Evidence map›Paper›PMID 38705159›Full record

ArticleLancet (London, England)2024

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization.

Andrew J Shattock, Helen C Johnson, So Yoon Sim, Austin Carter, Philipp Lambach, Raymond C W Hutubessy, Kimberly M Thompson, Kamran Badizadegan, Brian Lambert, Matthew J Ferrari and 11 more

Registry-linked trialAbstract readHistorical Article
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07592260 (OptiMAx), which is not on this map. Cited by 309 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
309citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07592260 narecruitingnot on this mapstarted 2025, after this paper: background citation

OptiMAx: Incentivizing EPI Vaccination Via Distribution of SQ-LNS Nutritional Supplementation to Children From Age 6-11 Months Until 18 Months of Age in Rural Chad and Niger, With a Cost Effectiveness Analysis Protocol for a Research Study Nested in the OptiMA Research Study in Ngouri Health District, Lake Region, Chad and Mirriah Health District, Zinder Region, Niger

TypeinterventionalSponsorAlliance for International Medical ActionRan2025 to 2026Enrolled20,000ConditionsMalnutrition Severe, VaccinationArmssmall quantity lipid-based supplement (SQ-LNS)
3 · Its place in the literature

Who cites it

309 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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249 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Andrew J ShattockSwiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Telethon Kids Institute, Perth, Australia; University of Western Australia, Perth, Australia.
Helen C JohnsonSafinea, London, UK; London School of Economics and Political Science, London, UK; London School of Hygiene & Tropical Medicine, London, UK; University of Cambridge, Cambridge, UK.
So Yoon SimWorld Health Organization, Geneva, Switzerland.
Austin CarterUniversity of Washington, Seattle, WA, USA.
Philipp LambachWorld Health Organization, Geneva, Switzerland.
Raymond C W HutubessyWorld Health Organization, Geneva, Switzerland.
Kimberly M ThompsonKid Risk, Orlando, FL, USA.
Kamran BadizadeganKid Risk, Orlando, FL, USA.
Brian LambertPennsylvania State University, University Park, PA, USA.
Matthew J FerrariPennsylvania State University, University Park, PA, USA.
Mark JitLondon School of Hygiene & Tropical Medicine, London, UK.
Han FuLondon School of Hygiene & Tropical Medicine, London, UK.
Sheetal P SilalModelling and Simulation Hub, Africa, Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa; Centre for Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK.
Rachel A HounsellModelling and Simulation Hub, Africa, Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa; Centre for Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK.
Richard G WhiteLondon School of Hygiene & Tropical Medicine, London, UK; TB Modelling Group, Infectious Disease Epidemiology Department, London School of Hygiene & Tropical Medicine, London, UK.
Jonathan F MosserUniversity of Washington, Seattle, WA, USA.
Katy A M GaythorpeImperial College London, London, UK.
Caroline L TrotterUniversity of Cambridge, Cambridge, UK; Imperial College London, London, UK.
Ann LindstrandWorld Health Organization, Geneva, Switzerland.
Katherine L O'BrienWorld Health Organization, Geneva, Switzerland.
Naor Bar-ZeevWorld Health Organization, Geneva, Switzerland. Electronic address: barzeevn@who.int.

Funding

Gates Foundation INV-009125World Health Organization 001
6 · The paper itself

Abstract

backgroundWHO, as requested by its member states, launched the Expanded Programme on Immunization (EPI) in 1974 to make life-saving vaccines available to all globally. To mark the 50-year anniversary of EPI, we sought to quantify the public health impact of vaccination globally since the programme's inception.

methodsIn this modelling study, we used a suite of mathematical and statistical models to estimate the global and regional public health impact of 50 years of vaccination against 14 pathogens in EPI. For the modelled pathogens, we considered coverage of all routine and supplementary vaccines delivered since 1974 and estimated the mortality and morbidity averted for each age cohort relative to a hypothetical scenario of no historical vaccination. We then used these modelled outcomes to estimate the contribution of vaccination to globally declining infant and child mortality rates over this period.

findingsSince 1974, vaccination has averted 154 million deaths, including 146 million among children younger than 5 years of whom 101 million were infants younger than 1 year. For every death averted, 66 years of full health were gained on average, translating to 10·2 billion years of full health gained. We estimate that vaccination has accounted for 40% of the observed decline in global infant mortality, 52% in the African region. In 2024, a child younger than 10 years is 40% more likely to survive to their next birthday relative to a hypothetical scenario of no historical vaccination. Increased survival probability is observed even well into late adulthood.

interpretationSince 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

fundingWHO.

Indexed as

Child MortalityImmunization ProgramsVaccinationAdolescentAdultChildChild, PreschoolGlobal HealthHistory, 20th CenturyHumansInfantInfant MortalityInfant, NewbornMiddle AgedModels, StatisticalPublic Health

Identifiers

PMID38705159
PMCPMC11140691

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.