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
UnitedStates target an increasing number of
vaccine-preventable diseasesfor reduction, elimination, or
To compare morbidity and mortality before andafter
widespread implementation of national vaccine recommendationsfor
13 vaccine-preventable diseases for which recommendationswere
in place prior to 2005.
Setting, and Participants For the United States,prevaccine
baselines were assessed based on representative historicaldata
from primary sources and were compared to the most recentmorbidity
(2006) and mortality (2004) data for diphtheria, pertussis,tetanus,
poliomyelitis, measles, mumps, rubella (including congenitalrubella
syndrome), invasive Haemophilus influenzae type b (Hib),acute
hepatitis B, hepatitis A, varicella, Streptococcus pneumoniae,and smallpox.
Outcome Measures Number of cases, deaths, and hospitalizationsfor 13 vaccine-preventable diseases. Estimates of the percentreductions from baseline to recent were made without adjustmentfor 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 vaccinesrecommended
before 1980 were shown for diphtheria, mumps, pertussis,and
tetanus. Endemic transmission of poliovirus and measlesand
rubella viruses has been eliminated in the United States;smallpox
has been eradicated worldwide. Declines were 80% orgreater
for cases and deaths of most vaccine-preventable diseasestargeted
since 1980 including hepatitis A, acute hepatitis B,Hib,
and varicella. Declines in cases and deaths of invasiveS
pneumoniae were 34% and 25%, respectively.
The number of cases of most vaccine-preventablediseases is
at an all-time low; hospitalizations and deathshave also
shown striking decreases.
Author Affiliations: National Center for Immunization and
Respiratory Diseases (NCIRD); Centers for Disease Control and
Prevention, Atlanta, Georgia.