Vaccines do decrease death rate and very much related to infant mortality rates . after the innovation of vaccines death rates showed gross decrease in its rate .
Comparing countries is different ball game . vaccines you get in USA are available in india , ethiopia also .where they rank 152 , 205 respectively .
vaccines are available every where . very few countries are not getting completely vaccinated is due to lack of public distribution facility or due to uneducated masses .
If you look at the statistics given by CIA fact book . US ranks not 41 but 46 in infant mortality rates . Peculiar problem with US is its population and diversity . US is 3rd in population , if you see first 5 other highly populated countries infant mortality rates you could say US did well even with higher population

1.China - ranks 120 in IMR
2.India - ranks 152 in IMR
3.USA-ranks 46 in IMR
4.Indonasia- ranks 151 in IMR
5.Brazil - ranks 128 in IMR
6.pakistan - ranks 193 in IMR

much IMR in US are due to preterm deliveries and several other factors .
It is to be noted that US ranks 52 when you consider number of physicians per 1000 population .
Source(s):
https://www.cia.gov/library/publications/the-world-factbook/


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