I don't need to convince readers of Science-Based Medicine that childhood immunizations help children and society. Many people saw the advent of widespread public health efforts taking advantage of advances in our ability to mass produce safe and effective vaccines, starting with the discovery of vaccine science at the end of the 18th century. Many additional vaccines have been developed over the years that have improved the lives of billions of people.

Childhood immunizations have altered the world for the better. This is an irrefutable fact to be true. Despite this, the anti-vaccine movement has become more vocal in recent years, thanks to a rising tide of anti-science misinformation and even targeted misinformation inspired by the SARS-CoV-2 Pandemic. In an attempt to push back against measures designed to reduce the risk of serious COVID-19 cases, established vaccines are also taking a hit.

Even though some vaccines work better than others, they still work if people don't believe in them. This is an irrefutable truth at this time. The current childhood vaccine schedule is safe and effective even though there is no perfect medical intervention. A lack of belief in vaccines makes it difficult to get shots in arms or drops in mouth.

There are still a few vaccine hesitant parents out there who may be able to change their minds. It is great to have updated information on how effective childhood immunizations are. I'll talk about that today.

Impact of routine childhood immunization in reducing vaccine-preventable diseases in the United States

A paper with the title "Public health impact of childhood vaccines in the U.S. using 2019 population data" was published in the journal. The authors presented updated estimates of disease incidence with and without immunizations for children 10 years old and younger. Even if their conclusions are a little overestimation, the results would still be impressive.

There is a lot of data on the benefits of vaccines. There were an estimated 21 million hospitalizations, 732,000 deaths, and 322 million cases of disease in the United States between 1994 and the present day. Over the past 15 years or so, there have been additions to the vaccine schedule that are less represented in the literature.

This study updates estimates of the reduction in overall and age-specific disease incidence associated with the routine childhood immunization program in the United States (based on the 2017 to 2021 vaccination schedule). This update incorporates changes in vaccine utilization rates and observed incidence of the targeted vaccine-preventable diseases since previous evaluations.

Each of the 14 vaccine-preventable diseases targeted in the current schedule for young children will be described.


A common cold and diphtheria are both infections of the respiratory system. The toxin produced by this particular strain ofbacteria can cause serious tissue damage, such as airway obstruction and cardiac injury, that can lead to paralysis. Some children die from this condition.

  • Percent reduction of disease in the vaccine era: 100%
  • Prevaccine incidence per 100,000: 600
  • 2019 cases without immunization: 263,000
  • 2019 cases with immunization: <1<>
  • Cases prevented: 263,000

Hepatitis A

There is an infectious disease that targets the body's immune system. It is spread via contaminated food or water and can move quickly through groups of young children who are not familiar with good hand hygiene. While not likely to cause chronic disease that requires a liver transplant, it can cause serious injury with severe symptoms that last for weeks to months and there is no effective treatment.

  • Percent reduction of disease in the vaccine era: ~87%
  • Prevaccine incidence per 100,000: 17
  • 2019 cases without immunization: 56,000
  • 2019 cases with immunization: 7,000
  • Cases prevented: 49,000

Hepatitis B

Hepatitis B can be spread via contaminated blood, semen, or other body fluids when a woman is pregnant, but it can also be passed on to her unborn child. Most adults will have a self-limiting course, but it is likely to cause chronic disease in children and infants. In some cases, a transplant is needed. The hepatitis B vaccine had been preventing cancer for decades before the introduction of the human immunodeficiency virus.

  • Percent reduction of disease in the vaccine era: ~86%
  • Prevaccine incidence per 100,000: 46
  • 2019 cases without immunization: 150,000
  • 2019 cases with immunization: 22,000
  • Cases prevented: 128,000

Haemophilus influenzae type b

Hib is a common cause of ear infections and pneumonia, but it is also known for its ability to cause a severe form of Meningitis and a dangerous infections of the Epiglottis. Many patients died or had long lasting neurological injuries when they were hospitalized because of this common infection in the 1980's and 90's. I have never seen a case in my practice.

  • Percent reduction of disease in the vaccine era: ~100%
  • Prevaccine incidence per 100,000: 92
  • 2019 cases without immunization: 18,000
  • 2019 cases with immunization: <100<>
  • Cases prevented: 18,000


The flu is present. You're aware of this one. A typical case of the flu can be rough in healthy adults and even the majority of kids, but it can cause severe disease in the immune compromised, people with underlying cardiac or respiratory diseases, and the very young. Huge economic costs are associated with Guillain-Barré syndrome and other potential non-respiratory sequelae attributed to the flu.

  • Percent reduction of disease in the vaccine era: ~17%
  • Prevaccine incidence per 100,000: 1,232
  • 2019 cases without immunization: 7,115,000
  • 2019 cases with immunization: 5,879,000
  • Cases prevented: 1,236,000


Out of every 1,000 cases of the Measles, 1-2 are fatal because of its tendency to cause inflammation of the brain and its ability to spread. Subacute sclerosing panencephalitis is an uncommon but always fatal disease that can develop years after a mild case of measles.

  • Percent reduction of disease in the vaccine era: ~100%
  • Prevaccine incidence per 100,000: 2,129
  • 2019 cases without immunization: 3,639,000
  • 2019 cases with immunization: <1,000<>
  • Cases prevented: 3,639,000


Prior to the vaccine, mummies was a very common infectious disease. It can cause inflammation and swelling of salivary glands in the face and cause injury to the testicles that can result in infertility. It can cause deafness andInflammation of the Brain.

  • Percent reduction of disease in the vaccine era: ~100%
  • Prevaccine incidence per 100,000: 1,312
  • 2019 cases without immunization: 2,243,000
  • 2019 cases with immunization: 3,000
  • Cases prevented: 2,240,000


A mild or even asymptomatic Rubella is one of the most infectious viral infections. It is very different if you are a fetus whose mother is infectious during the first 3 months of pregnancy. Congenital rubella syndrome is a serious disease that can cause brain, heart, and eye damage. The World Health Organization defines Rubella as an eliminated disease in the US. I have never seen a case of any of them, but I am worried that will change.

  • Percent reduction of disease in the vaccine era: ~100%
  • Prevaccine incidence per 100,000: 1,124
  • 2019 cases without immunization: 1,921,000
  • 2019 cases with immunization: <10<>
  • Cases prevented: 1,921,000


Pertussis, also known as whooping cough, is a disease that can be fatal in infants. About 1% of infants with the disease will die, and a third of them will need to be hospitalized. It can cause inflammation of the brain in young people.

The current tetanus vaccine isn't the poster child for our vaccine schedule. Because of an unfortunate reaction to fear of bogus neurological side effects heavily promoted by an infamous 1982 anti-vaccine documentary and a subsequent drop in acceptance of the vaccine by parents, we changed from whole cell vaccine to an acellular vaccine which, while good, is just not as effective as the Boosters are needed because it doesn't provide as much protection and immunity doesn't last as long. We see a lot of the disease nowadays.

  • Percent reduction of disease in the vaccine era: ~91%
  • Prevaccine incidence per 100,000: 744
  • 2019 cases without immunization: 2,442,000
  • 2019 cases with immunization: 217,000
  • Cases prevented: 2,225,000

Streptococcus pneumoniae

Pneumococcus is the leading cause of ear infections and pneumonia, but is also a well-known cause of bloodstream infections and many other diseases. More than 300,000 children under the age of five are killed every year because of the lack of vaccine availability. The incidence has plummeted in the United States due to the effective vaccines that cover more and more strains of thisbacteria.

Even though there was an earlier version for older adults, the first vaccine for children didn't come out until 2000. The vaccine has been updated with new strains and better protection. I haven't seen a case of IPD in years, but I still see suspected PAIN and ear infections.

  • Percent reduction of disease in the vaccine era: ~60% (IPD only)
  • Prevaccine incidence per 100,000: 24 (IPD), 152 (hospitalizations)
  • 2019 cases without immunization: 79,000 (IPD), 500,000 (hospitalizations)
  • 2019 cases with immunization: 31,000 (IPD), 78,000 (hospitalizations)
  • Cases prevented: 48,000 (IPD), 422,000 (hospitalizations)


Although it can cause flu-like illness, plio is best known for its ability to progress to muscle weakness and the need for lifelong mechanical ventilation, which is why it's called the iron lung. The early days of the coronaviruses inspired some innovation in this outdated form of negative pressure ventilation, so we may see an updated version in the future In 1979 there was the last naturally occurring case of the disease in the US.

  • Percent reduction of disease in the vaccine era: ~100%
  • Prevaccine incidence per 100,000: 21
  • 2019 cases without immunization: 70,000
  • 2019 cases with immunization: 0
  • Cases prevented: 70,000


It's a blast from the past. It used to send a lot of kids to the ED and put a lot in the hospital because it was a very infectious cause of gastroenteritis. Widespread use of a safe and effective vaccine began right after I finished my residency. It looks like the vaccine may prevent the development of diabetes in a lot of children.

There is a conspiracy involving Big pharma and Uncle Sam, and there is a fascinating history of the vaccine for rotaviruses. A rare side effect was found after the approval of an earlier vaccine and it was recalled within a year. The safer versions came out after more research. This level of monitoring is required for all vaccines.

  • Percent reduction of disease in the vaccine era: ~91%
  • Prevaccine incidence per 100,000: 340 (hospitalizations), 1,072 (ED visits)
  • 2019 cases without immunization: 67,000 (hospitalizations), 210,000 (ED visits)
  • 2019 cases with immunization: 6,000 (hospitalizations), 82,000 (ED visits)
  • Cases prevented: 61,000 (hospitalizations), 128,000 (ED visits)


The only vaccine-preventable illness that is infectious but not transmittable is tetanus. When a wound is contaminated with a certain type ofbacteria, it can be fatal. In the case of a deep wound, thebacteria produce a toxin which causes uncontrollable muscle spasm and rigidity. It's a bad way to travel.

  • Percent reduction of disease in the vaccine era: ~98%
  • Prevaccine incidence per 100,000: <1<>
  • 2019 cases without immunization: 1,000
  • 2019 cases with immunization: <100<>
  • Cases prevented: 1,000


Chicken pox is the last but not least disease. The same virus can be found in the brain and can cause shingles in the future. The vaccine for that isn't recommended until 50. In 1983, I had chicken pox, and many readers did the same, unless they were born after 1995. It is more of an economic burden than a cause of disease in young children who aren't freshly born. Teens and adults with a compromised immune system are more likely to get infections that can lead to lung disease and brain inflammation.

  • Percent reduction of disease in the vaccine era: ~98%
  • Prevaccine incidence per 100,000: 1,328
  • 2019 cases without immunization: 4,359,000
  • 2019 cases with immunization: 97,000
  • Cases prevented: 4,262,000

Conclusion: the data speaks for itself

The authors concluded that the current childhood immunizations schedule for kids 10 and younger prevented 24 million cases of disease in 2019. The incidence of horrible diseases in the United States is less than one per 100,000 people. For diseases that aren't as effective, hospitalizations are reduced. If vaccine rates go down, this will fall apart, even if the diseases are not as bad as they used to be.

There were some limitations to the analysis. It's complex. Some credit for decreasing incidence rates historically goes to improved Sanitation/hygiene, healthcare access, and general standards of medical care Some adolescents and adults get booster shots for certain vaccines.

The problem with the data is that it assumes an even distribution of vaccine benefit. There is a lot of disparity when it comes to different racial and ethnic groups. For a variety of reasons, disease burden is often shifted towards groups of people who are less likely to get the care they need. Deaths and morbidity have been heavily skewed towards people of color during the current Pandemic.

The assumption that the disease burden of vaccine-preventable illnesses is constant over time is one of the reasons why this data is unavoidable. Some diseases can have differences. It's possible that it's painting too rosy a picture as it reflects data from before the outbreak of the disease.

This isn't an exact picture. It would not be possible. I don't think it's clinically meaningful because it probably underestimates the benefit of vaccines. The study adds to the evidence that vaccines are the greatest advancement in medical science at the top of a pile.