evidence: - We remove deaths that we think are likely to occur before each vaccine is administered.91 For example, in Bauchi state we estimate that 10% of under-five meningitis deaths occur in the first six weeks of life, before the first doses of the PCV and HiB vaccines are scheduled.92 - Some of the diseases covered by these vaccines are caused by multiple pathogens (e.g., only a portion of diarrheal disease is caused by rotavirus). We count only the portion of deaths that we think are caused by the specific pathogens targeted by vaccination (e.g., 41% of diarrheal disease is caused by rotavirus).93 Our adjustments are based on disease etiology estimates from GBD for rotavirus and View-Hub for lower respiratory tract infections and meningitis. View-Hub is a data visualization platform for vaccine-treatable diseases that we believe is likely to be a more reliable source than GBD for those diseases (details in footnote).94 We remain uncertain about these adjustments. In particular, we're highly uncertain how much weight to put on the findings of the PERCH study, which finds much lower etiological fractions of pneumonia due to bacteria like S. pneumoniae and HiB.95 [...] - What assumptions should we make about all-cause mortality? We currently assume 0.75 deaths are indirectly caused by every death directly caused by vaccine-preventable diseases. While we have some meta-analysis evidence that vaccines avert more deaths than would be expected from their impact on vaccine-preventable disease alone, this is a very rough guess.