Sex-specific differences in mortality after high-titre measles immunization in rural Senegal.
Administration of high-titre measles vaccine (Edmonston-Zagreb (EZ) at > 10(5) plaque-forming units (PFU) per dose) before the age of 9 months has been recommended in areas with high measles mortality before the routine age of immunization after 9 months. The study compares the long-term survival after high-titre measles immunization at 5 months of age with that following routine immunization with standard-titre vaccine at 10 months of age. At 5 months of age the high-titre group received Edmonston-Zagreb (EZ-HT, 5 months) or Schwarz (SW-HT, 5 months) at titres > 10(5) PFU per dose, while the standard-titre group received placebo at 5 months of age and < 10(4) PFU per dose of Schwarz vaccine at 10 months (SW-std, 10 months). All the children were followed up to at least 36 months of age. The mortality ratio (MR) for infants in the EZ-HT, 5 months and SW-HT, 5 months groups was 1.32 (P = 0.089) and 1.45 (P = 0.092), respectively, which did not differ significantly from that of recipients of the SW-std, 10 months. The higher MR among recipients of the high-titre vaccines was due to the significantly lower survival among females compared with the females who received SW-std vaccine (EZ-HT, 5 months MR = 1.76, P = 0.013; SW-HT, 5 months MR = 2.14, P = 0.017). For children aged 5-10 months the high-titre measles vaccine did not increase mortality relative to unvaccinated children who had received placebo.
Aaby
P
P
ORSTOM, Dakar, Senegal.
Samb
B
B
Simondon
F
F
Knudsen
K
K
Seck
A M
AM
Bennett
J
J
Markowitz
L
L
Rhodes
P
P
Whittle
H
H
D015982:Bias; D002423:Cause of Death; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000401:mortality*; D008458:Measles Vaccine / Q000008:administration & dosage*; D009752:Nutritional Status; D012424:Rural Population; D012675:Senegal / Q000453:epidemiology; D012737:Sex Factors; D016019:Survival Analysis
D008458:Measles Vaccine