Non-specific beneficial effect of measles immunisation: analysis of mortality studies from developing countries
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Objective : To examine whether the reduction in mortality after standard titre measles immunisation in developing countries can be explained simply by the prevention of acute measles and its long term consequences. Design : An analysis of all studies comparing mortality of unimmunised children and children immunised with standard titre measles vaccine in developing countries. Studies : 10 cohort and two case-control studies from Bangladesh, Benin, Burundi, Guinea-Bissau, Haiti, Senegal, and Zaire. Main outcome measures : Protective efficacy of standard titre measles immunisation against all cause mortality. Extent to which difference in mortality between immunised and unimmunised children could be explained by prevention of measles disease. Results : Protective efficacy against death after measles immunisation ranged from 30% to 86%. Efficacy was highest in the studies with short follow up and when children were immunised in infancy (range 44-100%). Vaccine efficacy against death was much greater than the proportion of deaths attributed to acute measles disease. In four studies from Guinea-Bissau, Senegal, and Burundi vaccine efficacy against death remained almost unchanged when cases of measles were excluded from the analysis. Diphtheria-tetanus-pertussis and polio vaccinations were not associated with reduction in mortality. Conclusion : These observations suggest that standard titre measles vaccine may confer a beneficial effect which is unrelated to the specific protection against measles disease.
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Cites
Review papers : The statistical basis of meta-analysis
Fleiss, J. (1993) · Statistical Methods in Medical Research · doi:10.1177/096228029300200202 · Cited by 1,284 · see citing works
Pathogenesis Of Measles Virus Infection: An Hypothesis For Altered Immune Responses
Griffin, D. E., Ward, B. J., & Esolen, L. M. (1994) · The Journal of Infectious Diseases · doi:10.1093/infdis/170.supplement_1.s24 · Cited by 165 · see citing works
MEASLES MORTALITY AND VACCINE EFFICACY IN RURAL WEST AFRICA
Hull, H., Williams, P. J., & Oldfield, F. S. J. (1983) · The Lancet · doi:10.1016/s0140-6736(83)92091-3 · Cited by 127 · see citing works
Velema, J. P., Alihonou, E., Gandaho, T., & Hounye, F. H. (1991) · International Journal of Epidemiology · doi:10.1093/ije/20.2.474 · Cited by 123 · see citing works
Aaby, P., Knudsen, K., Whittle, H. C., Lisse, I. M., Thaqrup, J., Poulsen, A., Sodemann, M., Jakobsen, M., Brink, L., Gansted, U., et al. (1993) · The Journal of Pediatrics · doi:10.1016/s0022-3476(09)90015-4 · Cited by 116 · see citing works
Self-citationDifferential Mortality by Measles Vaccine Titer and Sex
Holt, E. A., Moulton, L. H., Siberry, G. K., et al. (1993) · The Journal of Infectious Diseases · doi:10.1093/infdis/168.5.1087 · Cited by 112 · see citing works
Measles vaccination and reduction in child mortality: A community study from Guinea-Bissau
Aaby, P., Bukh, J., Lisse, I. M., et al. (1984) · Journal of Infection · doi:10.1016/s0163-4453(84)93192-x · Cited by 112 · see citing works
Self-citationImpact of measles vaccination on childhood mortality in rural Bangladesh.
Koenig, M., Khan, M. A., Wojtyniak, B., et al. (1990) · PubMed · Cited by 111 · see citing works
Pattern of Exposure and Measles Mortality in Senegal
Garenne, M., & Aaby, P. (1990) · The Journal of Infectious Diseases · doi:10.1093/infdis/161.6.1088 · Cited by 110 · see citing works
Self-citationMEASLES VACCINATION AND CHILDHOOD MORTALITY IN RURAL BANGLADESH1
CLEMENS, J. D., STANTON, B. F., Chakraborty, J., et al. (1988) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115086 · Cited by 100 · see citing works
Aaby, P., Samb, B., Simondon, F., et al. (1993) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116912 · Cited by 98 · see citing works
Self-citationACTION OF ENDOGENOUS INTERFERON AGAINST VACCINIA INFECTION IN CHILDREN
Petralli, J. K., Merigan, T., & Wilbur, J. R. (1965) · The Lancet · doi:10.1016/s0140-6736(65)90755-5 · Cited by 90 · see citing works
du Loû, A. D., Pison, G., & Aaby, P. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117688 · Cited by 88 · see citing works
Self-citationA ‘Post-Honeymoon Period’ Measles Outbreak in Muyinga Sector, Burundi
Chen, R. T., Weierbach, R., Bisoffi, Z., et al. (1994) · International Journal of Epidemiology · doi:10.1093/ije/23.1.185 · Cited by 86 · see citing works
Sex-specific differences in mortality after high-titre measles immunization in rural Senegal.
Aaby, P., Samb, B., Simondon, F., et al. (1994) · PubMed · Cited by 77 · see citing works
Self-citationAaby, P., Knudsen, K., Jensen, T. G., et al. (1990) · The Journal of Infectious Diseases · doi:10.1093/infdis/162.5.1043 · Cited by 74 · see citing works
Self-citationAaby, P., Andersen, M. Ø., Sodemann, M., et al. (1993) · BMJ · doi:10.1136/bmj.307.6915.1308 · Cited by 73 · see citing works
Self-citationChildhood Survival in Haiti: Protective Effect of Measles Vaccination
Holt, E., Boulos, R., Halsey, N. A., et al. (1990) · PEDIATRICS · doi:10.1542/peds.85.2.188 · Cited by 67 · see citing works
High measles mortality in infancy related to intensity of exposure
Aaby, P., Bukh, J., HOFF, G., et al. (1986) · The Journal of Pediatrics · doi:10.1016/s0022-3476(86)80569-8 · Cited by 63 · see citing works
Self-citationDeterminants of Measles Mortality in a Rural Area of Guinea-Bissau: Crowding, Age, and Malnutrition
Aaby, P., Bukh, J., Lisse, I. M., et al. (1984) · Journal of Tropical Pediatrics · doi:10.1093/tropej/30.3.164 · Cited by 51 · see citing works
Self-citationChild mortality related to seroconversion or lack of seroconversion after measles vaccination.
Aaby, P., Pedersen, I. R., Knudsen, K., et al. (1989) · PubMed · Cited by 51 · see citing works
Self-citationMeasles: State Of The Art And Future Directions
Gellin, B. G., & Katz, S. L. (1994) · The Journal of Infectious Diseases · doi:10.1093/infdis/170.supplement_1.s3 · Cited by 41 · see citing works
Hartfield, J., & Morley, D. (1963) · Journal of Hygiene · doi:10.1017/s0022172400020817 · Cited by 32 · see citing works
A study on malaria infection during the acute stage of measles infection.
Rooth, I., Sinani, H. M., Smedman, L., et al. (1991) · PubMed · Cited by 14 · see citing works
Mortality reductions from measles and tetanus immunization : a review of the evidencePreprint
Koenig, M. (1992) · RePEc: Research Papers in Economics · Cited by 13 · see citing works
Garenne, M., & Cantrelle, P. (1986) · Cited by 13 · see citing works
The safety of measles vaccine in severe illness.
van Rensburg, M. (1979) · PubMed · Cited by 12 · see citing works
Cantrelle, P., Dormont, S., & Fargues, P. (1986) · Cited by 7 · see citing works
Flagged first, then by citations
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Defining trained immunity and its role in health and disease
Netea, M. G., Domínguez-Andrés, J., Barreiro, L. B., Chavakis, T., Divangahi, M., Fuchs, E., Joosten, L. A. B., van der Meer, J. W. M., Mhlanga, M. M., Mulder, W. J. M., et al. (2020) · Nature Reviews Immunology · doi:10.1038/s41577-020-0285-6 · Cited by 2,690 · see citing works
A guide to vaccinology: from basic principles to new developments
Pollard, A. J., & Bijker, E. M. (2021) · Nature Reviews Immunology · doi:10.1038/s41577-020-00479-7 · Cited by 1,593 · see citing works
MMR Vaccination and Febrile Seizures: Evaluation of Susceptible Subgroups and Long-term Prognosis
Vestergaard, M., Hviid, A., Madsen, K. M., Wohlfahrt, J., Thorsen, P., Schendel, D., Melbye, M., & Olsen, J. (2004) · JAMA · doi:10.1001/jama.292.3.351 · Cited by 170 · see citing works
Otto, S., Mahner, B., Kadow, I., Beck, J. F., Wiersbitzky, S. K. W., & Bruns, R. (2000) · Journal of Infection · doi:10.1053/jinf.2000.0718 · Cited by 27 · see citing works
- Authors
- Aaby, P., Samb, B., Simondon, F., Seck, A. M. C., Knudsen, K., & Whittle, H.
- Affiliations
- Statens Serum Institut (DK)
- Cheikh Anta Diop University (SN)
- ORCID
- Aaby, Peter
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1995-08-19
- Volume
- 311
- Issue
- 7003
- Pages
- 481-485
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2550544
- OpenAlex
- W2014480218
- Cited by
- 344
- References
- 28
- Citations by year
- 2026: 5 · 2025: 19 · 2024: 10 · 2023: 16 · 2022: 22 · 2021: 18 · 2020: 28 · 2019: 9 · 2018: 6 · 2017: 13 · 2016: 12 · 2015: 12 · 2014: 13 · 2013: 11 · 2012: 11
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- measles vaccine, non-specific vaccine effects, child mortality, vaccine efficacy, measles mortality, developing countries, infant immunization, DTP vaccine, polio vaccine
- MeSH terms
- Bangladesh, Benin, Burundi, Child, Preschool, Developing Countries, Diphtheria Toxoid, Guinea-Bissau, Haiti, Humans, Immunization, Infant, Measles, Measles Vaccine, Mortality, Pertussis Vaccine, Poliovirus Vaccine, Inactivated, Senegal, Tetanus Toxoid, Democratic Republic of the Congo, Cohort Studies, Diphtheria-Tetanus-Pertussis Vaccine, Case-Control Studies, Vaccines, Combined
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