{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:37:16Z","timestamp":1790613436629,"version":"4.1.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012390","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000}}],"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1115522 \/ AWD-252768"],"award-info":[{"award-number":["OPP1115522 \/ AWD-252768"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Japanese encephalitis (JE) virus is the leading cause of vaccine-preventable encephalitis and a significant cause of disability in Asia and the western Pacific. Many countries have introduced JE vaccination programs, including several low resource countries following WHO\u2019s prioritization of JE vaccination in 2006. We sought to characterize the public health impact of JE vaccination programs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>JE case data and vaccination coverage rates, were requested from country health officials in 23 JE endemic countries and Chinese Taipei. Additional data were extracted from meeting presentations and published literature. JE incidence was compared before and after vaccination using a minimum three year period pre and post program introduction or expansion. Data suitable for analysis were available for 13 JE-endemic countries and Chinese Taipei, for either all age groups or for children aged under 15 years only. Five countries and Chinese Taipei introduced vaccine prior to 2006 and the all-age JE incidence was reduced by 73\u2013100% in about 5\u201320 years following introduction. Six countries have introduced JE vaccine since 2006, and JE incidence in children aged younger than 15 years has been reduced by 14\u201379% as of 2015\u20132021. JE-specific data were unavailable before introduction in Thailand and Vietnam, but vaccination programs reduced acute encephalitis incidence by 80% and 74%, respectively. Even in the programs with greatest impact, it took several years to achieve their results.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/Significance<\/jats:title>\n<jats:p>JE vaccination has greatly reduced JE in 13 JE-endemic countries and Chinese Taipei. Highest impact has been observed in countries that introduced prior to 2006, but it often took roughly two decades and substantial resources to achieve that level of success. For greatest possible impact, more recently introducing countries and funding agencies should commit to continuous improvements in delivery systems to sustain coverage after initial vaccine introduction.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012390","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T17:42:14Z","timestamp":1725385334000},"page":"e0012390","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Impact of vaccination against Japanese encephalitis in endemic countries"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4994-0944","authenticated-orcid":true,"given":"G. William","family":"Letson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony A.","family":"Marfin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Mooney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huong Vu","family":"Minh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Hills","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the JE Vaccine Global Impact Assessment Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"pntd.0012390.ref001","first-page":"e11","article-title":"Chapter 35: Japanese Encephalitis Vaccines.","volume":"607","author":"SB Halstead","year":"2023","journal-title":"Plotkin\u2019s Vaccines Elsevier"},{"issue":"2","key":"pntd.0012390.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6802a1","article-title":"Japanese encephalitis vaccine: Recommendations of the Advisory Committee on Immunization Practices.","volume":"68","author":"SL Hills","year":"2019","journal-title":"ACIP Japanese Encephalitis Vaccine Work Group.MMWR Recomm Rep"},{"issue":"9","key":"pntd.0012390.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000437","article-title":"Japanese Encephalitis\u2014A Pathological and Clinical Perspective.","volume":"3","author":"D Ghosh","year":"2009","journal-title":"PLoS Negl Trop Dis."},{"issue":"6","key":"pntd.0012390.ref004","doi-asserted-by":"crossref","first-page":"e0001873","DOI":"10.1371\/journal.pgph.0001873","article-title":"Estimating the cost of illness of acute Japanese encephalitis and sequelae care in Vietnam and Laos: A cross-sectional study.","volume":"3","author":"ALT Nguyen","year":"2023","journal-title":"PLOS Glob Public Health."},{"key":"pntd.0012390.ref005","first-page":"93","volume-title":"Emerging infections 8.","author":"M Fischer","year":"2008"},{"key":"pntd.0012390.ref006","doi-asserted-by":"crossref","first-page":"766","DOI":"10.2471\/BLT.10.085233","article-title":"Estimated global incidence of Japanese encephalitis: a systematic review","volume":"89","author":"GL Campbell","year":"2011","journal-title":"Bull World Health Organ"},{"key":"pntd.0012390.ref007","author":"WHO","year":"2014","journal-title":"Background Paper of the Strategic Advisory Group of Experts on Japanese encephalitis vaccines"},{"issue":"10","key":"pntd.0012390.ref008","doi-asserted-by":"crossref","first-page":"e0009385","DOI":"10.1371\/journal.pntd.0009385","article-title":"The current burden of Japanese encephalitis and the estimated impacts of vaccination: Combining estimates of the spatial distribution and transmission intensity of a zoonotic pathogen.","volume":"15","author":"SM Moore","year":"2021","journal-title":"PLoS Negl Trop Dis."},{"key":"pntd.0012390.ref009","doi-asserted-by":"crossref","first-page":"e51027","DOI":"10.7554\/eLife.51027","article-title":"Estimates of the global burden of Japanese encephalitis and the impact of vaccination from 2000\u20132015.","volume":"9","author":"TM Quan","year":"2020","journal-title":"Elife."},{"issue":"5","key":"pntd.0012390.ref010","doi-asserted-by":"crossref","first-page":"e0010361","DOI":"10.1371\/journal.pntd.0010361","article-title":"Estimates of Japanese Encephalitis mortality and morbidity: A systematic review and modeling analysis.","volume":"16","author":"Y Cheng","year":"2022","journal-title":"PLoS Negl Trop Dis."},{"key":"pntd.0012390.ref011","first-page":"S0264","article-title":"Modeling the impact of vaccination for the immunization Agenda 2030: Deaths averted due to vaccination against 14 pathogens in 194 countries from 2021 to 2030.","author":"A Carter","year":"2023","journal-title":"Vaccine"},{"key":"pntd.0012390.ref012","doi-asserted-by":"crossref","first-page":"579","DOI":"10.15585\/mmwr.mm6622a3","article-title":"Japanese Encephalitis Surveillance and Immunization\u2014Asia and Western Pacific Regions, 2016.","volume":"66","author":"JD Heffelfinger","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pntd.0012390.ref013","author":"WHO","year":"2007","journal-title":"Meeting Report: Third Biregional Meeting on Control of Japanese Encephalitis, Ho Chi Minh City, Viet Nam, 26\u201327"},{"key":"pntd.0012390.ref014","author":"WHO","year":"2009","journal-title":"Meeting Report: Fourth Bi-regional Meeting on the Control of Japanese Encephalitis (JE), Bangkok, Thailand, 7\u20138"},{"key":"pntd.0012390.ref015","unstructured":"WHO. 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