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ABSTRACT: Background
Measles vaccine (MV) may protect against non-measles mortality. We tested whether survival depended on age of measles vaccination.Methods
Bandim Health Project follows children under 5 years of age through a Health and Demographic Surveillance System in rural Guinea-Bissau. Children aged 6-36 months with a vaccination card inspected were followed to the next visit or for a maximum of 6 months. In Cox proportional-hazards models adjusted for age and village cluster, we compared the survival of children vaccinated with MV early (< 9 months), as recommended (9-11 months) or late (> 12+ months) with the survival of measles-unvaccinated children. Among measles-vaccinated children, we modelled the effect of age at measles vaccination linearly to assess mortality changes per month increase in vaccination age.Results
From 1999 to 2006, 14,813 children (31,725 observations) were included. Children vaccinated with MV had a Hazard Ratio (HR) of 0.76 (95% CI: 0.63-0.91) compared with measles-unvaccinated children; censoring measles deaths did not change the results (HR = 0.79 (0.65-0.95)). For early MV the HR was 0.68 (0.53-0.87), for MV as recommended the HR was 0.77 (0.62-0.96) and for late MV the HR was 0.86 (0.67-1.11). Limiting the analysis to measles-vaccinated children, age at measles vaccination was associated with a 2.6% (0.4-5.1%) increase in mortality per month increase in vaccination age.Conclusion
Early MV was associated with a large survival advantage. The current policy to increase vaccination age, when measles control improves, may not optimize the impact of MV on child survival.
SUBMITTER: Hansen JS
PROVIDER: S-EPMC6081866 | biostudies-literature | 2018 Aug
REPOSITORIES: biostudies-literature
Hansen Jesper Sloth JS Thysen Sanne Marie SM Rodrigues Amabelia A Martins Cesario C Fisker Ane Bærent AB
BMC public health 20180807 1
<h4>Background</h4>Measles vaccine (MV) may protect against non-measles mortality. We tested whether survival depended on age of measles vaccination.<h4>Methods</h4>Bandim Health Project follows children under 5 years of age through a Health and Demographic Surveillance System in rural Guinea-Bissau. Children aged 6-36 months with a vaccination card inspected were followed to the next visit or for a maximum of 6 months. In Cox proportional-hazards models adjusted for age and village cluster, we ...[more]