title: Campaigns with oral polio vaccine may lower mortality and create unexpected results.
abstract: Three studies from Guinea-Bissau found conflicting effects of OPV-at-birth (OPV0) on child survival. One study from 2004 suggested excess male mortality among children receiving OPV0 compared with children receiving NoOPV0 during a period of shortage of OPV. However, two subsequent studies showed beneficial effects of OPV0. In 2004, two national OPV-campaigns had been conducted in Guinea-Bissau. In a reanalysis of the 2004-study, in a survival analysis the age-adjusted mortality rate of study participants was 67% (95% CI=42-81%) lower after the OPV-campaigns than before the campaigns. In the OPV0 group only 22% (655/3031 person-years (pyrs)) of follow-up time was "after" the OPV-campaigns whereas 55% (473/859 pyrs) of the time in the NoOPV0 group was post-campaign (p<0.0001, Chi2). Censoring for OPV-campaigns in the original study removed excess male mortality and made the three studies more homogeneous. Overall, there is now considerable evidence that OPV, like other live vaccines, has important beneficial non-specific effects.
authors.affiliation: Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; OPEN, Institute of Clinical Research, University of Southern Denmark/Odense University Hospital, Denmark. Electronic address: cb@ssi.dk.
authors.forename: C S
authors.initials: CS
authors.lastname: Benn
authors.affiliation: Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: L H
authors.initials: LH
authors.lastname: Jacobsen
authors.affiliation: Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: A B
authors.initials: AB
authors.lastname: Fisker
authors.affiliation: Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau.
authors.forename: A
authors.initials: A
authors.lastname: Rodrigues
authors.affiliation: Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Sartono
authors.affiliation: Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Lund
authors.affiliation: The London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
authors.forename: H C
authors.initials: HC
authors.lastname: Whittle
authors.affiliation: Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau.
authors.forename: P
authors.initials: P
authors.lastname: Aaby
mesh_terms: D005260:Female; D006169:Guinea-Bissau; D006801:Humans; D064789:Immunity, Heterologous; D007223:Infant; D007226:Infant Mortality; D008297:Male; D011051:Poliomyelitis / Q000276:immunology / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D017955:Poliovirus / Q000187:drug effects / Q000276:immunology*; D011055:Poliovirus Vaccine, Oral / Q000627:therapeutic use*; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D011055:Poliovirus Vaccine, Oral
keywords: Heterologous effects; Infant mortality; Non-specific effects; Oral polio vaccine; Sex-differential effects