Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival

Peter Aaby; Cesário L Martins; May-Lill Garly; Andreas Andersen; Ane B Fisker; Mogens H Claesson; Henrik Ravn; Amabelia Rodrigues; Hilton C Whittle; Christine S Benn

doi:10.1093/cid/ciu354

Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival

Peter Aaby, Cesário L Martins, May-Lill Garly, Andreas Andersen, Ane B Fisker, Mogens H Claesson, Henrik Ravn, Amabelia Rodrigues, Hilton C Whittle, Christine S Benn

53 Citations (Scopus)

Abstract

Background. Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. Methods. To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data from 2 previously published randomized trials of a 2-dose schedule with MV given at 4-6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. Results. In trial I (1993-1995), the mortality rate was 0.0 per 1000 person-years among children vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0-.52). In trial II (2003-2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal measles antibody and 14.5 per 1000 person-years without measles antibody (MRR, 0.29; 95% CI, .09-.91). Possible confounding factors did not explain the difference. In a combined analysis, children who had measles antibody detected when they received their first dose of MV at 4-6 months of age had lower mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. Conclusions. Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4-6 months (earlier than currently recommended) and a booster dose at 9-12 months of age.

Original language	English
Journal	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume	59
Issue number	4
Pages (from-to)	484-92
Number of pages	9
ISSN	1058-4838
DOIs	https://doi.org/10.1093/cid/ciu354
Publication status	Published - 15 Aug 2014

Keywords

Antibodies, Viral
Child, Preschool
Developing Countries
Female
Humans
Immunity, Maternally-Acquired
Infant
Male
Measles
Measles Vaccine
Survival Analysis
Vaccination

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/ciu354

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Aaby, P., Martins, C. L., Garly, M-L., Andersen, A., Fisker, A. B., Claesson, M. H., Ravn, H., Rodrigues, A., Whittle, H. C., & Benn, C. S. (2014). Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 59(4), 484-92. https://doi.org/10.1093/cid/ciu354

Measles vaccination in the presence or absence of maternal measles antibody : impact on child survival. / Aaby, Peter; Martins, Cesário L; Garly, May-Lill et al.

In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 59, No. 4, 15.08.2014, p. 484-92.

Research output: Contribution to journal › Journal article › Research › peer-review

Aaby, P, Martins, CL, Garly, M-L, Andersen, A, Fisker, AB, Claesson, MH, Ravn, H, Rodrigues, A, Whittle, HC & Benn, CS 2014, 'Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 59, no. 4, pp. 484-92. https://doi.org/10.1093/cid/ciu354

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title = "Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival",

abstract = "Background. Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. Methods. To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data from 2 previously published randomized trials of a 2-dose schedule with MV given at 4-6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. Results. In trial I (1993-1995), the mortality rate was 0.0 per 1000 person-years among children vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0-.52). In trial II (2003-2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal measles antibody and 14.5 per 1000 person-years without measles antibody (MRR, 0.29; 95% CI, .09-.91). Possible confounding factors did not explain the difference. In a combined analysis, children who had measles antibody detected when they received their first dose of MV at 4-6 months of age had lower mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. Conclusions. Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4-6 months (earlier than currently recommended) and a booster dose at 9-12 months of age.",

keywords = "Antibodies, Viral, Child, Preschool, Developing Countries, Female, Humans, Immunity, Maternally-Acquired, Infant, Male, Measles, Measles Vaccine, Survival Analysis, Vaccination",

author = "Peter Aaby and Martins, {Ces{\'a}rio L} and May-Lill Garly and Andreas Andersen and Fisker, {Ane B} and Claesson, {Mogens H} and Henrik Ravn and Amabelia Rodrigues and Whittle, {Hilton C} and Benn, {Christine S}",

note = "{\textcopyright} The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.",

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month = aug,

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doi = "10.1093/cid/ciu354",

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volume = "59",

pages = "484--92",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

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TY - JOUR

T1 - Measles vaccination in the presence or absence of maternal measles antibody

T2 - impact on child survival

AU - Aaby, Peter

AU - Martins, Cesário L

AU - Garly, May-Lill

AU - Andersen, Andreas

AU - Fisker, Ane B

AU - Claesson, Mogens H

AU - Ravn, Henrik

AU - Rodrigues, Amabelia

AU - Whittle, Hilton C

AU - Benn, Christine S

N1 - © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

PY - 2014/8/15

Y1 - 2014/8/15

N2 - Background. Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. Methods. To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data from 2 previously published randomized trials of a 2-dose schedule with MV given at 4-6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. Results. In trial I (1993-1995), the mortality rate was 0.0 per 1000 person-years among children vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0-.52). In trial II (2003-2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal measles antibody and 14.5 per 1000 person-years without measles antibody (MRR, 0.29; 95% CI, .09-.91). Possible confounding factors did not explain the difference. In a combined analysis, children who had measles antibody detected when they received their first dose of MV at 4-6 months of age had lower mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. Conclusions. Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4-6 months (earlier than currently recommended) and a booster dose at 9-12 months of age.

AB - Background. Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. Methods. To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data from 2 previously published randomized trials of a 2-dose schedule with MV given at 4-6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. Results. In trial I (1993-1995), the mortality rate was 0.0 per 1000 person-years among children vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0-.52). In trial II (2003-2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal measles antibody and 14.5 per 1000 person-years without measles antibody (MRR, 0.29; 95% CI, .09-.91). Possible confounding factors did not explain the difference. In a combined analysis, children who had measles antibody detected when they received their first dose of MV at 4-6 months of age had lower mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. Conclusions. Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4-6 months (earlier than currently recommended) and a booster dose at 9-12 months of age.

KW - Antibodies, Viral

KW - Child, Preschool

KW - Developing Countries

KW - Female

KW - Humans

KW - Immunity, Maternally-Acquired

KW - Infant

KW - Male

KW - Measles

KW - Measles Vaccine

KW - Survival Analysis

KW - Vaccination

U2 - 10.1093/cid/ciu354

DO - 10.1093/cid/ciu354

M3 - Journal article

C2 - 24829213

SN - 1058-4838

VL - 59

SP - 484

EP - 492

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 4

ER -

Measles vaccination in the presence or absence of maternal measles antibody: impact on child survival

Abstract

Keywords

UN SDGs

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