abc

Best viewed on desktop. Having trouble? Open map in new window

How to navigate the tool:

  1. Select a vaccine-preventable disease from the dropdown menu
  2. Hover over any state to view projected impacts specific to that location
  3. Adjust the slider to model different magnitudes of coverage decline (e.g., 5%, 10%, 15% reduction)
  4. Choose your outcome:
    • Additional burden (default): Increase above current levels due to declining coverage
    • Total burden: Combined current and additional disease burden
  5. Choose your scale:
    • Counts (default): Total projected cases, hospitalizations, and deaths (useful for understanding overall burden)
    • Rates: Results are normalized by the number of children at risk in each state (useful for comparing risk intensity across states)

Understanding the metrics:

Additional cases
The projected annual increase in children with the disease, resulting from reduced vaccination of infants.

Additional hospitalizations
The number of additional cases severe enough to require inpatient hospital care.

Additional deaths
Estimated annual increase in deaths attributable to the disease, based on historical case-fatality rates.

Additional workdays lost:
Projected increase in workdays lost annually as caregivers stay home to care for sick children.

Additional productivity costs:
Projected annual cost in US dollars of lost productivity due to missed days of work.

Additional hospitalization costs:
Projected annual cost in US dollars of direct medical expenses (hospitalizations, treatment).

Disease Fact Sheets:

Rotavirus

Pertussis

Pneumococcal Disease

.

Interpreting the Results

What these projections represent:

The estimates model the steady-state impact of sustained lower vaccination coverage—the annual disease burden expected once reduced immunization rates become established across the population. These are not outbreak scenarios or one-time events.

The model assumes coverage declines affect infants beginning now, with impacts accumulating as these cohorts age through childhood. Burden estimates assume that incidence is stable in a given year. Results reflect long-term equilibrium conditions.  

VE is assumed to be against infection. For each pathogen, a proportion of infections become cases, are hospitalized or die. VE is the direct protection against infection. Non linear effects (like herd immunity) are captured by the incidence equation. 

Key considerations:

  • Even modest coverage declines (5-10%) can produce substantial increases in disease burden, particularly in populous states or those with higher birth rates
  • Geographic variation in existing coverage levels means some states face higher baseline risk than others
  • Declines are not evenly distributed—communities with lower vaccination rates experience disproportionate impacts
  • These projections use conservative assumptions; outbreaks could produce more severe short-term spikes

Case definitions:

  • Rotavirus: For rotavirus, cases correspond to symptomatic rotavirus gastroenteritis, recognizing a spectrum of disease severity.
  • Pertussis: Pertussis is a notifiable disease, so the model represents symptomatic clinical pertussis, a fraction of which result in hospitalization and death.
  • Pneumococcal: For pneumococcal disease, modeled cases correspond specifically to invasive pneumococcal disease episodes (e.g., bacteremia or meningitis), consistent with Active Bacterial Core Surveillance definitions, a fraction of which result in hospitalization and death.

.

Use Cases

For public health departments:
Project disease resurgence in your state under different coverage scenarios to inform resource planning and intervention priorities.

For journalists and media:
Access state-specific, evidence-based estimates to illustrate the concrete consequences of vaccine hesitancy for your audience.

For advocacy organizations:
Use data-driven projections to demonstrate the importance of maintaining high vaccination coverage and to support policy recommendations.