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

J Infect Dis. 2017 Apr 15;215(8):1188-1196. doi: 10.1093/infdis/jiw512.

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 MV at 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: adverse events; heterologous immunity; measles vaccine; morbidity; non-specific effects of vaccines; pediatric.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diarrhea / epidemiology*
  • Female
  • Guinea-Bissau / epidemiology
  • House Calls / statistics & numerical data
  • Humans
  • Immunity, Heterologous*
  • Immunization Schedule
  • Infant
  • Male
  • Measles / prevention & control*
  • Measles Vaccine / administration & dosage*
  • Morbidity
  • Proportional Hazards Models
  • Vaccination
  • Vomiting / epidemiology*

Substances

  • Measles Vaccine