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Estimating the Population-Level Effectiveness of Vaccination Programs in the Netherlands
Epidemiology (Cambridge, Mass.)
|November 1, 2017
Summary
Childhood vaccination programs in the Netherlands significantly reduced mortality. Diphtheria and pertussis vaccines demonstrated herd protection, highlighting the indirect benefits of widespread immunization.
Area of Science:
- Epidemiology
- Public Health
- Immunization
Background:
- Limited data exists on the long-term effectiveness of established vaccination programs in developed nations.
- This study addresses this gap by assessing childhood vaccination impacts in the Netherlands.
Purpose of the Study:
- To estimate the direct and indirect effectiveness of childhood vaccination programs on population-level mortality.
- To quantify the impact of herd protection for specific infectious diseases.
Main Methods:
- Utilized mortality data (1903-2012) and vaccination coverage data from the Netherlands.
- Employed restricted mean lifetime survival methods to estimate childhood mortality burden.
- Modeled pre-vaccination mortality trends to estimate expected burden without vaccination.
Main Results:
- Vaccination programs achieved high effectiveness, nearing 100% within ten birth cohorts.
- Indirect protection (herd effect) accounted for 14.9% of diphtheria mortality burden averted and 32.1% for pertussis.
- No significant indirect effects were observed for poliomyelitis or tetanus.
Conclusions:
- Childhood vaccination programs in the Netherlands have been highly effective in reducing mortality.
- Evidence of substantial indirect effects for diphtheria and pertussis vaccines supports the concept of herd protection.
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