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Cited by 122Global Maternal and Child HealthVaccine Coverage and HesitancyImmune responses and vaccinations

Vaccination and All-Cause Child Mortality From 1985 to 2011: Global Evidence From the Demographic and Health Surveys

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McGovern, Mark E., Canning, David·2015·American Journal of Epidemiology
DOI 10.1093/aje/kwv125PMC PMC4757942
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Abstract

Based on models with calibrated parameters for infection, case fatality rates, and vaccine efficacy, basic childhood vaccinations have been estimated to be highly cost effective. We estimated the association of vaccination with mortality directly from survey data. Using 149 cross-sectional Demographic and Health Surveys, we determined the relationship between vaccination coverage and the probability of dying between birth and 5 years of age at the survey cluster level. Our data included approximately 1 million children in 68,490 clusters from 62 countries. We considered the childhood measles, bacillus Calmette-Guérin, diphtheria-pertussis-tetanus, polio, and maternal tetanus vaccinations. Using modified Poisson regression to estimate the relative risk of child mortality in each cluster, we also adjusted for selection bias that resulted from the vaccination status of dead children not being reported. Childhood vaccination, and in particular measles and tetanus vaccination, is associated with substantial reductions in childhood mortality. We estimated that children in clusters with complete vaccination coverage have a relative risk of mortality that is 0.73 (95% confidence interval: 0.68, 0.77) times that of children in a cluster with no vaccinations. Although widely used, basic vaccines still have coverage rates well below 100% in many countries, and our results emphasize the effectiveness of increasing coverage rates in order to reduce child mortality.

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  • Unnecessary child death is related to rejection of standard childhood vaccinations.

    “To illustrate the risks of ignoring false beliefs based on common sense, consider the staggering cost of unnecessary child death related to rejection of standard childhood vaccinations (McGovern & Canning, 2015).”

    From Lessons from the field: Isn't it just common sense? Naïve realism as a barrier to learning (2024) · cites this paper as McGovern & Canning, 2015

    The Discussion reports that higher vaccination coverage is associated with lower under-5 mortality and estimates that expanding measles and maternal tetanus coverage could avert child deaths. The paper does not examine whether children were unvaccinated because their caregivers rejected vaccines or held false beliefs, and it cautions that the causal relationship needs further validation. (LLM, conf=0.86)

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Cited by

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Authors
McGovern, M. E., & Canning, D.
Affiliations
Queen's University Belfast (GB)
Corresponding author
McGovern, Mark E.
ORCID
Venue
American Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2015-10-08
Volume
182
Issue
9
Pages
791-798
ISSN
  • 0002-9262 (ISSN-L)
  • 1476-6256
DOI
10.1093/aje/kwv125
PMC
PMC4757942
OpenAlex
W2245309059
Cited by
122
References
3
Citations by year
2026: 7 · 2025: 14 · 2024: 11 · 2023: 12 · 2022: 18 · 2021: 15 · 2020: 16 · 2019: 16 · 2018: 9 · 2017: 1 · 2016: 1 · 2015: 2
FWCI
4.33
Type
journal article
Language
en
Open access
Locations
  • American Journal of Epidemiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
Funders
  • Bill & Melinda Gates Institute
  • National Institute for Aging (P30 AG024409-09)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Keywords
childhood immunization, child mortality, measles vaccination, BCG vaccination, DTP vaccine, polio vaccine, vaccination coverage, selection bias, Demographic and Health Surveys
MeSH terms
Child, Female, Health Surveys, Humans, Immunization Schedule, Male, Vaccination, Global Health, Poisson Distribution, Child Mortality

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