Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis

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From: The Lancet Infectious Diseases(Vol. 17, Issue 11)
Publisher: Elsevier B.V.
Document Type: Article
Length: 635 words

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To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/S1473-3099(17)30419-X Byline: Freya M Shearer, BSc [freya.m.shearer@gmail.com] (a,*), Catherine L Moyes, PhD (a), David M Pigott, DPhil (c), Oliver J Brady, DPhil (e), Fatima Marinho, PhD (g), Aniruddha Deshpande, MPH (c), Joshua Longbottom, MSc (a), Annie J Browne, MPH (a), Moritz U G Kraemer, DPhil (b,h,i), Kathleen M O'Reilly, PhD (f), Joachim Hombach, PhD (j), Sergio Yactayo, MD (k), Valdelaine E M de Araujo, PhD (l), AglaA*r A da Nobrega, PhD (l), Jonathan F Mosser, MD (c,d), Jeffrey D Stanaway, PhD (c), Prof Stephen S Lim, PhD (c), Prof Simon I Hay, FMedSci (a,c), Nick Golding, DPhil (m), Robert C Reiner Jr, PhD (c) Summary Background Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. Methods For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Findings Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393*7 million and 472*9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Interpretation Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. Funding The Rhodes Trust, Bill & Melinda Gates Foundation, the Wellcome Trust, the National Library of Medicine of the National Institutes of Health, the European Union's Horizon 2020 research and innovation programme. Author Affiliation: (a) Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK (b) Department of Zoology, University of Oxford, Oxford, UK (c) Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA (d) Division of Pediatric Infectious Diseases, Seattle Children's Hospital, University of Washington, Seattle, WA, USA (e) Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK (f) Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK (g) University of State of Rio de Janeiro, Maracana, Rio de Janeiro, Brazil (h) Harvard Medical School, Boston, MA, USA (i) Boston Children's Hospital, Boston, MA, USA (j) Initiative for Vaccine Research, Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland (k) Infectious Hazard Management, World Health Organization, Geneva, Switzerland (l) Secretariat of Health Surveillance of the Ministry of Health of Brazil, Rio de Janeiro, Brazil (m) Quantitative & Applied Ecology Group, School of BioSciences, University of Melbourne, Parkville, VIC, Australia * Correspondence to: Miss Freya M Shearer, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK

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Gale Document Number: GALE|A522972340