Historical Comparisons of Morbidity and Mortality for
Vaccine-Preventable Diseases in the United States
Sandra W. Roush, MT, MPH; Trudy V. Murphy, MD;
and the Vaccine-Preventable Disease Table Working Group
Context National vaccine recommendations in the
United States target an increasing number of
vaccine-preventable diseases for reduction, elimination, or
To compare morbidity and mortality before and after
widespread implementation of national vaccine recommendations for
13 vaccine-preventable diseases for which recommendations were
in place prior to 2005.
Setting, and Participants For the United States, prevaccine
baselines were assessed based on representative historical data
from primary sources and were compared to the most recent morbidity
(2006) and mortality (2004) data for diphtheria, pertussis, tetanus,
poliomyelitis, measles, mumps, rubella (including congenital rubella
syndrome), invasive Haemophilus influenzae type b (Hib), acute
hepatitis B, hepatitis A, varicella, Streptococcus pneumoniae,
Outcome Measures Number of cases, deaths, and hospitalizations
for 13 vaccine-preventable diseases. Estimates of the percent
reductions from baseline to recent were made without adjustment
for factors that could affect vaccine-preventable disease
morbidity, mortality, or reporting.
A greater than 92% decline in cases and a 99% or greater
decline in deaths due to diseases prevented by vaccines recommended
before 1980 were shown for diphtheria, mumps, pertussis, and
tetanus. Endemic transmission of poliovirus and measles and
rubella viruses has been eliminated in the United States; smallpox
has been eradicated worldwide. Declines were 80% or greater
for cases and deaths of most vaccine-preventable diseases targeted
since 1980 including hepatitis A, acute hepatitis B, Hib,
and varicella. Declines in cases and deaths of invasive S
pneumoniae were 34% and 25%, respectively.
The number of cases of most vaccine-preventable diseases is
at an all-time low; hospitalizations and deaths have also
shown striking decreases.
Author Affiliations: National Center for Immunization and
Respiratory Diseases (NCIRD); Centers for Disease Control and
Prevention, Atlanta, Georgia.