The effect of early measles vaccination on morbidity and growth: A randomised trial from Guinea-Bissau

Steiniche, Mette Møller; Thysen, Sanne Marie; Jensen, Aksel Karl Georg; Rodrigues, Amabélia; Martins, Cesário; Meyrowitsch, Dan Wolf; Aaby, Péter; Fisker, Ane Bærent

doi:10.1016/j.vaccine.2020.01.096

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Notably, randomised trials for outcomes of both overall mortality and morbidity consistently result in non-significant beneficial non-specific effects. 10 11 12 17 19 20 21 22 23 24 25 26 27 28 56 …”

Section: Discussionmentioning

confidence: 99%

“…However, based on our systematic review and meta-analysis of 22 randomised controlled trials testing the potential non-specific effects of measles vaccines, 5 6 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 no such beneficial effects were identified for non-measles related overall mortality or morbidity. A systematic review and meta-analysis published in 2016 came to the same conclusion.…”

Section: Introductionmentioning

confidence: 98%

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Measles, mumps, and rubella vaccine at age 6 months and hospitalisation for infection before age 12 months: randomised controlled trial

Zimakoff,

Jensen,

Vittrup

et al. 2023

BMJ

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Objective To test for potential non-specific effects of an additional, early measles, mumps, and rubella (MMR) vaccine at age 5-7 months on risk of infection related hospitalisation before age 12 months. Design Randomised, double blinded, placebo controlled trial. Setting Denmark, a high income setting with low exposure to MMR. Participants 6540 Danish infants aged 5 to 7 months. Interventions Infants were randomly allocated 1:1 to intramuscular injection with standard titre MMR vaccine (M-M-R VaxPro) or placebo (solvent only). Main outcome measures Hospitalisations for infection, defined as all hospital contacts of infants referred from primary care for hospital evaluation and with an infection diagnosed, analysed as recurrent events, from randomisation to 12 months of age. In secondary analyses implications of censoring for date of subsequent diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, and immunisation with pneumococci conjugate vaccine (DTaP-IPV-Hib+PCV), potential effect modification by sex, prematurity (<37 weeks’ gestation), season, and age at randomisation were tested, and the secondary outcomes of hospitalisations ≥12 hours and antibiotic use were evaluated. Results 6536 infants were included in the intention-to-treat analysis. 3264 infants randomised to MMR vaccine experienced 786 hospitalisations for infection before age 12 months compared with 762 for the 3272 infants randomised to placebo. In the intention-to-treat analysis the rate of hospitalisations for infection did not differ between the MMR vaccine and placebo groups (hazard ratio 1.03, 95% confidence interval 0.91 to 1.18). For infants randomised to MMR vaccine compared with those randomised to placebo, the hazard ratio of hospitalisations for infection with a duration of at least 12 hours was 1.25 (0.88 to 1.77), and for prescriptions of antibiotics was 1.04 (0.88 to 1.23). No significant effect modifications were found by sex, prematurity, age at randomisation, or season. The estimate did not change when censoring at the date infants received DTaP-IPV-Hib+PCV after randomisation (1.02, 0.90 to 1.16). Conclusion Findings of this trial conducted in Denmark, a high income setting, do not support the hypothesis that live attenuated MMR vaccine administered early to infants aged 5-7 months decreases the rate of hospitalisations for non-targeted infection before age 12 months. Trial registration EU Clinical Trials Registry EudraCT 2016-001901-18 and ClinicalTrials.gov NCT03780179 .

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Measles, mumps, and rubella vaccine at age 6 months and hospitalisation for infection before age 12 months: randomised controlled trial

Zimakoff,

Jensen,

Vittrup

et al. 2023

BMJ

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A narrative review of nonspecific effects of pediatric vaccines on child mortality and morbidity

Omar

Muhsen

2021

Human Vaccines & Immunotherapeutics

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Reduction in Short-term Outpatient Consultations After a Campaign With Measles Vaccine in Children Aged 9–59 Months: Substudy Within a Cluster-Randomized Trial

Varma

Aaby

Thysen

et al. 2020

Journal of the Pediatric Infectious Diseases Society

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Background We assessed a measles vaccination campaign’s potential short-term adverse events. Methods In a cluster-randomized trial assessing a measles vaccination campaign’s effect on all-cause mortality and hospital admission among children aged 9–59 months in Guinea-Bissau, children received a measles vaccination (intervention) or a health check-up (control). One month to 2 months later, we visited a subgroup of children to ask mothers/guardians about outpatient consultations since enrollment. In log-binomial models, we estimated the relative risk (RR) of nonaccidental outpatient consultations. Results Among 8319 children (4437 intervention/3882 control), 652 nonaccidental outpatient consultations occurred (322 intervention/330 control). The measles vaccination campaign tended to reduce nonaccidental outpatient consultations by 16% (RR, 0.84 [95% confidence interval {CI}, .65–1.11]), especially if caused by respiratory symptoms (RR, 0.68 [95% CI, .42–1.11]). The reduction tended to be larger in children who prior to trial enrollment had a pentavalent vaccination (diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b) as the most recent vaccination (RR, 0.61 [95% CI, .42–.89]) than in children who prior to trial enrollment had a routine measles vaccination as the most recent vaccination (RR, 0.93 [95% CI, .68–1.26]) (P = .04 for interaction). Conclusions In the short term, a measles vaccination campaign seems not to increase nonaccidental outpatient consultations but may reduce them. Clinical Trials Registration NCT03460002.

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The effect of early measles vaccination on morbidity and growth: A randomised trial from Guinea-Bissau

Cited by 3 publications

References 15 publications

Measles, mumps, and rubella vaccine at age 6 months and hospitalisation for infection before age 12 months: randomised controlled trial

Measles, mumps, and rubella vaccine at age 6 months and hospitalisation for infection before age 12 months: randomised controlled trial

A narrative review of nonspecific effects of pediatric vaccines on child mortality and morbidity

Reduction in Short-term Outpatient Consultations After a Campaign With Measles Vaccine in Children Aged 9–59 Months: Substudy Within a Cluster-Randomized Trial

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