Is early measles vaccination associated with stronger survival benefits than later measles vaccination?
Is early measles vaccination associated with stronger survival benefits than later measles vaccination?
复制标题
DOI：
10.1186/s12889-018-5866-y
复制
发表时间：
2018-08-07
影响因子：
4.5
通讯作者：
Fisker AB
中科院分区：
文献类型：
--
作者：
Hansen JS;Thysen SM;Rodrigues A;Martins C;Fisker AB
麻疹疫苗(MV)可以预防非麻疹死亡。我们测试了存活是否取决于接种麻疹疫苗的年龄。班迪姆健康项目通过几内亚比绍农村的健康和人口监测系统跟踪5岁以下儿童。检查过疫苗接种卡的6-36个月大的儿童被跟踪到下一次就诊或最多6个月。在根据年龄和村庄群调整的COX比例风险模型中，我们比较了早期(<； 9个月)、推荐的(9-11个月)或晚期(>； 12个月以上)接种MV的儿童与未接种麻疹疫苗的儿童的生存率。在接种麻疹疫苗的儿童中，我们线性模拟了接种麻疹疫苗时年龄的影响，以评估接种年龄每月增加时的死亡率变化。从1999年到2006年，14,813名儿童(31,725名观察对象)被纳入研究范围。接种麻疹疫苗的儿童与未接种麻疹疫苗的儿童相比，危险比(HR)为0.76(95%CI：0.63~0.91)；审查麻疹死亡人数不会改变结果(HR = 为0.79(0.65~0.95))。早期MV的HR为0.68(0.53~0.87)，推荐的MV HR为0.77(0.62~0.96)，晚期MV的HR为0.86(0.67~1.11)。将分析局限于接种麻疹疫苗的儿童，接种麻疹疫苗的年龄与每月接种疫苗年龄增加2.6%(0.4-5.1%)的死亡率相关。早期MV与较大的生存优势相关。当麻疹控制有所改善时，当前提高疫苗接种年龄的政策可能不会优化MV对儿童生存的影响。本文的在线版本(10.1186/s12889-0185866-y)包含向授权用户提供的补充材料。
Measles vaccine (MV) may protect against non-measles mortality. We tested whether survival depended on age of measles vaccination. Bandim Health Project follows children under 5 years of age through a Health and Demographic Surveillance System in rural Guinea-Bissau. Children aged 6–36 months with a vaccination card inspected were followed to the next visit or for a maximum of 6 months. In Cox proportional-hazards models adjusted for age and village cluster, we compared the survival of children vaccinated with MV early (< 9 months), as recommended (9–11 months) or late (> 12+ months) with the survival of measles-unvaccinated children. Among measles-vaccinated children, we modelled the effect of age at measles vaccination linearly to assess mortality changes per month increase in vaccination age. From 1999 to 2006, 14,813 children (31,725 observations) were included. Children vaccinated with MV had a Hazard Ratio (HR) of 0.76 (95% CI: 0.63–0.91) compared with measles-unvaccinated children; censoring measles deaths did not change the results (HR = 0.79 (0.65–0.95)). For early MV the HR was 0.68 (0.53–0.87), for MV as recommended the HR was 0.77 (0.62–0.96) and for late MV the HR was 0.86 (0.67–1.11). Limiting the analysis to measles-vaccinated children, age at measles vaccination was associated with a 2.6% (0.4–5.1%) increase in mortality per month increase in vaccination age. Early MV was associated with a large survival advantage. The current policy to increase vaccination age, when measles control improves, may not optimize the impact of MV on child survival. The online version of this article (10.1186/s12889-018-5866-y) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
105.7
作者：
Martins, Cesario L.;Garly, May-Lill;Aaby, Peter
通讯作者：
Aaby, Peter
影响因子：
6.4
作者：
Martins, Cesario;Garly, May-Lill;Aaby, Peter
通讯作者：
Aaby, Peter
DOI：
10.1093/cid/ciu354
发表时间：
2014-08-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Aaby P;Martins CL;Garly ML;Andersen A;Fisker AB;Claesson MH;Ravn H;Rodrigues A;Whittle HC;Benn CS
通讯作者：
Benn CS
影响因子：
6.4
作者：
Gans, H;Yasukawa, L;Arvin, AM
通讯作者：
Arvin, AM
影响因子：
2.9
作者：
Fisker AB;Aaby P;Bale C;Balde I;Biering-Sørensen S;Agergaard J;Martins C;Bibby BM;Benn CS
通讯作者：
Benn CS