RTI Health Solutions, Research Triangle Park, North Carolina.
Merck & Co, Inc, Rahway, New Jersey.
Pediatrics. 2022 Sep 1;150(3). doi: 10.1542/peds.2021-056013.
Current routine immunizations for children aged ≤10 years in the United States in 2019 cover 14 vaccine-preventable diseases. We characterize the public-health impact of vaccination by providing updated estimates of disease incidence with and without universally recommended pediatric vaccines.
Prevaccine disease incidence was obtained from published data or calculated using annual case estimates from the prevaccine period and United States population estimates during the same period. Vaccine-era incidence was calculated as the average incidence over the most recent 5 years of available surveillance data or obtained from published estimates (if surveillance data were not available). We adjusted for underreporting and calculated the percent reduction in overall and age-specific incidence for each disease. We multiplied prevaccine and vaccine-era incidence rates by 2019 United States population estimates to calculate annual number of cases averted by vaccination.
Routine immunization reduced the incidence of all targeted diseases, leading to reductions in incidence ranging from 17% (influenza) to 100% (diphtheria, Haemophilus influenzae type b, measles, mumps, polio, and rubella). For the 2019 United States population of 328 million people, these reductions equate to >24 million cases of vaccine-preventable disease averted. Vaccine-era disease incidence estimates remained highest for influenza (13 412 per 100 000) and Streptococcus pneumoniae-related acute otitis media (2756 per 100 000).
Routine childhood immunization in the United States continues to yield considerable sustained reductions in incidence across all targeted diseases. Efforts to maintain and improve vaccination coverage are necessary to continue experiencing low incidence levels of vaccine-preventable diseases.
2019 年，美国 10 岁以下儿童常规免疫涵盖 14 种疫苗可预防疾病。本研究通过提供有和无普遍推荐的儿科疫苗情况下疾病发病率的更新估计值，来描述疫苗接种的公共卫生影响。
使用已发表的数据或根据疫苗前时期的年度病例估计值和同期美国人口估计值计算疫苗前疾病发病率。疫苗时代的发病率计算为最近 5 年可用监测数据的平均发病率或从已发表的估计值中获得（如果没有监测数据）。我们对漏报情况进行了调整，并计算了每种疾病的总发病率和年龄特异性发病率的降低百分比。我们将疫苗前和疫苗时代的发病率乘以 2019 年美国人口估计值，以计算疫苗接种预防的每年发病例数。
常规免疫降低了所有目标疾病的发病率，发病率降幅从 17%（流感）到 100%（白喉、乙型流感嗜血杆菌、麻疹、腮腺炎、脊髓灰质炎和风疹）不等。对于 2019 年 3.28 亿人口的美国，这些减少相当于预防 2400 多万例疫苗可预防疾病。在疫苗时代，流感（每 10 万人中有 13412 例）和肺炎链球菌相关急性中耳炎（每 10 万人中有 2756 例）的疾病发病率估计值仍然最高。
美国常规儿童免疫接种继续在所有目标疾病中产生相当大的持续发病率降低。需要努力维持和提高疫苗接种覆盖率，以继续保持低水平的疫苗可预防疾病发病率。
