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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Expanding rotavirus vaccination coverage in Pakistan would greatly reduce deaths, especially among the poorest children
A cost-effectiveness analysis of rotavirus vaccination in Pakistan found that, if rotavirus vaccination coverage was equally high across regions and income groups, the percent reduction in deaths due to rotavirus would be 4 times greater in the highest risk regions than in the lowest-risk regions, and would be 3-4 times greater among children in the poorest versus the wealthiest households.
Expanding vaccination coverage among the poorest and most vulnerable children would substantially increase the overall impact of rotavirus immunization in Pakistan.
Rheingans R, Anderson JD, Bagamian KH et al.. 2018. Effects of geographic and economic heterogeneity on the burden of rotavirus diarrhea and the impact and cost-effectiveness of vaccination in Pakistan. Vaccine. 36(51).
Immunization against rotavirus is cost-effective, especially in poorer regions, saving lives and reducing disabilities
According to a cost-effectiveness study of rotavirus vaccination in Pakistan, the vaccine would be the most cost-effective in the poorer provinces of Sindh and Balochistan (that also have the highest rates of death from rotavirus)- with a cost per disability-adjust life year averted $155-$167 compared to almost $600 in the wealthier region of Islamabad. Within all regions, vaccination was the most cost-effective among the two poorest income groups (quintiles), and was almost 12 times more cost-effective in the poorest households in the most marginalized region than in the wealthiest households in the most advantaged region (cost/DALY averted of $76 vs. $897).
Rheingans R, Anderson JD, Bagamian KH et al.. 2018. Effects of geographic and economic heterogeneity on the burden of rotavirus diarrhea and the impact and cost-effectiveness of vaccination in Pakistan. Vaccine. 36(51).
Children in Pakistan with educated parents are more likely to receive timely immunizations
In a large survey in Pakistan, children were about 30% more likely to receive all the national immunization program vaccinations on time if either their mother or father had a secondary school or higher level of education than those whose mothers or fathers had no formal education.
Noh JW, Kim YM, Akram N et al.. 2018. Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan: A secondary analysis of cross-sectional survey data. PLoS One. 13(10).
Children in Pakistan whose mothers had more antenatal care visits were more likely to receive vaccines on time
Children in Pakistan born to women who had 3 or 4 antenatal care (ANC) visits were 40-60% more likely to receive all required vaccines on time than children whose mothers made only 1 or 2 ANC visits.
Noh JW, Kim YM, Akram N et al.. 2018. Factors affecting complete and timely childhood immunization coverage in Sindh, Pakistan: A secondary analysis of cross-sectional survey data. PLoS One. 13(10).
Efforts to eradicate polio have also led to improved access to other vaccines
The expertise and assets gained through efforts to eradicate polio at least partially explain the improvement between 2013 and 2015 in vaccination coverage of DPT3 in six out of ten “focus” countries of the Polio Eradication Endgame strategic plan. This includes substantial increases in vaccination rates in India, Nigeria, and Ethiopia, which, combined, reduced the number of children not fully vaccinated with DPT by 2 million in 2 years.
van den Ent MMVX, Mallya A, Sandhu H et al.. 2017. Experiences and lessons from polio eradication in 10 focus countries of the polio endgame strategic plan. Journal of Infectious Diseases. 216(1).
Mothers with higher education are more likely to vaccinate their children, leading to better immunization rates
A study conducted in Pakistan, designed to explore the association of maternal education and empowerment with childhood polio vaccination, showed that mothers with more education are more likely to vaccinate their children – 74% of children of mothers with higher education were completely vaccinated compared to 67% of those with primary education and only 47% of those with no education.
Khan, M.T., Zaheer, S., Shafique, K.. 2017. Maternal education, empowerment, economic status, and child polio vaccination uptake in Pakistan: a population based cross sectional study. BJM Open. 7(3).
Mothers involved in decision-making have higher rates of vaccinating their children against polio
A study conducted in Pakistan exploring the association of maternal education and empowerment with childhood polio vaccination found a positive association between maternal empowerment, defined as mother’s involvement in decision-making regarding family, healthcare, and other issues, and complete polio vaccination of their children.
Khan, M.T., Zaheer, S., Shafique, K.. 2017. Maternal education, empowerment, economic status, and child polio vaccination uptake in Pakistan: a population based cross sectional study. BJM Open. 7(3).
Children of wealthier mothers in Pakistan have higher polio vaccination rates compared to poorer mothers
In a study designed to explore the association of maternal education and empowerment with childhood polio vaccination rates in Pakistani mothers, it was observed that the highest percentage of completely vaccinated children (72.6%) was seen among mothers of the richest quintile, followed by 63.4%, 58.0%, 49.8%, and 39% for the richer, middle, poorer, and poorest wealth quintiles, respectively.
Khan, M.T., Zaheer, S., Shafique, K.. 2017. Maternal education, empowerment, economic status, and child polio vaccination uptake in Pakistan: a population based cross sectional study. BJM Open. 7(3).
Vaccine-preventable diarrhea is linked to poor growth
A prospective case-control study conducted in several developing countries found that children with moderate-to-severe diarrhea grew significantly less in length in the two months following their episode compared to age- and gender-matched controls.
Kotloff, K.L., Nataro, J.P., Blackwelder, W.C., et al. 2013. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet. 382(9888).
Undernutrition is an underlying cause of child deaths associated with diarrhea, malaria, pneumonia, and measles
An analysis of the association between undernutrition and mortality in young children revealed that in 60% of deaths due to diarrhea, 52% of deaths due to pneumonia, 45% of deaths due to measles and 57% of deaths attributable to malaria, undernutrition was a contributing factor.
Caulfield, L.E., de Onis, M., and Black, R.E.. 2004. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria and measles. American Journal of Clinical Nutrition. 80(1).