Background: Vaccine-preventable diseases (VPDs) are a major global health concern for children and adolescents. The COVID-19 pandemic further complicated VPDs prevention by halting vaccinations in many areas. This study aimed to analyze the global burden and trends of eight high - burden VPDs in 0 - 19 - year - olds from 1990 to 2021.
Methods: Using data from the Global Burden of Disease 2021 database across 204 countries, incidence and DALYs were stratified by age, sex, and SDI. A linear regression model calculated AAPCs, and a joinpoint regression model identified a significant trend - change years. The SII and CII quantified SDI-related burden inequality.
Results: From 1990 to 2021, global VPDs incidence and DALYs decreased. However, in 2021, there were still a large number of cases and DALYs. Hepatitis E DALYs rose, especially in males and infants. Males generally had a higher incidence of most VPDs. Lower SDI regions had heavier burdens, except for varicella and herpes zoster in high-SDI areas. The COVID-19 pandemic increased the incidence of some VPDs.
Conclusions: Despite progress in VPDs control, gaps in vaccination, socioeconomic inequalities, and new threats like hepatitis E remain. Targeted actions such as perinatal immunization, hepatitis E vaccination in endemic areas, and restoring pandemic-affected health systems are needed to achieve global health equity.
Keywords: Children and adolescents; DALYs; Global burden of disease; Incidence; Vaccine-preventable diseases.
© 2026. The Author(s).