Mortality reductions from measles and tetanus immunization: a review of the evidence

In recent years, tetanus and measles are estimated to account for more than 2.5 million childhood deaths annually; measles alone may account for more than 2 million such deaths. The author reviews empirical evidence on the most effective and feasible strategies for measles and tetanus vaccination programs. He found that tetanus and measles immunization programs could significantly reduce deaths among children up to the age of 4 in many developing countries. Vaccinations had a pronounced effect in reducing childhood deaths from measles - with benefits sustained over time, and with the greatest benefits accruing to the most disadvantaged children. He found little support for the existence of a replacement mortality effect. Studies on maternal immunization against tetanus showed a great reduction in the number of neonatal deaths, but considerable uncertainty about the number of doses needed and how long the immunity lasted. Recent evidence suggests that giving the mother two doses of tetanus toxoid may confer significant levels of protection against neonatal death from tetanus for 15 years or more. Evidence on the impact of a single dose is less conclusive.

http://documents.worldbank.org/curated/en/784051468765590214/Mortality-reductions-from-measles-and-tetanus-immunization-a-review-of-the-evidence