Modeling the Impact of Vaccination for the Immunization Agenda 2030: Deaths Averted Due to Vaccination Against 14 Pathogens in 194 Countries from 2021-2030

Background: The Immunization Agenda 2030 (IA2030) Impact Goal 1.1. aims to reduce the number of future deaths averted through immunization in the next decade. In order to estimate the potential impact according to the aspirational coverage targets for IA2030, we developed an analytical framework and estimated the number of deaths averted due to vaccination from 2021-2030 in 194 countries. Method: A demographic model was used to determine annual age-specific mortality estimates associated with vaccine coverage rates. For ten pathogens (Hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, yellow fever), we derived single measures of country- , age-, and pathogen-specific relative risk of deaths conditional upon coverage rates, leveraging the data from 18 modeling groups as part of the Vaccine Impact Model Consortium (VIMC). We used a logistic model to extrapolate the relative risk estimates to countries that were not modeled by VIMC. For four pathogens (diphtheria, tetanus, pertussis and tuberculosis), we used data from the Global Burden of Disease 2019 study and existing literature on vaccine efficacy. A future scenario defining years of vaccine introduction, scale-up and aspirational targets was developed as an input to estimate the long term impact of vaccination taking place from 2021-2030. Findings: Overall, an estimated 51.0 million (95% CI: 48.5 – 53.7) deaths are expected to be averted due to vaccinations administered between the years 2021 and 2030. With immunization coverage projected to increase over 2021-2030 an average of 5.1 million per year (4.9 – 5.4) deaths will be averted annually, with 4.4 million(3.6- 5.1) deaths be averted for the year 2021, gradually rising to 5.8 million(4.9-6.6) deaths averted in 2030. The largest proportion of deaths is attributed to Measles and Hepatitis B accounting for 18.8 million (16.7-21.1) and 14 million (13.6-14.4) of total deaths averted respectively. Interpretation: The results from this global analysis demonstrate the major impact of mortality reductions if the IA2030 targets are met by 2030. Deaths caused by vaccine preventable diseases disproportionately affect LMICs in the African region.