Vaccination and Immunization Programs

Measles and rubella incidence declined to low levels, attributed to effective implementation of China's Expanded Program on Immunization from 2008 to 2021. The reduction of pertussis, measles, and rubella to low levels reflects the Expanded Program on Immunization. Pertussis incidence in Baiyin was the lowest of all eight diseases, but local underestimation from misdiagnosis and inadequate surveillance likely explains this rather than a true absence of disease. Rubella now predominantly affects the 15–59 age group rather than children, a shift attributed to vaccine-induced immunity changing who remains susceptible.