindler,et al.  Recommended Childhood Immunization Schedule--United States, January-June 1996. , 1996, Clinical pediatrics.

[26]  D. Commerce.  Statistical abstract of the United States , 1978 .

[27]  Racial/ethnic disparities in influenza and pneumococcal vaccination levels among persons aged > or =65 years--United States, 1989-2001. , 2003, MMWR. Morbidity and mortality weekly report.

[28]  M. Wharton,et al.  Lessons learned from establishing and evaluating indicators of the quality of measles surveillance in the United States, 1996-1998. , 2004, The Journal of infectious diseases.

[29]  R. Baltimore,et al.  Recommended Immunization Schedules for Children and Adolescents—United States, 2007 , 2007, Pediatrics.

[30]  J. Gordon,et al.  Whooping cough and its epidemiological anomalies. , 1951, The American journal of the medical sciences.

[31]  D. A. Dotson,et al.  Vaccinia (smallpox) vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2001. , 2001, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[32]  A. Hinman.  Addressing the vaccine financing conundrum. , 2005, Health affairs.

[33]  C. Helms,et al.  Ensuring preparedness for potential poliomyelitis outbreaks: Recommendations for the US poliovirus vaccine stockpile from the National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Practices (ACIP). , 2004, Archives of pediatrics & adolescent medicine.

[34]  B. Bell,et al.  Costs of a hepatitis A outbreak affecting homosexual men: Franklin County, Ohio, 1999. , 2003, American journal of preventive medicine.

[35]  Mitesh S. Patel,et al.  Decline in Varicella-Related Hospitalizations and Expenditures for Children and Adults After Introduction of Varicella Vaccine in the United States , 2004, Pediatrics.

[36]  Peng‐jun Lu,et al.  Influenza vaccination of persons with cardiovascular disease in the United States. , 2004, Texas Heart Institute journal.

[37]  Vaccination coverage among children entering school--United States, 2003-04 school year. , 2004, MMWR. Morbidity and mortality weekly report.

[38]  J. Rao,et al.  Compensating for provider nonresponse using response propensities to form adjustment cells: the National Immunization Survey. , 2001, Vital and health statistics. Series 2, Data evaluation and methods research.

[39]  A. Hightower,et al.  Immunization of US children with Hemophilus influenzae type b polysaccharide vaccine. A cost-effectiveness model of strategy assessment. , 1985, JAMA.

[40]  K. Nichol,et al.  Influenza Vaccination of Healthcare Workers , 1997, Infection Control & Hospital Epidemiology.

[41]  Elimination of rubella and congenital rubella syndrome--United States, 1969-2004. , 2005, MMWR. Morbidity and mortality weekly report.

[42]  T. Lieu,et al.  Incidence of outpatient visits and hospitalizations related to influenza in infants and young children. , 2004, Pediatrics.

[43]  L. Harrison,et al.  Active bacterial core surveillance of the emerging infections program network. , 2001, Emerging infectious diseases.

[44]  C. Byington,et al.  Recommended Immunization Schedules for Children and Adolescents—United States, 2008 , 2008, Pediatrics.

[45]  Walter A Orenstein,et al.  Immunizations in the United States: success, structure, and stress. , 2005, Health affairs.

[46]  Rapid assessment of influenza vaccination coverage among HMO members--northern California influenza seasons, 2001-02 through 2004-05. , 2005, MMWR. Morbidity and mortality weekly report.

[47]  M. McCauley,et al.  Standards for adult immunization practices. , 2003, American journal of preventive medicine.

[48]  P. Rota,et al.  Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States. , 2006, The New England journal of medicine.

[49]  T. Lieu,et al.  Overcoming economic barriers to the optimal use of vaccines. , 2005, Health affairs.

[50]  J. Ballard,et al.  Assessing influenza immunization rates in Medicare managed care plans: a comparison of three methods. , 1997, The Joint Commission journal on quality improvement.

[51]  Deborah A. Adams,et al.  Summary of notifiable diseases --- United States, 2005. , 2007, MMWR. Morbidity and mortality weekly report.

[52]  Susan S Ellenberg,et al.  Evaluating the safety of new vaccines: summary of a workshop. , 2005, American journal of public health.

[53]  G. Pugliese,et al.  Severe Streptococcus pyogenes Infections, United Kingdom, 2003–2004 , 2008, Emerging infectious diseases.

[54]  I. Ortega-Sánchez,et al.  The Cost of Containing One Case of Measles: The Economic Impact on the Public Health Infrastructure—Iowa, 2004 , 2005, Pediatrics.

[55]  J. Seward,et al.  Decline in mortality due to varicella after implementation of varicella vaccination in the United States. , 2005, The New England journal of medicine.

[56]  Ten great public health achievements--United States, 1900-1999. , 1999, MMWR. Morbidity and mortality weekly report.

[57]  W. Rush,et al.  Syndromic surveillance for measleslike illnesses in a managed care setting. , 2004, The Journal of infectious diseases.

[58]  R. Harpaz,et al.  Completeness of measles case reporting: review of estimates for the United States. , 2004, The Journal of infectious diseases.

[59]  J. Gerberding,et al.  National, state, and urban area vaccination coverage among children aged 19-35 months--United States, 2005. , 2006, MMWR. Morbidity and mortality weekly report.

[60]  E. Zell,et al.  National Immunization Survey: the methodology of a vaccination surveillance system. , 2000, Public health reports.

[61]  Dallas,et al.  Poliomyelitis prevention in the United States. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2000, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[62]  F. Destefano,et al.  The Vaccine Safety Datalink project , 2001, Pharmacoepidemiology and drug safety.

[63]  J. Seward,et al.  Hospitalizations for varicella in the United States, 1988 to 1999 , 2002, The Pediatric infectious disease journal.

[64]  Violaine S. Mitchell,et al.  The children's vaccine initiative : achieving the vision , 1993 .

[65]  B. Bell,et al.  Hepatitis A virus infections in the United States: model-based estimates and implications for childhood immunization. , 2002, Pediatrics.

[66]  M. Wharton,et al.  Varicella mortality: trends before vaccine licensure in the United States, 1970-1994. , 2000, The Journal of infectious diseases.

[67]  Robert T. Chen,et al.  Understanding vaccine safety information from the Vaccine Adverse Event Reporting System. , 2004, The Pediatric infectious disease journal.

[68]  M. Wharton,et al.  Diphtheria in the former Soviet Union: reemergence of a pandemic disease. , 1998, Emerging infectious diseases.

[69]  F. Eugene Yates,et al.  The national center for health statistics , 1973, Annals of Biomedical Engineering.

[70]  Samuel L. Groseclose,et al.  Summary of Notifiable Diseases, United States. , 1997 .

[71]  Abigail Shefer,et al.  Economic evaluation of the 7-vaccine routine childhood immunization schedule in the United States, 2001. , 2005, Archives of pediatrics & adolescent medicine.

[72]  Hepatitis B vaccination coverage among adults--United States, 2004. , 2006, MMWR. Morbidity and mortality weekly report.

[73]  L. Barker,et al.  National, state and urban-area vaccination-coverage levels among children aged 19-35 months, United States, 1999. , 2001, American journal of preventive medicine.

[74]  L. Dales,et al.  Acute measles mortality in the United States, 1987-2002. , 2004, The Journal of infectious diseases.

[75]  T. Lieu,et al.  Societal costs and morbidity of pertussis in adolescents and adults. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[76]  D. Hoaglin,et al.  Statistical methodology of the National Immunization Survey, 1994-2002. , 2005, Vital and health statistics. Series 2, Data evaluation and methods research.

[77]  D Koo,et al.  Mandatory reporting of diseases and conditions by health care professionals and laboratories. , 1999, JAMA.

[78]  Update: Guillain-Barré syndrome among recipients of Menactra meningococcal conjugate vaccine--United States, June 2005-September 2006. , 2006, MMWR. Morbidity and mortality weekly report.

[79]  T. Doyle,et al.  Summary of notifiable diseases--United States, 2004. , 2006, MMWR. Morbidity and mortality weekly report.

[80]  S. L. Murphy,et al.  Deaths: final data for 2003. , 2006, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[81]  Prevots Dr,et al.  Poliomyelitis prevention in the United States. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2000 .

[82]  L. Moulton,et al.  Exemptions to school immunization requirements: the role of school-level requirements, policies, and procedures. , 2005, American journal of public health.

[83]  J. Iskander,et al.  Monitoring vaccine safety during an influenza pandemic. , 2005, The Yale journal of biology and medicine.

[84]  B. Canavan,et al.  Immunization information systems progress - United States, 2005. , 2006, MMWR. Morbidity and mortality weekly report.

[85]  K. O'Brien,et al.  Toward elimination of Haemophilus influenzae type B carriage and disease among high-risk American Indian children. , 2000, American journal of public health.

[86]  Richard S Hopkins,et al.  Summary of notifiable diseases--United States, 2003. , 2005, MMWR. Morbidity and mortality weekly report.

[87]  Case definitions for infectious conditions under public health surveillance. Centers for Disease Control and Prevention. , 1997, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[88]  S. Cochi,et al.  The Vaccine Adverse Event Reporting System (VAERS). , 1994, Vaccine.

[89]  W. Bellini,et al.  Genetic analysis of measles viruses isolated in the United States, 1995-1996. , 1998, The Journal of infectious diseases.

[90]  From the Centers for Disease control and Prevention. Effectiveness of a middle school vaccination law--California, 1999-2001. , 2001, JAMA.

[91]  P. Peduzzi,et al.  A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. , 2005, The New England journal of medicine.

[92]  John F. Modlin,et al.  Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP) , 1996, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[93]  D. Sosin,et al.  Vaccine-preventable diseases on college campuses: the emergence of mumps. , 1989, Journal of American college health : J of ACH.

[94]  R. Pinner,et al.  Progress toward eliminating Haemophilus influenzae type b disease among infants and children--United States, 1987-1997. , 1999, MMWR. Morbidity and mortality weekly report.

[95]  S S Ellenberg,et al.  The complicated task of monitoring vaccine safety. , 1997, Public health reports.

[96]  J. Gerberding,et al.  Morbidity and Mortality Weekly Report Prevention of Hepatitis a through Active or Passive Immunization Recommendations of the Advisory Committee on Immunization Practices (acip) Centers for Disease Control and Prevention Coordinating Center for Health Information and Service Recommendations and Repo , 2022 .

[97]  Joseph Britto,et al.  Whooping cough—a continuing problem , 2002, BMJ : British Medical Journal.

[98]  L Phillips,et al.  Health consequences of religious and philosophical exemptions from immunization laws: individual and societal risk of measles. , 1999, JAMA.

[99]  Surveillance for laboratory-confirmed, influenza-associated hospitalizations--Colorado, 2004-05 influenza season. , 2005, MMWR. Morbidity and mortality weekly report.

[100]  M. Pallansch,et al.  Vaccine policy changes and epidemiology of poliomyelitis in the United States. , 2004, JAMA.

[101]  Henry Nider,et al.  Report of the Committee on Infectious Diseases , 1989 .

[102]  R. Chen,et al.  Combination vaccines: postlicensure safety evaluation. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[103]  H. Lawson,et al.  Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2007, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[104]  M. Alter,et al.  A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States , 2006, Pediatrics.

[105]  B. Schwartz,et al.  Immunization of adolescents. Recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. , 1997, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.