Deaths from Vaccine Preventable Diseases

Vaccine Basics

A measles alert posted on a home of a child with measles by the health department.
A warning notice put on homes of children with measles to show that they were quarantined because of a measles infection. Photo by Buyenlarge/Getty Images

Pre-Vaccine to Post-Vaccine Era

What was the pre-vaccine era like?

  • up to 15,000 deaths and 200,000 diphtheria cases each year until the 1940s
  • at least 265,000 cases of pertussis each year and 7,000 deaths up to 1934
  • up to 20,000 cases of paralytic polio each year until the early 1950s
  • up to 500 deaths and 500,000 measles cases each year until the early 1960s
  • a 1964-65 rubella epidemic caused 12.5 million rubella virus infections and “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome”
  • up to 20,000 cases of invasive H. influenzae disease each year, with more than half of them having meningitis, and about 300 to 600 deaths, mostly children under age 2 years
  • up to 11,000 hospitalizations and 100 chicken pox deaths each year until 1996
  • before a vaccine was introduced, rotavirus used to cause just over 400,000 visits to the doctor and up to 272,000 visits to the emergency room, 70,000 hospitalizations and 20 to 60 deaths each year in children under age 5 years.
  • up to 17,000 cases of invasive pneumococcal disease in children younger than 5 years each year, including 13,000 cases of bacteremia (blood infection) and 700 cases of pneumococcal meningitis, with 200 deaths.

But none of this could happen today, right? We have modern health care now, so people wouldn't die in these kinds of outbreaks, right?

In the measles outbreaks in the US from 1989 to 1991, 123 people died in the US.

Those deaths occurred despite modern healthcare and good hygiene and nutrition.

And the vaccines for pneumococcal disease, Hib, and rotavirus, etc., came out fairly recently, in the past 20 to 30 years. Those children died in the era of modern healthcare.

Hib Deaths

The first Haemophilus influenzae type b vaccine was licensed in 1985.

It was a pure polysaccharide vaccine that wasn’t effective in children younger than 18 months, and it was only used for a few years.

In 1988, the first Haemophilus b conjugate vaccine (PRP-D) was approved but was still just recommended for toddlers who were at least 18 months old. In 1990, it was replaced with two improved Hib conjugate vaccines (PRP-HbOC and PRP-OMP) that could be given to infants as young as two months old and that significantly accelerated the drop in Hib cases and Hib deaths that had begun in the mid-1980s:

  • 1980 - 45 deaths (epiglottitis) and 222 deaths (meningitis)
  • 1985 - 42 deaths (epiglottitis) and 162 deaths (meningitis)
  • 1988 - 21 deaths (epiglottitis) and 111 deaths (meningitis)
  • 1990 - 15 deaths (epiglottitis) and 58 deaths (meningitis)
  • 2000 - 3 deaths (epiglottitis) and 0 deaths (meningitis)
  • 2001 - 4 deaths (epiglottitis) and 1 death (meningitis)
  • 2002 - 4 deaths (epiglottitis) and 3 deaths (meningitis)
  • 2003 - 3 deaths (epiglottitis) and 1 death (meningitis)
  • 2004 - 1 death (epiglottitis) and 1 death (meningitis)
  • 2005 - 3 deaths (epiglottitis) and 0 deaths (meningitis)
  • 2006 - 2 deaths (epiglottitis) and 0 deaths (meningitis)
  • 2007 - 1 death (epiglottitis) and 1 death (meningitis)
  • 2008 - 3 deaths (epiglottitis) and 4 deaths (meningitis)
  • 2009 - 2 deaths (epiglottitis) and 3 deaths (meningitis)
  • 2010 - 2 deaths (epiglottitis) and 3 deaths (meningitis)
  • 2011 - 2 deaths (epiglottitis) and 1 death (meningitis)
  • 2012 - 1 death (epiglottitis) and 2 deaths (meningitis)
  • 2013 - 0 deaths (epiglottitis) and 5 deaths (meningitis)

In addition to epiglottitis, the Hib vaccine protects against bacterial meningitis and pneumonia. According to the CDC, “By 1998, only 54 cases of invasive Hib disease were reported in children younger than 5 years old.”

It’s important that we don’t stop vaccinating against Hib though.

“Despite the success of the vaccine, parents need to remember the disease is still out there. It is common in some countries and so it can spread to the United States. Hib can also spread in this country because Hib bacteria are carried in the noses and throats of people who are not sick from the disease,” explains Dr. Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases. “So, vaccinating infants and toddlers on time to protect them against Hib disease is crucial. And fully vaccinated children won’t spread the disease to others, including infants and toddlers who are too young to have gotten all their recommended doses of Hib vaccine.”

Other Vaccine Preventable Disease Deaths

Tragically, vaccine-preventable diseases haven’t gone away.

Over the past few years, in children and teens, there have been at least:

  • two deaths from rotavirus (2012 and 2013)
  • one death from congenital rubella syndrome (2012) - while most cases of CRS since 2004 (when endemic rubella was declared eliminated in the United States) report international travel, at least one did not.
  • two deaths from chicken pox (2012)
  • seven deaths from Hib meningitis (2012 and 2013)
  • nine deaths from Hib pneumonia (2012 and 2013)
  • twenty-seven deaths from whooping cough (2012 and 2013)
  • fifteen deaths from pneumococcal meningitis (2012 and 2013)
  • twenty deaths from pneumococcal sepsis (2012 and 2013)
  • 29 deaths from meningococcal disease (2012 and 2013) - while this likely includes some strains that are not currently vaccine preventable, it also includes some that are currently vaccine preventable
  • 248 deaths from the flu (2014 and 2015)

Two measles deaths in 2012 were in adults. Three other measles deaths since 2000 in the United States were in young children, though, including one infant. Since 2000, there have also been thirty-two SSPE deaths in the United States, a long-term complication of natural measles infections.

And tragically, there was another measles death in 2015, an immunocompromised young adult who was exposed to measles during an outbreak in Washington.

There was also a recent death from Hib meningitis - a 14-month-old in Michigan who was a few months behind on her vaccines.

Again, vaccine-preventable diseases haven’t gone away.

Sources:

CDC. Epidemiology and Prevention of Vaccine-Preventable Diseases. The Pink Book: Course Textbook - 13th Edition (2015)

CDC. Haemophilus b Conjugate Vaccines for Prevention of Haemophilus influenzae Type b Disease Among Infants and Children Two Months of Age and Older Recommendations of the ACIP. MMWR. January 11, 1991 / 40(RR01);1-7

CDC. Hib. Diseases and the Vaccines that prevent them. Reviewed February 2013.

CDC. Three Cases of Congenital Rubella Syndrome in the Postelimination Era — Maryland, Alabama, and Illinois, 2012. MMWR. March 29, 2013 / 62(12);226-229.

Vaccines. Sixth Edition.

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