VoICE : Search Immunization Evidence
The VoICE tool is a compendium of the many direct and downstream impacts of vaccine-preventable disease and immunization. The database contains summary explanations of the link between immunization and each impact, as well as sources of evidence for each link. You can browse the VoICE tool by topic, or use the filters to find results based on topic, disease or vaccine, location and published year.
A strong national immunization program can be leveraged during critical health emergencies to aid in outbreak response.
The detection of H1N1 influenza virus in Mexico in 2009, and subsequently throughout other countries in the Americas, benefited from the laboratory experience with measles and rubella in the region, leading to the rapid detection of and response to what eventually became a novel pandemic virus.
Integrated community based health intervention programs targeting high risk and underserved populations can lead to significant reductions in socioeconomic inequalities.
After instituting a multiple-strategy community intervention program in India, for pregnant women who had an institutional delivery, the geographic and socioeconomic inequities between those in urban and rural areas declined from 22% to 7.6%, and disparities between the rich and poor declined from 48.2% to 13%.
Implementation of community based multi-strategy health intervention programs targeting the at-risk and underserved populations can lead to significant improvements in Maternal & Child Health outcomes.
Through use of local Maternal Child Health (MCH) incentives, along with the use of locally appointed Health Activists, India’s National Rural Health Mission (NRHM) multiple-strategy community intervention program was able to achieve household level improvements in all of the following indicators for women and children over the 7 year program:
– the proportion of pregnant women having 3 or more ante-natal check-ups (from 43% to 74.5%)
– receiving at least one Tetanus Toxoid injection (from 83.5% to 93.6%)
– institutional deliveries (from 35.7% to 77%)
– post-natal check-ups within 2 weeks of delivery (from 49% to 67.2%) and,
– children who received ORS for diarrhea from (32.3% to 44.8%).
Children living in slum conditions who are at greater risk of infectious diseases than those in urban areas, are less likely to be vaccinated.
Children in slum settings have higher burdens of vaccine-preventable disease (one study found children in slums in Manila, Philippines were 9 times more likely to have tuberculosis than other urban children) and lower rates of immunization (a study in Niger found 35% coverage in slums vs. 86% in non-slum urban areas).
Mothers infected with rubella virus during the first trimester of pregnancy can give birth to children with permanent disabilities such as intellectual impairment, autism, blindness, deafness, and cardiac defects. The infection is completely preventable if mothers are vaccinated before pregnancy.
Children in slums suffer from higher rates of diarrheal and respiratory illness, malnutrition, and have lower vaccination rates. Mothers residing in slums are more poorly educated and less likely to receive antenatal care and skilled birth assistance.
Maternal immunization offers an opportunity to protect the mother and fetus, but also passes this protection on to the infant after birth.
Immunization against tetanus, pertussis, and influenza during pregnancy has been shown to have a profound affect on the health of the mother and fetus and increases survival of infants in their first months of life.
The approach to polio eradication in the Americas has already been leveraged for the control and tracking of measles and rubella.
In the Americas, a platform built to secure polio eradication has been expanded to help track, control, prevent, and monitor immunization impact for measles and rubella. In India, highly trained polio health workers have become the basis for a trained workforce working towards the elimination of measles and rubella and helping ensure India’s certification by WHO for having eliminated maternal and neonatal tetanus.
Introduction of vaccines or strengthening of immunization programs can provide opportunities for increased collaboration between agencies with potential for long-term benefits.
The American Academy of Pediatrics and the International Pediatric Association were included as partners in the measles and rubella elimination initiative, allowing for more direct collaboration around the interactions of primary health and immunization services and concerns.
The detection of H1N1 influenza virus in Mexico in 2009, and subsequently throughout other countries in the Americas, benefited from the laboratory experience with measles and rubella in the region, leading to the rapid detection of, and response to, what eventually became a novel pandemic virus.
Prenatal care-seeking can be combined with maternal immunization to compound the health benefits to mother and child while leveraging the cost-savings of integrating programs.
Increased uptake of immunization for vaccine-preventable diseases, particularly in low- and middle-income countries, could save the lives of thousands of mothers and children each year. The disease burden of tetanus, influenza, and pertussis has been minimized in many countries through maternal immunization, but wider applications of this strategy are now needed.