The Knowledge Hub

What is the Knowledge Hub?

Explore the VoICE Knowledge Hub—a searchable database featuring the latest peer-reviewed research on immunization benefits, especially in low- and middle-income countries. Browse the Knowledge Hub using a variety of different filters to find vaccine evidence based on country, region, topic, or disease. Click on a tag to find more evidence on a specific area, such as the return on investment of vaccines or impacts of infectious disease outbreaks.


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Child vaccination coverage in Guinea decreased significantly during and after the Ebola epidemic, affecting all vaccines

During and after the Ebola epidemic in a hard-hit region of Guinea, the increasing trend of child vaccination coverage was reversed resulting in a significant decrease in coverage for most vaccines. Despite an uptick immediately following the end of the outbreak, the downward trend continued or plateaued for all vaccines.

Delamou A, El Ayadi AM, Sidibe S et al.. 2017. Effect of Ebola virus disease on maternal and child health services in Guinea: a retrospective observational cohort study. Lancet Global Health. 5(4).

Disease outbreaks can be associated with school closures, food insecurity, and health system disruptions

In a 2018 study, researchers describe the devastating and far-reaching impacts of the 2014 Ebola outbreak in West Africa, including more than half a million people experiencing food insecurity, school closures lasting more than 7 months, tens of thousands of children orphaned, and a huge proportion of the health workforce killed by the disease, leading to infant, maternal, and child deaths due to a lack of skilled health workers and a 97% reduction in surgical capacity.

Huber C, Finelli L, Stevens W. 2018. The economic and social burden of the 2014 Ebola outbreak in West Africa. JID. 22(5).

The impact of disease outbreaks on health systems and governments can cost billions of dollars

In a comprehensive accounting of the costs of the 2014 Ebola outbreak in West Africa, Huber et al. estimate the economic and social costs to have been US$53 billion, of which US$18.8 billion was attributed to non-Ebola deaths.

Huber C, Finelli L, Stevens W. 2018. The economic and social burden of the 2014 Ebola outbreak in West Africa. JID. 22(5).

Vaccinating all healthcare workers against Ebola could have dramatically reduced cases

Using data on the spread of Ebola from person to person during historical Ebola outbreaks to compare vaccination strategies, researchers found that prophylatically vaccinating all healthcare workers would have decreased the number of disease cases in the 2014 epidemics in Guinea and Nigeria by 60-80%.

Coltart CE, Johnson AM, Whitty CJ. 2015. Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control. BMC Medicine. 13(271).

Outbreaks of one illness can lead to reduced access to immunization services, increasing risk of additional outbreaks

A 2015 study projected that the crippling of immunization programs resulting from the 2014 Ebola epidemic in Guinea, Liberia, and Sierra Leone could double the number of people at risk of a measles outbreak, and could cause up to 16,000 measles deaths, surpassing the number of deaths caused by Ebola itself.

Takahashi S, Metcalf JE, Ferrari MJ et al.. 2015. Reduced vaccination and the risk of measles and other childhood infections post-Ebola. Science. 347(6227).

Vaccines are most cost-effective in low income countries

An analysis of the impact of rotavirus vaccine in 25 countries found that the rates of vaccination in all countries were highest and risk mortality lowest in the top two wealth quintile’s coverage. Countries differed in the relative inequities in these two underlying variables. Cost per DALYs averted in substantially greater in the higher quintiles. In all countries, the greatest potential vaccine benefit was in the poorest quintiles; however, reduced vaccination coverage lowered the projected vaccine benefit.

Rheingans, R., Atherly, D., and Anderson, J.. 2012. Distributional impact of rotavirus vaccination in 25 GAVI countries: Estimating disparities in benefits and cost-effectiveness. Vaccine. 30(1).