An study using GIS to quantify the percent of pregnant women in Mozambique without access to tetanus toxoid (TT) vaccine at varying distances from health facilities estimated that if women cannot travel more than 5 km to a TT immunization site there will be almost 18,000 neonatal tetanus cases each year that could be prevented, costing the country more than US$362 million in treatment costs and lost productivity. Covering 99% of women with TT will currently require people to travel up to 35 km to obtain an immunization.
Africa
Immunizing children against pneumonia also provides protection for unvaccinated people through herd immunity
A study of the 10-strain pneumococcal conjugate vaccine in rural Kenya demonstrated herd protection. Over a 4-year period following the introduction of the vaccine for infants, coupled with a “catch-up” campaign for all children 12-59 months of age, the incidence of invasive pneumococcal disease (IPD) caused by the strains in the vaccine fell by 100% in infants less than two months of age who were too young to be vaccinated. In adults (≥ 15 years old) the incidence of IPD fell by 81% and in 5-14 year olds the incidence fell by nearly 75%. The chances of unvaccinated persons becoming ill with any strain of the disease also fell significantly – by 87% in infants under two months old, by nearly half (47%) in 5-14 year olds, and by more than one-third (37%) in adults.
Catch-up vaccination can protect unvaccinated individuals, reducing disease burden across communities
A study in rural Kenya, over a 4-year period following the introduction of the 10-strain pneumococcal conjugate vaccine for infants, that included a catch-up vaccination campaign for children 12-59 months of age, suggests that the catch-up vaccination for older birth cohorts may have been a key factor in protecting unvaccinated individuals and speeding up the reduction of the disease in the community. In contrast, a study in The Gambia, where no catch-up campaign took place, found no herd effects during the first three years following the introduction of PCV-13 for infants.
The Gambia study publication referenced can be found at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4909992/
Universal hepatitis B vaccination for newborns in refugee camps is highly cost-effective
Providing a birth dose of hepatitis B vaccine to all newborns (in addition to routine HepB immunization) was found to be a highly cost-effective means of preventing hepatitis B-related deaths in three refugee populations in Africa which are at extremely high risk of hepatitis B infection. Providing a birth dose only to newborns whose mothers test positive on a rapid diagnostic test was less cost-effective than vaccinating all newborns automatically. Thus, universal hepatitis B vaccination of newborns should remain a priority in refugee camps, despite competing humanitarian needs.
Adding hepatitis B vaccine to routine immunization for refugees in Africa reduces transmission and improves global health security
Adding a birth dose of hepatitis B vaccine to routine immunization of refugees in Africa — who have particularly high infection rates — is a highly cost-effective means of reducing transmission of the infection thus strengthening the overall global health security among these mobile, vulnerable populations.
Rotavirus vaccine introduction reduces hospitalizations for infants and children
A study in four hospitals in Botswana found that over a two-year period following the introduction of rotavirus vaccine, hospitalizations from all causes of diarrhea fell by one-third in infants (0-11 months old), and by nearly one-quarter in all children under five years of age. Ninety percent of infants 4-11 months old in the study population received at least one dose of the vaccine, and 75% received both doses during this period. The vaccine’s impact was most apparent during the rotavirus season when the average number of hospitalizations from diarrhea fell 43% among infants and by one-third among all children under five.
Vaccines reduce hospital admissions and free up more resources to treat and prevent other illnesses
One of the first studies of real-world use of pneumococcal conjugate vaccine (PCV) in Africa, found 48% fewer cases of pneumonia in children confirmed by x-ray after PCV introductoin. The results show the vaccine greatly reduced childhood pneumonia hospital admissions in Kenya: Hospital admissions for pneumonia went down 27%.The vaccine led to 329 fewer pneumonia cases per 100,000 kids each year.
Children of divorced mothers and mothers who work part-time are less likely to be fully immunized
Children of divorced mothers in Ghana were three times less likely to be fully immunized than mothers cohabitating with a partner. In addition, it was found that children of mothers who work part time were approximately 2.3 times less likely to be fully immunized than mothers who work full time.
Maternal education interventions improve immunization rates for children across a community
Maternal education benefits immunization rates of all community members, not only mothers’ own children. In Nigeria, children’s odds of being fully immunized improved by 1.06 times for every additional year of education the mothers received. Children’s odds of being fully immunized increased by 1.2 times for each additional year of maternal education in the community.
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.