BACKGROUND AND OBJECTIVES Current routine immunizations for children aged ≤10 years in the United States in 2019 cover 14 vaccine-preventable diseases. We characterize the public-health impact of vaccination by providing updated estimates of disease incidence with and without universally recommended pediatric vaccines. METHODS Prevaccine disease incidence was obtained from published data or calculated using annual case estimates from the prevaccine period and United States population estimates during the same period. Vaccine-era incidence was calculated as the average incidence over the most recent 5 years of available surveillance data or obtained from published estimates (if surveillance data were not available). We adjusted for underreporting and calculated the percent reduction in overall and age-specific incidence for each disease. We multiplied prevaccine and vaccine-era incidence rates by 2019 United States population estimates to calculate annual number of cases averted by vaccination. RESULTS Routine immunization reduced the incidence of all targeted diseases, leading to reductions in incidence ranging from 17% (influenza) to 100% (diphtheria, Haemophilus influenzae type b, measles, mumps, polio, and rubella). For the 2019 United States population of 328 million people, these reductions equate to >24 million cases of vaccine-preventable disease averted. Vaccine-era disease incidence estimates remained highest for influenza (13 412 per 100 000) and Streptococcus pneumoniae-related acute otitis media (2756 per 100 000). CONCLUSIONS Routine childhood immunization in the United States continues to yield considerable sustained reductions in incidence across all targeted diseases. Efforts to maintain and improve vaccination coverage are necessary to continue experiencing low incidence levels of vaccine-preventable diseases.

中文翻译：

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常规儿童免疫接种对减少美国疫苗可预防疾病的影响。

背景与目的 2019 年美国 10 岁以下儿童的常规免疫接种涵盖 14 种疫苗可预防疾病。我们通过提供有和没有普遍推荐的儿科疫苗的疾病发病率的最新估计来描述疫苗接种对公共卫生的影响。方法 疫苗前疾病发病率从已发表的数据中获得，或使用疫苗前时期的年度病例估计值和同期美国人口估计值进行计算。疫苗时代的发病率计算为最近 5 年可用监测数据的平均发病率，或从已发表的估计中获得（如果监测数据不可用）。我们针对漏报进行了调整，并计算了每种疾病的总体发病率和特定年龄发病率的降低百分比。我们将疫苗前和疫苗时代的发病率乘以 2019 年美国人口估计数，以计算每年通过疫苗接种避免的病例数。结果 常规免疫降低了所有目标疾病的发病率，导致发病率从 17%（流感）降低到 100%（白喉、b 型流感嗜血杆菌、麻疹、腮腺炎、脊髓灰质炎和风疹）。对于 2019 年 3.28 亿美国人口而言，这些减少相当于避免了超过 2400 万例疫苗可预防疾病。流感（每 10 万人 13 412 人）和肺炎链球菌相关的急性中耳炎（每 10 万人 2756 人）的疫苗时代疾病发病率估计值仍然最高。结论 美国的常规儿童免疫接种持续显着降低所有目标疾病的发病率。必须努力维持和提高疫苗接种覆盖率，才能继续经历疫苗可预防疾病的低发病率水平。