TY - JOUR
T1 - The effect of early measles vaccination on morbidity and growth
T2 - A randomised trial from Guinea-Bissau
AU - Steiniche, Mette Møller
AU - Thysen, Sanne Marie
AU - Jensen, Aksel Karl Georg
AU - Rodrigues, Amabelia
AU - Martins, Cesario
AU - Meyrowitsch, Dan Wolf
AU - Aaby, Peter
AU - Fisker, Ane Bærent
PY - 2020/3/4
Y1 - 2020/3/4
N2 - Background: Measles vaccine (MV) has beneficial non-specific effects protecting against non-measles infections in some situations. Within a trial of the effect of MV on mortality, we assessed effects of early MV on the secondary outcomes consultations and growth, overall, and by sex and exposure to campaigns with oral polio vaccine (OPV). Materials and methods: Children were randomly assigned to MV at 4.5 + 9 months or MV at 9 months as recommended. At enrolment and 9 months children had their mid-upper-arm-circumference (MUAC) and weight measured. Consultations (out/inpatient) were registered at monthly home visits. Weight-for-age and MUAC-for-age Z-scores were obtained using the WHO growth reference and compared by group in linear regression models. Consultation rates between enrolment and 9 months were compared in Cox proportional hazards models, providing consultation Hazard Ratios (HRs) for early MV versus no early MV. We tested whether the effect of early MV was modified by OPV campaigns by splitting observation time at exposure to OPV campaigns. Results: Among 3548 children enrolled between 2012 and 2015, early MV had no effect on MUAC-for-age (mean difference comparing early MV vs. no MV −0.01, 95% CI −0.06–0.04), weight-for-age (mean difference −0.03, 95% CI −0.07–0.02) or rates of consultations (HR = 1.03, 95% CI 0.92–1.16). The rate of consultations for children enrolled was lower after exposure to OPV campaigns (HR = 0.81, 95% CI 0.71–0.92). The effect of MV differed before exposure to OPV campaigns (HR = 1.12, 95% CI 0.98–1.29) and after OPV campaigns (HR = 0.83, 95% CI 0.67–1.03) (test for interaction: p = 0.03). Associations did not differ by sex. Conclusion: Early MV had no overall effect on consultation rates and growth between enrolment and 9 months of age. However, early MV tended to have beneficial effects for children subsequently exposed to OPV campaigns. As beneficial effects were observed in subgroups, the results should be interpreted with caution. Clinical trials registration: NCT01644721.
AB - Background: Measles vaccine (MV) has beneficial non-specific effects protecting against non-measles infections in some situations. Within a trial of the effect of MV on mortality, we assessed effects of early MV on the secondary outcomes consultations and growth, overall, and by sex and exposure to campaigns with oral polio vaccine (OPV). Materials and methods: Children were randomly assigned to MV at 4.5 + 9 months or MV at 9 months as recommended. At enrolment and 9 months children had their mid-upper-arm-circumference (MUAC) and weight measured. Consultations (out/inpatient) were registered at monthly home visits. Weight-for-age and MUAC-for-age Z-scores were obtained using the WHO growth reference and compared by group in linear regression models. Consultation rates between enrolment and 9 months were compared in Cox proportional hazards models, providing consultation Hazard Ratios (HRs) for early MV versus no early MV. We tested whether the effect of early MV was modified by OPV campaigns by splitting observation time at exposure to OPV campaigns. Results: Among 3548 children enrolled between 2012 and 2015, early MV had no effect on MUAC-for-age (mean difference comparing early MV vs. no MV −0.01, 95% CI −0.06–0.04), weight-for-age (mean difference −0.03, 95% CI −0.07–0.02) or rates of consultations (HR = 1.03, 95% CI 0.92–1.16). The rate of consultations for children enrolled was lower after exposure to OPV campaigns (HR = 0.81, 95% CI 0.71–0.92). The effect of MV differed before exposure to OPV campaigns (HR = 1.12, 95% CI 0.98–1.29) and after OPV campaigns (HR = 0.83, 95% CI 0.67–1.03) (test for interaction: p = 0.03). Associations did not differ by sex. Conclusion: Early MV had no overall effect on consultation rates and growth between enrolment and 9 months of age. However, early MV tended to have beneficial effects for children subsequently exposed to OPV campaigns. As beneficial effects were observed in subgroups, the results should be interpreted with caution. Clinical trials registration: NCT01644721.
KW - Childhood vaccination
KW - Growth
KW - Measles vaccine
KW - Morbidity
KW - Non-specific (heterologous) effects of vaccines
U2 - 10.1016/j.vaccine.2020.01.096
DO - 10.1016/j.vaccine.2020.01.096
M3 - Journal article
C2 - 32061387
AN - SCOPUS:85079291733
SN - 0264-410X
VL - 38
SP - 2487
EP - 2494
JO - Vaccine
JF - Vaccine
IS - 11
ER -