Estimates of the global burden of Japanese encephalitis and the impact of vaccination from 2000-2015

Japanese encephalitis (JE) is a mosquito-borne disease, known for its high mortality and disability rate among symptomatic cases. Many effective vaccines are available for JE, and the use of a recently developed and inexpensive vaccine, SA 14-14-2, has been increasing over the recent years particularly with Gavi support. Estimates of the local burden and the past impact of vaccination are therefore increasingly needed, but difficult due to the limitations of JE surveillance. In this study, we implemented a mathematical modelling method (catalytic model) combined with age-stratifed case data from our systematic review which can overcome some of these limitations. We estimate in 2015 JEV infections caused 100,308 JE cases (95% CI: 61,720–157,522) and 25,125 deaths (95% CI: 14,550–46,031) globally, and that between 2000 and 2015 307,774 JE cases (95% CI: 167,442–509,583) were averted due to vaccination globally. Our results highlight areas that could have the greatest benefit from starting vaccination or from scaling up existing programs and will be of use to support local and international policymakers in making vaccine allocation decisions.


Fig4-Supp3 -2. Susceptible proportion after vaccination in a study of 5 northern provinces in
Vietnam. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -3. Susceptible proportion after vaccination in a study of 6 provinces in Indonesia. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -4. Susceptible proportion after vaccination in a study of 13 southern provinces in
Vietnam. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -5. Susceptible proportion after vaccination in a study of Assam in medium incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -6. Susceptible proportion after vaccination in a study of Bali in Indonesia. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -7. Susceptible proportion after vaccination in a study of Bangkok and Hat Yai in Thailand. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -8. Susceptible proportion after vaccination in a study of Baoji in high incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -9. Susceptible proportion after vaccination in a study of Bellary and neighbors in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -10
Susceptible proportion after vaccination in a study of Bellary in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -11. Susceptible proportion after vaccination in a study of central Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -12. Susceptible proportion after vaccination in a study of Cuddalore in medium incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -13. Susceptible proportion after vaccination in a study of Dhemaji in medium incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -14.
Susceptible proportion after vaccination in a study of eastern Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -15. Susceptible proportion after vaccination in a study of endemic provinces in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -16.
Susceptible proportion after vaccination in a study of Gorakhupur in high incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -17. Susceptible proportion after vaccination in a study of Gorakhupur division in high incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -18. Susceptible proportion after vaccination in a study of Guigang in high incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -19. Susceptible proportion after vaccination in a study of Guizhou in high incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -20. Susceptible proportion after vaccination in a study of hill and mountain districts in low incidence region in Nepal. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -21. Susceptible proportion after vaccination in a study of Jinan in high incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -22.
Susceptible proportion after vaccination in a study of Kaopping in Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -23. Susceptible proportion after vaccination in a study of Kathmandu districts in low incidence region in Nepal. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -24.
Susceptible proportion after vaccination in a study of Longnan in high incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -25. Susceptible proportion after vaccination in a study in Cambodia. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -26. Susceptible proportion after vaccination in a study in India.
For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -27. Susceptible proportion after vaccination in a study in Japan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -28. Susceptible proportion after vaccination in a study in Malayasia.
For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -29. Susceptible proportion after vaccination in a study In Nepal. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -30. Susceptible proportion after vaccination in a study in Philippines.
For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -31. Susceptible proportion after vaccination in a study in South Korea. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -32. Susceptible proportion after vaccination in a study
In Sri Lanka. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -33. Susceptible proportion after vaccination in a study In Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.

Fig4-Supp3 -34.
Susceptible proportion after vaccination in a study of Northern Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -35. Susceptible proportion after vaccination in a study of Northern of Uttar Pradesh in high incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -36. Susceptible proportion after vaccination in a study of not western Terai region in low incidence region in Nepal. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -37. Susceptible proportion after vaccination in a study of Pondicherry in medium incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -38. Susceptible proportion after vaccination in a study of Shijiazhuang in low incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -39. Susceptible proportion after vaccination in a study in Southern Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -40. Susceptible proportion after vaccination in a study of Taipei in Taiwan. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -41. Susceptible proportion after vaccination in a study of Tamil Nadu in medium incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -42. Susceptible proportion after vaccination in a study of Uttar Pradesh in high incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -43. Susceptible proportion after vaccination in a study of Vientiane in Laos. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -44. Susceptible proportion after vaccination in a study of West Bengal in medium incidence region in India. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -45. Susceptible proportion after vaccination in a study of Western Terai in high incidence region in Nepal. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.
Fig4-Supp3 -46. Susceptible proportion after vaccination in a study of Yichang in high incidence region in China. For each study, the red dots with red vertical lines are the mean susceptible proportion after vaccination by age group estimated from the model with 95% credible interval. The blue dots with blue vertical lines are the mean susceptible proportion after vaccination by age group calculated from vaccination information with generated 95% credible interval from the beta distributions. This is the susceptible proportion so (1-vaccinated proportion) therefore estimates of 1 here means no vaccination.