Contradictory mortality results in early 2-dose measles vaccine trials

• Verfasst von: Nielsen, Sebastian [VerfasserIn]
• Verfasst von: Fisker, Ane B. [VerfasserIn]
• Verfasst von: Sie, Ali [VerfasserIn]
• Verfasst von: Müller, Olaf [VerfasserIn]
• Verfasst von: Nebie, Eric [VerfasserIn]
• Verfasst von: Becher, Heiko [VerfasserIn]
• Verfasst von: van der Klis, Fiona [VerfasserIn]
• Verfasst von: Biering-Sørensen, Sofie [VerfasserIn]
• Verfasst von: Byberg, Stine [VerfasserIn]
• Verfasst von: Thysen, Sanne M. [VerfasserIn]
• Verfasst von: da Silva, Isaquel [VerfasserIn]
• Verfasst von: Rodrigues, Amabelia [VerfasserIn]
• Verfasst von: Martins, Cesario [VerfasserIn]
• Verfasst von: Whittle, Hilton C. [VerfasserIn]
• Verfasst von: Aaby, Peter [VerfasserIn]
• Verfasst von: Benn, Christine S. [VerfasserIn]
• Titel: Contradictory mortality results in early 2-dose measles vaccine trials
• Titelzusatz: interactions with oral polio vaccine may explain differences
• Verf.angabe: Sebastian Nielsen, Ane B. Fisker, Ali Sie, Olaf Müller, Eric Nebie, Heiko Becher, Fiona van der Klis, Sofie Biering-Sørensen, Stine Byberg, Sanne M. Thysen, Isaquel da Silva, Amabelia Rodrigues, Cesario Martins, Hilton C. Whittle, Peter Aaby, Christine S. Benn
• E-Jahr: 2024
• Jahr: November 2024
• Umfang: 9 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 26.03.2025
• Titel Quelle: Enthalten in: International journal of infectious diseases
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1997
• Jahr Quelle: 2024
• Band/Heft Quelle: 148(2024) vom: Nov., Artikel-ID 107224, Seite [1]-9
• ISSN Quelle: 1878-3511
• DOI: doi:10.1016/j.ijid.2024.107224
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Campaigns
• Sach-SW: Child mortality
• Sach-SW: Measles vaccine
• Sach-SW: Non-specific effects of vaccines
• Sach-SW: Oral polio vaccine
• K10plus-PPN: 1920604618

Abstract

Objectives - Between 2003 and 2019, three trials (randomised controlled trials [RCTs]) in Guinea-Bissau randomised infants to an early 2-dose measles vaccine (MV) schedule at 4 and 9 months vs standard MV at 9 months. The RCTs produced contradictory mortality results; the effect being beneficial in the 2-dose group in the first but tending to have higher mortality in the last two RCTs. We hypothesised that increased frequency of campaigns with oral polio vaccine (C-OPV) explained the pattern. - Methods - We performed per-protocol analysis of individual-level survival data from the three RCTs in Cox proportional hazards models yielding hazard ratios (HR) for the 2-dose vs the 1-dose MV group. We examined whether timing of C-OPVs and early administration of OPV0 (birth to day 14) affected the HRs for 2-dose/1-dose MV. - Results - The combined HR(2-dose/1-dose) was 0.79 (95% confidence interval: 0.62-1.00) for children receiving no C-OPV-before-enrolment, but 1.39 (0.97-1.99) for those receiving C-OPV-before-enrolment (homogeneity, P = 0.01). C-OPV-before-enrolment had a beneficial effect in the 1-dose group but tended to have a negative effect in the 2-dose group, especially in females. These effects were amplified further by early administration of OPV0. - Conclusion - In the absence of C-OPVs, an early 2-dose MV strategy had beneficial effects on mortality, but frequent C-OPVs may have benefitted the 1-dose group more than the 2-dose MV group, leading to varying results depending on the intensity of C-OPVs.