a Department of Global Health , Boston University School of Public Health , Boston , MA , USA.
b Center for Global Health and Development, Boston University , Boston , MA , USA.
Hum Vaccin Immunother. 2018 May 4;14(5):1179-1187. doi: 10.1080/21645515.2017.1328334. Epub 2017 Jun 19.
In 2013, the US Advisory Committee on Immunization Practices (ACIP) opted against adding meningococcal vaccines to the infant schedule due to poor cost-effectiveness. This raises a policy question: if meningococcal disease is too rare to justify routine vaccination, are there other vaccine-preventable causes of US infant deaths that could be supported?
We tabulated US infant deaths from 2009-2013 using the CDC WONDER database. These causes of death were then categorized into one of 3 categories: 1) vaccine-preventable using currently available interventions; 2) potentially vaccine-preventable within the next 10 years; and 3) not preventable.
From 19.8 million births (3.9 million/year), ∼122,000 infants died (0.62%). Of these, 181 (0.15% of all deaths) were preventable using currently available vaccines, while an additional 779 were categorized as potentially preventable in the next 10 y. By exclusion, 121,040 (99.2%) were judged 'not vaccine-preventable'. Meningococcal deaths contributed at most 0.03% of all infant deaths, but accounted for 17-34% of current vaccine-preventable deaths.
The low number of vaccine-preventable deaths in the US makes it increasingly difficult to justify the introduction of any new infant vaccines.
2013 年，美国免疫实践咨询委员会（ACIP）因成本效益不佳而选择不在婴儿计划中添加脑膜炎球菌疫苗。这引发了一个政策问题：如果脑膜炎球菌病罕见到不足以证明常规疫苗接种是合理的，那么是否有其他可以通过疫苗预防的美国婴儿死亡原因可以得到支持？
我们使用 CDC WONDER 数据库汇总了 2009-2013 年美国婴儿死亡人数。然后，这些死因被分为以下三类之一：1）使用当前可用干预措施可预防的疫苗；2）在未来 10 年内可能可预防的疫苗；3）不可预防的。
从 1980 万出生人数（390 万/年）中，约有 12.2 万名婴儿死亡（0.62%）。其中，181 例（所有死亡的 0.15%）可使用当前可用疫苗预防，而另外 779 例在未来 10 年内可预防。因此，121040 例（99.2%）被判定为“不可通过疫苗预防”。脑膜炎球菌死亡在所有婴儿死亡中最多占 0.03%，但占当前可通过疫苗预防死亡的 17-34%。
美国可通过疫苗预防的死亡人数很少，使得引入任何新的婴儿疫苗越来越难以证明其合理性。
