Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau

Vu An Do, Sofie Biering-Sorensen, Ane Bærent Fisker, Carlito Balé, Stine Møller Rasmussen, Lone Damkjær Christensen, Kristoffer Jarlov Jensen, Cesário Martins, Peter Aaby, Christine Stabell Benn

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    Abstract

    Background: Children in Guinea-Bissau receive measles vaccine (MV) at 9 months of age, but studies have shown that an additional dose before 9 months of age might have beneficial nonspecific effects. Within a randomized trial designed to examine nonspecific effects of early MV receipt on mortality, we conducted a substudy to investigate the effect of early MV receipt on morbidity. Methods: Children were randomly assigned at a ratio of 2: 1 to receive 2 doses of MVat 18 weeks and age 9 months (intervention group) or 1 dose of MV at age 9 months, in accordance with current practice (control group). Children were visited weekly from enrollment to age 9 months; the mother reported morbidity, and the field assistants examined the children. Using Cox and binomial regression models, we compared the 2 randomization groups. Results: Among the 1592 children, early measles vaccination was not associated with a higher risk of the well-known adverse events of fever, rash, and convulsions within the first 14 days. From 15 days after randomization to age 9 months, early measles vaccination was associated with reductions in maternally reported diarrhea (hazard ratio [HR], 0.89; 95% confidence interval [CI],.82-. 97), vomiting (HR, 0.86; 95% CI,.75-. 98), and fever (HR, 0.93; 95% CI,.87-1.00).Conclusion. Early MV receipt was associated with reduced general morbidity in the following months, supporting that early MV receipt may improve the general health of children.
    Original languageEnglish
    JournalJournal of Infectious Diseases
    Volume215
    Issue number8
    Pages (from-to)1188-1196
    ISSN0022-1899
    DOIs
    Publication statusPublished - 2017

    Bibliographical note

    This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence.

    Keywords

    • Measles vaccine
    • Adverse events
    • Morbidity
    • Non-specific effects of vaccines
    • Heterologous immunity
    • Pediatric

    Cite this

    Do, V. A., Biering-Sorensen, S., Fisker, A. B., Balé, C., Rasmussen, S. M., Christensen, L. D., ... Benn, C. S. (2017). Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau. Journal of Infectious Diseases, 215(8), 1188-1196. https://doi.org/10.1093/infdis/jiw512
    Do, Vu An ; Biering-Sorensen, Sofie ; Fisker, Ane Bærent ; Balé, Carlito ; Rasmussen, Stine Møller ; Christensen, Lone Damkjær ; Jensen, Kristoffer Jarlov ; Martins, Cesário ; Aaby, Peter ; Benn, Christine Stabell. / Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau. In: Journal of Infectious Diseases. 2017 ; Vol. 215, No. 8. pp. 1188-1196.
    @article{381cc24b10df4f1da770709403ebb582,
    title = "Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau",
    abstract = "Background: Children in Guinea-Bissau receive measles vaccine (MV) at 9 months of age, but studies have shown that an additional dose before 9 months of age might have beneficial nonspecific effects. Within a randomized trial designed to examine nonspecific effects of early MV receipt on mortality, we conducted a substudy to investigate the effect of early MV receipt on morbidity. Methods: Children were randomly assigned at a ratio of 2: 1 to receive 2 doses of MVat 18 weeks and age 9 months (intervention group) or 1 dose of MV at age 9 months, in accordance with current practice (control group). Children were visited weekly from enrollment to age 9 months; the mother reported morbidity, and the field assistants examined the children. Using Cox and binomial regression models, we compared the 2 randomization groups. Results: Among the 1592 children, early measles vaccination was not associated with a higher risk of the well-known adverse events of fever, rash, and convulsions within the first 14 days. From 15 days after randomization to age 9 months, early measles vaccination was associated with reductions in maternally reported diarrhea (hazard ratio [HR], 0.89; 95{\%} confidence interval [CI],.82-. 97), vomiting (HR, 0.86; 95{\%} CI,.75-. 98), and fever (HR, 0.93; 95{\%} CI,.87-1.00).Conclusion. Early MV receipt was associated with reduced general morbidity in the following months, supporting that early MV receipt may improve the general health of children.",
    keywords = "Measles vaccine, Adverse events, Morbidity, Non-specific effects of vaccines, Heterologous immunity, Pediatric",
    author = "Do, {Vu An} and Sofie Biering-Sorensen and Fisker, {Ane B{\ae}rent} and Carlito Bal{\'e} and Rasmussen, {Stine M{\o}ller} and Christensen, {Lone Damkj{\ae}r} and Jensen, {Kristoffer Jarlov} and Ces{\'a}rio Martins and Peter Aaby and Benn, {Christine Stabell}",
    note = "This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence.",
    year = "2017",
    doi = "10.1093/infdis/jiw512",
    language = "English",
    volume = "215",
    pages = "1188--1196",
    journal = "Journal of Infectious Diseases",
    issn = "0022-1899",
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    Do, VA, Biering-Sorensen, S, Fisker, AB, Balé, C, Rasmussen, SM, Christensen, LD, Jensen, KJ, Martins, C, Aaby, P & Benn, CS 2017, 'Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau', Journal of Infectious Diseases, vol. 215, no. 8, pp. 1188-1196. https://doi.org/10.1093/infdis/jiw512

    Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau. / Do, Vu An; Biering-Sorensen, Sofie; Fisker, Ane Bærent; Balé, Carlito; Rasmussen, Stine Møller; Christensen, Lone Damkjær; Jensen, Kristoffer Jarlov; Martins, Cesário; Aaby, Peter; Benn, Christine Stabell.

    In: Journal of Infectious Diseases, Vol. 215, No. 8, 2017, p. 1188-1196.

    Research output: Contribution to journalJournal articleResearchpeer-review

    TY - JOUR

    T1 - Effect of an Early Dose of Measles Vaccine on Morbidity Between 18 Weeks and 9 Months of Age: A Randomized, Controlled Trial in Guinea-Bissau

    AU - Do, Vu An

    AU - Biering-Sorensen, Sofie

    AU - Fisker, Ane Bærent

    AU - Balé, Carlito

    AU - Rasmussen, Stine Møller

    AU - Christensen, Lone Damkjær

    AU - Jensen, Kristoffer Jarlov

    AU - Martins, Cesário

    AU - Aaby, Peter

    AU - Benn, Christine Stabell

    N1 - This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence.

    PY - 2017

    Y1 - 2017

    N2 - Background: Children in Guinea-Bissau receive measles vaccine (MV) at 9 months of age, but studies have shown that an additional dose before 9 months of age might have beneficial nonspecific effects. Within a randomized trial designed to examine nonspecific effects of early MV receipt on mortality, we conducted a substudy to investigate the effect of early MV receipt on morbidity. Methods: Children were randomly assigned at a ratio of 2: 1 to receive 2 doses of MVat 18 weeks and age 9 months (intervention group) or 1 dose of MV at age 9 months, in accordance with current practice (control group). Children were visited weekly from enrollment to age 9 months; the mother reported morbidity, and the field assistants examined the children. Using Cox and binomial regression models, we compared the 2 randomization groups. Results: Among the 1592 children, early measles vaccination was not associated with a higher risk of the well-known adverse events of fever, rash, and convulsions within the first 14 days. From 15 days after randomization to age 9 months, early measles vaccination was associated with reductions in maternally reported diarrhea (hazard ratio [HR], 0.89; 95% confidence interval [CI],.82-. 97), vomiting (HR, 0.86; 95% CI,.75-. 98), and fever (HR, 0.93; 95% CI,.87-1.00).Conclusion. Early MV receipt was associated with reduced general morbidity in the following months, supporting that early MV receipt may improve the general health of children.

    AB - Background: Children in Guinea-Bissau receive measles vaccine (MV) at 9 months of age, but studies have shown that an additional dose before 9 months of age might have beneficial nonspecific effects. Within a randomized trial designed to examine nonspecific effects of early MV receipt on mortality, we conducted a substudy to investigate the effect of early MV receipt on morbidity. Methods: Children were randomly assigned at a ratio of 2: 1 to receive 2 doses of MVat 18 weeks and age 9 months (intervention group) or 1 dose of MV at age 9 months, in accordance with current practice (control group). Children were visited weekly from enrollment to age 9 months; the mother reported morbidity, and the field assistants examined the children. Using Cox and binomial regression models, we compared the 2 randomization groups. Results: Among the 1592 children, early measles vaccination was not associated with a higher risk of the well-known adverse events of fever, rash, and convulsions within the first 14 days. From 15 days after randomization to age 9 months, early measles vaccination was associated with reductions in maternally reported diarrhea (hazard ratio [HR], 0.89; 95% confidence interval [CI],.82-. 97), vomiting (HR, 0.86; 95% CI,.75-. 98), and fever (HR, 0.93; 95% CI,.87-1.00).Conclusion. Early MV receipt was associated with reduced general morbidity in the following months, supporting that early MV receipt may improve the general health of children.

    KW - Measles vaccine

    KW - Adverse events

    KW - Morbidity

    KW - Non-specific effects of vaccines

    KW - Heterologous immunity

    KW - Pediatric

    U2 - 10.1093/infdis/jiw512

    DO - 10.1093/infdis/jiw512

    M3 - Journal article

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    JO - Journal of Infectious Diseases

    JF - Journal of Infectious Diseases

    SN - 0022-1899

    IS - 8

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