Lernout Tinne, Theeten Heidi, Leuridan Elke, Van Damme Pierre
Centre for the Evaluation of Vaccination. Vaccine and Infectious Disease Institute. University of Antwerp. Antwerp. Belgium..
Acta Med Port. 2014 Mar-Apr;27(2):160-2. Epub 2014 Apr 30.
Since their introduction and widespread use, vaccines have been very successful in reducing morbidity and mortality of the diseases they target, at an individual level and through herd immunity. The impact on the mortality has been rapid and easy to measure for some diseases, such as diphtheria, pertussis and measles. For other diseases, including hepatitis B and human papillomavirus infections, deaths averted occur many years after vaccination, and it takes years until the full potential of the vaccine can be established. Finally, in middle and high income countries, the impact of vaccination against some diseases, like invasive pneumococcal disease and rotavirus gastro-enteritis, is measured by decrease in incidence of the disease and reduction in hospitalization rather than impact on mortality. But in the countries with the highest incidence of these diseases, mortality remains high due to low availability of these vaccines, and millions of deaths could be averted by optimal use of vaccines in these regions. Major challenges for vaccination programmes are to maintain and strengthen trust in the benefits of vaccination and adapt immunization schedules according to the changing epidemiological landscape.
自从疫苗被引入并广泛使用以来，无论是在个体层面还是通过群体免疫，疫苗在降低其所针对疾病的发病率和死亡率方面都非常成功。对于某些疾病，如白喉、百日咳和麻疹，疫苗对死亡率的影响迅速且易于衡量。对于其他疾病，包括乙型肝炎和人乳头瘤病毒感染，接种疫苗多年后才避免死亡，且要数年才能确定疫苗的全部潜力。最后，在中高收入国家，针对某些疾病（如侵袭性肺炎球菌疾病和轮状病毒肠胃炎）的疫苗接种效果是通过疾病发病率的降低和住院率的减少来衡量的，而不是对死亡率的影响。但在这些疾病发病率最高的国家，由于这些疫苗的可及性低，死亡率仍然很高，在这些地区通过优化疫苗使用可避免数百万人死亡。疫苗接种计划面临的主要挑战是维持和加强对疫苗益处的信任，并根据不断变化的流行病学情况调整免疫接种计划。
