VoICE Immunization Evidence: Long term disability
Long Term Disability
Episodes of vaccine-preventable diseases in childhood can lead to health consequences later in life.
Key Evidence: Those who experienced more frequent or longer episodes of diarrhea as an infant were more likely to have metabolic syndrome as adults. A longitudinal study in Guatemala found that diarrhea episodes in early infancy are associated with chronic health issues later in life. Each 1% increase in diarrhea burden in children 0-6 months was associated with a 3% increased prevalence in high blood pressure in adulthood. Similarly, a 1% increase in diarrhea burden in older infants 6-12 months was associated with a 4% increased prevalence in elevated waist circumference in adulthood.
Key Evidence: In a study of data from England & Wales, Denmark and the US, it was shown that measles infection suppresses the immune system for up to 3 years after infection, increasing the risk of death due to other childhood infections during that time. This means that prevention of measles significantly impacts overall health during critical childhood years.
Children who survive vaccine-preventable causes of meningitis and encephalitis are at high risk of lifelong disabilities as a result of the infection.
Key Evidence: According to a review of nervous system infections, up to 50% of survivors of encephalitis caused by Japanese Encephalitis Virus (JEV) are left with permanent cognitive, psychological or neurological disabilities.
Key Evidence: In Gambia, 58% of children who survived a bout of pneumococcal meningitis “had clinical sequelae; half of them had major disability preventing normal adaptation to social life” (mental retardation, hearing loss, motor abnormalities, seizures).
Key Evidence: A systematic literature review analyzing data from 21 African countries revealed that bacterial meningitis is associated with high case fatality and frequent neurophysiological sequelae. Pneumococcal and Hib meningitis contribute to one third of disease related mortality. They also cause clinically evident sequalae in 25% of survivors prior to hospital discharge. The three main causes of bacterial meningitis- Haemophilus influenzae type B; Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are vaccine preventable, routine use of conjugate vaccines have potential for significant health and economic benefits.
From the VoICE Editors: Neuropsychological sequelae includes hearing loss, vision loss, cognitive delay, speech/language disorder, behavioural problems, motor delays/impairment, and seizures.
Key Evidence: A systematic literature review of studies of the long-term effects of invasive meningococcal disease in high-income countries found that children who survived the disease had a greater incidence of hearing loss and psychological problems, including attention-deficit/hyperactivity disorder (ADHD) than control groups or the general population. In addition, they had increased odds of death – one study showed more than a 25% greater mortality rate in this population than did the general public up to 30 years after having the disease.