Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage

Peter Aaby, K Knudsen, T G Jensen, J Thårup, A Poulsen, Morten Sodemann, M C da Silva, H Whittle

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9 months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7% in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68% (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66% (CI 32%-83%) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas.
OriginalsprogEngelsk
TidsskriftJournal of Infectious Diseases
Vol/bind162
Udgave nummer5
Sider (fra-til)1043-8
Antal sider6
ISSN0022-1899
StatusUdgivet - 1990

Fingeraftryk

Measles
Incidence
Confidence Intervals

Citer dette

Aaby, Peter ; Knudsen, K ; Jensen, T G ; Thårup, J ; Poulsen, A ; Sodemann, Morten ; da Silva, M C ; Whittle, H. / Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage. I: Journal of Infectious Diseases. 1990 ; Bind 162, Nr. 5. s. 1043-8.
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title = "Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage",
abstract = "Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81{\%} (Bandim 1) and 61{\%} (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1{\%} and 7.6{\%}, respectively). Between 9 months and 2 years of age, however, 6.1{\%} contracted measles in Bandim 1 and 13.7{\%} in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95{\%} of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68{\%} (95{\%} confidence interval [CI] 39{\%}-84{\%}) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66{\%} (CI 32{\%}-83{\%}) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas.",
keywords = "Age Factors, Antibodies, Viral, Cohort Studies, Guinea-Bissau, Humans, Incidence, Infant, Measles, Measles Vaccine, Measles virus, Prospective Studies, Regression Analysis, Urban Population, Vaccination",
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Aaby, P, Knudsen, K, Jensen, TG, Thårup, J, Poulsen, A, Sodemann, M, da Silva, MC & Whittle, H 1990, 'Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage', Journal of Infectious Diseases, bind 162, nr. 5, s. 1043-8.

Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage. / Aaby, Peter; Knudsen, K; Jensen, T G; Thårup, J; Poulsen, A; Sodemann, Morten ; da Silva, M C; Whittle, H.

I: Journal of Infectious Diseases, Bind 162, Nr. 5, 1990, s. 1043-8.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Measles incidence, vaccine efficacy, and mortality in two urban African areas with high vaccination coverage

AU - Aaby, Peter

AU - Knudsen, K

AU - Jensen, T G

AU - Thårup, J

AU - Poulsen, A

AU - Sodemann, Morten

AU - da Silva, M C

AU - Whittle, H

PY - 1990

Y1 - 1990

N2 - Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9 months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7% in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68% (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66% (CI 32%-83%) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas.

AB - Measles incidence, vaccine efficacy, and mortality were examined prospectively in two districts in Bissau where vaccine coverage for children aged 12-23 months was 81% (Bandim 1) and 61% (Bandim 2). There was little difference in cumulative measles incidence before 9 months of age (6.1% and 7.6%, respectively). Between 9 months and 2 years of age, however, 6.1% contracted measles in Bandim 1 and 13.7% in Bandim 2. Even adjusting for vaccination status, incidence was significantly higher in Bandim 2 (relative risk 1.6, P = .04). Even though 95% of the children had measles antibodies after vaccination, vaccine efficacy was not more than 68% (95% confidence interval [CI] 39%-84%) and was unrelated to age at vaccination. Unvaccinated children had a mortality hazard ratio of 3.0 compared with vaccinated children (P = .002), indicating a protective efficacy against death of 66% (CI 32%-83%) of measles vaccination. These data suggest that it will be necessary to vaccinate before age 9 months to control measles in hyperendemic urban African areas.

KW - Age Factors

KW - Antibodies, Viral

KW - Cohort Studies

KW - Guinea-Bissau

KW - Humans

KW - Incidence

KW - Infant

KW - Measles

KW - Measles Vaccine

KW - Measles virus

KW - Prospective Studies

KW - Regression Analysis

KW - Urban Population

KW - Vaccination

M3 - Journal article

C2 - 2230232

VL - 162

SP - 1043

EP - 1048

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

SN - 0022-1899

IS - 5

ER -