http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=11840077&form=6&db=m&dopt=r
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Pediatr Infect Dis J 2002 Feb;21(2):112-119 |
Books
No evidence for short or long term morbidity
after increased titer measles vaccination in Sudan.
Libman MD, Ibrahim SA, Omer MI, Adlan IA, Bellavance F, Hoskins E, Bertley
F, Ward BJ.
Microbiology Department, Montreal General Hospital (MDL, BJW), McGill
University Tropical Diseases Center (MDL, BJW), Department of Epidemiology and
Biostatistics (FBellavance), and Montreal General Hospital Research Institute
(FBertley), McGill University, Montreal, Quebec, and Public Health Department,
McMaster University, Hamilton, Ontario (EH), Canada; and the Department of
Pediatrics, University of Khartoum, Khartoum, Sudan (SAI, MIAO, IAA).
BACKGROUND: Increased mortality rates have been reported after high titer
measles [>105.0 plaque-forming units (PFU)] vaccination in several large
studies in the developing world. An increased titer measles vaccine study
conducted in Sudan included a prolonged prospective evaluation of childhood
morbidity after vaccination. METHODS: Five hundred ten children (170 per group)
were randomized to receive 1 of 3 regimens at 5 and 9 months of age: (1)
meningococcal vaccine, then standard titer (50% tissue culture-infective dose,
103.8) Schwarz measles vaccine; (2) increased titer (104.7 PFU)
Edmonston-Zagreb measles vaccine followed by meningococcal vaccine; and (3)
increased titer (104.7 PFU) Connaught vaccine followed by standard titer
Schwarz measles vaccine. RESULTS: Health workers collected information at 31
582 semimonthly and monthly visits during 5 years. No increase in infant
mortality was observed, but the statistical power was limited. There were 13,
13 and 10 deaths in the Schwarz, Edmonston-Zagreb and Connaught groups,
respectively. There were no differences in duration or incidence of illness
between groups at any time during the 5-year follow-up, with comparisons
stratified by age and sex. Statistical power for each pairwise comparison was
good, with at least 80% power to detect a difference of 1 day per month of
illness and a 12% difference in the proportion of visits with an illness
recorded. CONCLUSIONS: We were unable to document increased morbidity in
recipients of the increased titer measles vaccines used in this study. These
data do not support the hypothesis that increased mortality after increased
titer vaccine exposure is the result of increased and cumulative morbidity.
PMID: 11840077 [PubMed - as supplied by publisher]
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