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Reduced childhood mortality after standard measles vaccination at 4-8 months compared with 9-11 months of age

Aaby, P ; Andersen, M ; Sodemann, M ; Jakobsen, M ; Gomes, J ; Fernandes, M

BMJ, 1993-11, Vol.307 (6915), p.1308-1311 [Periódico revisado por pares]

England: British Medical Journal Publishing Group

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  • Título:
    Reduced childhood mortality after standard measles vaccination at 4-8 months compared with 9-11 months of age
  • Autor: Aaby, P ; Andersen, M ; Sodemann, M ; Jakobsen, M ; Gomes, J ; Fernandes, M
  • Assuntos: Age Factors ; Children ; Death ; Developing Countries ; Dosage ; Female ; Follow-Up Studies ; Guinea-Bissau - epidemiology ; Humans ; Immunization Schedule ; Infant ; Infections ; Male ; Measles ; Measles - prevention & control ; Measles Vaccine - administration & dosage ; Measles vaccines ; measles virus ; Mortality ; Population ; Rainy seasons ; Socioeconomic Factors ; Vaccination ; Youths at risk
  • É parte de: BMJ, 1993-11, Vol.307 (6915), p.1308-1311
  • Notas: local:bmj;307/6915/1308
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  • Descrição: OBJECTIVE--To evaluate the impact on mortality of standard Schwarz measles immunisation before 9 months of age. DESIGN--Children vaccinated in 1980-3 at 4-5, 6-8, and 9-11 months of age were followed to migration, death, or the age of 5 years. SETTING--One urban district and nine villages in two rural areas of Guinea-Bissau. SUBJECT--307 children vaccinated at 4-8 months and 256 at 9-11 months. MAIN OUTCOME MEASURES--Mortality from 9 months to 5 years of age for children immunised at 4-5, 6-8, and 9-11 months. RESULTS--Mortality was significantly lower in children vaccinated at 6-8 months than at 9-11 months (mortality ratio = 0.63, (95% confidence interval 0.41 to 0.97), p = 0.047). As vaccination was provided in semiannual or annual campaigns it is unlikely that age at vaccination reflected a selection bias. The trend was the same in all three study areas. Improved survival after early immunisation was not related to better protection against measles infection. With a Cox multivariate regression model to adjust for age, sex, season at risk, season at birth, measles infection, and region, children vaccinated at 4-8 months had a mortality ratio of 0.61 (0.40 to 0.92, p = 0.020) compared with children vaccinated at 9-11 months. Reimmunised children tended to have lower mortality than children who received only one vaccine (0.59 (0.28 to 1.27, p = 0.176)). CONCLUSION--Standard measles vaccination before 9 months is not associated with higher childhood mortality than is the currently recommended strategy of immunising from 9 months, and it may reduce mortality. This has implications for measles immunisation strategy in developing countries.
  • Editor: England: British Medical Journal Publishing Group
  • Idioma: Inglês
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