Divergent mortality for male and female recipients of low-titer and high-titer measles vaccines in rural Senegal.
The female/male mortality ratio among unimmunized children and children vaccinated with standard or high-titer measles vaccines was examined for all children born in the period 1985-1991 in a rural area of Senegal. The female/male mortality ratio from 9 months to 5 years of age for unvaccinated children was 0.94 (95% confidence interval (CI) 0.75-1.19), significantly different from the ratio of 0.64 (95% CI 0.48-0.85) for recipients of the Schwarz standard measles vaccine (p = 0.040). In the 4-year period, where high-titer measles vaccines were used in the study area, the female/male mortality ratio was 1.33 (95% CI 1.00-1.78) for recipients of high-titer Edmonston-Zagreb or Schwarz vaccines compared with 0.67 (95% CI 0.42-1.07) for recipients of the Schwarz standard vaccine (p = 0.013). Hence, the Schwarz standard and high-titer measles vaccines have divergent sex-specific effects on mortality throughout childhood. Further studies of the underlying mechanisms are needed.
Aaby
P
P
ORSTOM, Dakar, Senegal.
Samb
B
B
Simondon
F
F
Knudsen
K
K
Seck
A M
AM
Bennett
J
J
Whittle
H
H
D002423:Cause of Death; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000401:mortality / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D009026:Mortality; D016016:Proportional Hazards Models; D012423:Rural Health; D012675:Senegal / Q000453:epidemiology; D012737:Sex Factors; D016019:Survival Analysis
D008458:Measles Vaccine