Progress in worldwide control and elimination of disease through immunization

Abstract

Routine immunization against childhood diseases has been so successful in recent years that many vaccine-preventable diseases occur infrequently in the United States. Many pediatric residents now comptete training without encountering a single child with poliomyelitis, diphtheria, tetanus, or measles (rubeola). As a result, some pediatricians may have lost sigh t of the continuing impact these diseases have on child health in other parts of the world. Some seem surprised to learn, for example, that almost 2 million children still die annually from measles, and another 800,000 infants die each year from neonatal tetanus (Table I). Despite the continuing toll of these disease, great strides have been made over the past decade toward improving rates of immunization among all children. One important contributor has been the Expanded Programme on Immunization of the World Health Organization. Our purposes are to familiarize pediatricians with the strategies and accomplishments of this program, to review the current global status of several vaccine-preventable childhood diseases, and to outline strategies for improvement in the years ahead