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Vaccination averted 45% deaths due to 10 pathogens between 2000 & 2019 — Lancet study

Most of the impact in the 98 low and middle income nations studied is concentrated in a reduction in mortality among children younger than 5 years, notably from measles.

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New Delhi: Vaccinations against 10 major pathogens, including measles and Japanese encephalitis, will have averted 69 million deaths between 2000 and 2030 in 98 low and middle income countries, including of India, a new modelling study in the journal Lancet estimated.

“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,” said the study published Friday.

The estimate includes the 37 million deaths prevented overall until 2019.

The health impact of the vaccination programmes was quantified over calendar year and annual birth cohorts between 2000 and 2030, and expressed in terms of deaths and disability-adjusted life-years (DALYs) averted.

DALYs measure the number of healthy years lost due to premature death or disability due to the 10 pathogens.

This the largest study to assess the impact of vaccinations so far, and the first to use data from the Vaccine Impact Modelling Consortium (VIMC), an organisation formed in 2016 which coordinates the work of research groups around the world modelling the impact of vaccination programmes.

“By estimating how much higher mortality levels would be if there were no vaccination programmes in place, our study has highlighted how crucial it is to maintain high coverage levels. This will require continuing political commitment, funding, public engagement to promote the benefits and safety of vaccinations, and programmes to deliver education, training and supervision on immunisation,” Katy Gaythorpe, co-author of the study, said in a statement.


Also read: Covaxin & Covishield safe for those on aspirin, vaccine factsheets will be changed — ICMR chief


How the study was conducted

The study included the assessment of vaccines against 10 pathogens: hepatitis B (HepB), haemophilus influenzae type b (Hib), human papillomavirus (HPV), Japanese encephalitis (JE), measles, neisseria meningitidis serogroup A (MenA), streptococcus pneumoniae, rotavirus, rubella virus and yellow fever virus (YF).

Under the VIMC, 16 independent research groups “provided model-based disease burden estimates under a range of vaccination coverage scenarios”, for the 10 pathogens.

Using demographic data and existing information about vaccine coverage, the study determined impact by “comparing model estimates from a no-vaccination counterfactual scenario with those from a reported and projected vaccination scenario”.

According to the study, “vaccination between 2000 and 2030 was estimated to cause substantial reductions in mortality in the same time period,” with the exception of the hepatitis B virus and HPV, whose mortality will only be seen after 2030 due to the “typically long time delay between infection and severe outcomes for those infections”.

“In the period 2000–19, we estimate that vaccination in the 98 countries reduced overall mortality due to these pathogens by 45% and mortality among children younger than 5 years by 57%,” the study said.

The scientists further predicted that “for the period 2020–30, we project these reductions will increase to 60% for overall mortality and 77% for mortality among children younger than 5 years in all 98 countries”.

Need to ‘maintain high levels’ of vaccination

The study found that vaccines against measles, Hib, and S pneumoniae have the largest relative impact on mortality of children younger than five years, while vaccines against HPV, hepatitis B, and yellow fever have the largest impact per person vaccinated by year of birth.

It also predicted that “increasing HPV coverage in girls will avert more deaths per person vaccinated than any other immunisation activity, whereas increasing PCV (pneumococcal conjugate vaccines) coverage will give the largest reductions in mortality among children younger than 5 years”.

“It is crucial to increase vaccine coverage and maintain high coverage levels in all countries to avoid the coverage gains achieved since 2000 being undone,” the study said.


Also read: There were warnings on Twitter even before WHO declared first Covid case, says study


 

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