Background: This paper presents the results of systematic reviews of the effectiveness, applicability, other effects, economic impact, and barriers to use of selected population-based interventions intended to improve vaccination coverage. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis for recommendations by the Task Force on Community Preventive Services (the Task Force) regarding the use of these selected interventions. The Task Force recommendations are presented on pp. 92-96 of this issue.
Medical Subject Headings (MeSH):vaccine-preventable diseases, vaccination coverage, community health services, decision-making, evidence-based medicine, systematic reviews, population-based interventions, practice guidelines, preventive health services, public health practice, task force. Introduction V accine-preventable diseases among children, adolescents, and adults represent major continuing causes of morbidity and mortality in the United States. During the latter half of the twentieth century, the success of childhood vaccination programs in the United States has led to a Ͼ95 % decline in most vaccine-preventable diseases of childhood. However, Ͼ400,000 cases of illness and Ͼ30,000 deaths caused by vaccine-preventable diseases still occur each year 1 (CDC unpublished data).Diphtheria, invasive Haemophilus influenzae type b (Hib) disease, measles, poliomyelitis, rubella, tetanus, mumps, varicella, and pertussis are typically referred to as vaccine-preventable diseases of childhood. Vaccinations primarily indicated for adults include influenza, pneumococcal, and hepatitis B. However, during the 1990s, the distinction between childhood and adult vaccine-preventable diseases became less clear. Many childhood vaccine-preventable infections, including measles and pertussis, are found increasingly among adults, 2,3 and hepatitis B vaccinations are now routinely recommended for infants and adolescents. Table 1 outlines universally recommended (i.e., vaccinations recommended for most or all persons in certain age groups) vaccinations for children, adolescents, and older adults.In children, Ͼ50,000 cases of varicella occur each year, making that disease the most common vaccinepreventable disease among children 4 ; in adults, influenza, pneumococcal disease, and hepatitis B are all still common vaccine-preventable diseases, with hundreds of thousands of cases occurring each year.5 Mortality attributable to vaccine-preventable diseases is still substantial. Each year, approximately 500 persons in the United States die of childhood vaccine-preventable diseases, and Ͼ30,000 adults die of influenza, pneumococcal infections, and hepatitis B.1 Influenza, which accounts for an average of 20,000 deaths/year, is usually the largest killer.
5The effectiveness of universally recommended vaccinations in preventing disease for adults, adolescents, and children is well-established. 6 -14 In addition to protecting individuals from diseases passed from person to person contact, vaccinat...
