Vaccine-preventable Diseases

This chapter analyzes the costs and cost-effectiveness of scaling up the EPI and introducing selected new vaccines into the program. It also summarizes the epidemiology of diseases preventable through immunization and estimates the disease burden with and without immunization programs. In addition the chapter discusses the organization delivery and financing of immunization programs and highlights future prospects and areas for further study. Several areas overlap with other chapters. For example the vaccines that prevent measles tuberculosis diphtheria pertussis Hib and Neisseria meningitis prevent respiratory diseases. Some vaccines such as those against measles and pertussis prevent diseases that cause or contribute to malnutrition. Chapter 16 provides an in-depth review of tuberculosis and a discussion of the potential impact of bacillus Calmette-Guerin (BCG) vaccines. This chapter also does not discuss some new vaccines including conjugate Streptococcus pneumoniae influenza typhoid fever and rotavirus because other chapters deal with those diseases and vaccines. Vaccines to prevent mumps and varicella that are routinely used in some developed countries are not included in most vaccination programs in developing countries. Other interventions that can reduce the burden of vaccine-preventable diseases and are not covered in this chapter include clean umbilical cord care to reduce the incidence of neonatal tetanus vitamin A therapy to reduce the case-fatality rate (CFR) from measles and intensive clinical care that can reduce the mortality associated with most of the vaccine-preventable diseases. (excerpt)

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