Reaching populations at risk Developed nations

The greatest benefits of vaccine development and widespread immunization have been realized in developed nations. In the 200 years since Edward Jenner, vaccines have been developed against more than 25 infectious agents (CDC, 1999b). National, regional, and local efforts to promote immunization have led to high rates of vaccine coverage, marked reductions in mortality and morbidity from vaccine-preventable disease, and expansion in the number of recommended vaccines (CDC, 1999b, 2006; Plotkin and Orenstein, 2004; see also Figures 10.1, 10.2).

Estimated annual cases

Smallpox Diphtheria Measles Mumps Pertussis Polio

Rubella

Conginital Rubella Syndrome

Tetanus

100,000

Down 100%

Down 100%

Down 99.9%

Down 99.8%

Down 87.1%

Down 100%

Down 99.9%

Down 100%

Down 94.1%

200,000

300,000

400,000

500,000

4,000,000

Typical number of cases in pre-vaccine era, 20th century ■ 2004 cases

Figure 10.1 Comparison of twentieth-century estimated annual and 2004 reported cases of vaccine-preventable diseases (pre-1990 vaccines). Source: US Centers for Disease Control.

Estimated Annual Cases

0 100,000 200,000 300,000 400,000 500,000 600,000 700,000 800,000 4,000,000

Hepatitis A

Hepatitis B (Acute)

Hib (Invasive)

Hepatitis A

Hepatitis B (Acute)

Down 79.3%

Down 73.8%

Down 79.3%

Down 73.8%

Down 99.9%

Typical number of cases in pre-vaccine era, 20th century

I 2004 cases

Pneumococcus (Invasive)

Down 41.8%

Varicella

Down 41.8%

Varicella

Figure 10.2 Comparison of pre-vaccine era estimated annual cases and 2004 estimated cases of vaccine-preventable diseases (post-1990 vaccines). Source: US Centers for Disease Control.

Figure 10.2 Comparison of pre-vaccine era estimated annual cases and 2004 estimated cases of vaccine-preventable diseases (post-1990 vaccines). Source: US Centers for Disease Control.

The 2007 US Recommended Childhood and Adolescent Immunization Schedule includes vaccines against 15 infectious agents (Figure 10.3).

Findings from the 2003 US National Immunization Survey demonstrated high rates of vaccine coverage, with immunization rates of 80-90 percent or higher for children aged 19-35 months for most of these vaccines (Orenstein et al., 2005; Figures 10.4, 10.5).

Vital to this success has been increasing access to vaccines and immunization services through the Vaccines for Children Program, which provides vaccines to children covered by Medicaid and to insured children. Ongoing surveillance of vaccine-preventable diseases, the safety and effectiveness of vaccines, and their use in the community is essential to sustain this success.

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