Vaccination Rates Overreported in Developing Countries

Charities may be overpaying to vaccinate poor children.

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When it comes to vaccinating kids in developing countries, immunization rates have long lagged behind those in the United States—which means a significant number of children are still dying from infectious diseases. Efforts by the World Health Organization, UNICEF, and others have dramatically improved immunizations against such diseases as diphtheria, tetanus, and pertussis, but the increase in vaccination rates may have been greatly exaggerated. Foreign governments—which get paid $20 for each child vaccinated against DTP by a global alliance of health organizations—may be overestimating how well they get the job done, according to a study published today in the journal Lancet.

University of Washington researchers funded by the Bill & Melinda Gates Foundation (which is a member of the alliance) discovered from household surveys that about 7.4 million children were vaccinated against DTP in 51 countries from 1999 to 2006. The countries, though, reported vaccinating 13.9 million. That indicates they received overpayments to the tune of $140 million.

The study authors called for a better system for tracking immunizations to ensure that funds to government health organizations are being "used for their intended purpose," adding that "an incentive to overreport progress either intentionally or unintentionally will always exist."

But this may not actually be the case here, Johns Hopkins public health professor David Bishai says in an editorial that accompanied the study. He questions why the overreporting trend wasn't consistent over the seven-year duration of the study, with several years showing fairly consistent estimations of the number of children vaccinated. He writes that the "pattern of results is suggestive, but not conclusive."

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