A comparison of vaccine efficacy and mortality during routine use of high-titre Edmonston-Zagreb and Schwarz standard measles vaccines in rural Senegal
A comparison of vaccine efficacy and mortality during routine use of high-titre Edmonston-Zagreb and Schwarz standard measles vaccines in rural Senegal
复制标题
DOI：
10.1016/s0035-9203(96)90275-8
复制
发表时间：
1996-05-01
影响因子：
2.2
通讯作者：
Whittle, H
中科院分区：
文献类型：
--
作者：
Aaby, P;Samb, B;Whittle, H
在塞内加尔的一个农村地区，对常规接种埃德蒙顿-萨格勒布高滴度（EZ-HT）或施瓦茨标准（SW-STD）麻疹疫苗的连续队列儿童的疫苗效力和死亡率进行了检查。这两种疫苗对麻疹感染的保护作用相同（疫苗接种效率：EZ-HT 94%; SW-STD 93%）。未参加预定接种麻疹疫苗的儿童在9个月至2岁期间的死亡率高于接种EZ-HT（死亡率[MR] = 1.81，95%置信区间[CI] 1.06-3.08）或SW-STD麻疹疫苗（MR=1.74，95% CI 0.95-3.21）的儿童。接种EZ-HT疫苗的男女儿童的死亡率低于未接种任何麻疹疫苗的儿童。EZ-HT和SW-STD受体的总体死亡率无差异（MR=0.96，95%CI 0.70-1.30）。使用考克斯回归分析调整性别、年龄和重要背景因素（季节和母亲死亡），男性接受EZ-HT的死亡率往往低于接受SW-STD的男孩（MR=0.73，95% CI 0.50-1.11），接受EZ-HT的女孩高于接受SW-STD的女孩（MR=1.30，95% CI 0.81-2.09）（性别和疫苗之间的其他相互作用，P=0.067）。在接受高滴度麻疹疫苗后，女孩的生存益处减少的趋势证实了几内亚比绍、塞内加尔和海地随机试验的观察结果。现有数据几乎不支持高滴度疫苗是有害的，但它可能不具有与标准滴度麻疹疫苗相同的有益效果。
Vaccine efficacy and mortality in successive cohorts of children who routinely received either Edmonston-Zagreb high-titre (EZ-HT) or Schwarz standard (SW-STD) measles vaccines have been examined in a rural area of Senegal. The 2 vaccines were equally protective against measles infection (vaccination efficacy: EZ-HT 94%; SW-STD 93%). Children who did not attend a scheduled session to receive measles vaccine had a higher mortality rate between 9 months and 2 years of age than did children receiving either EZ-HT (mortality ratio [MR] = 1.81, 95% confidence interval [CI] 1.06-3.08) or SW-STD measles vaccine (MR=1.74, 95% CI 0.95-3.21). Children of either sex vaccinated with EZ-HT had lower mortality than their equivalents who had not received any measles vaccine. There was no difference in overall mortality between recipients of EZ-HT and SW-STD (MR=0.96, 95% CI 0.70-1.30). Using a Cox regression analysis to adjust for sex, age and significant background factors (season and death of mother), mortality rates tended to be lower for male recipients of EZ-HT than for boys receiving SW-STD (MR=0.73, 95% CI 0.50-1.11) and higher for girls receiving EZ-HT than for girls receiving SW-STD (MR=1.30, 95% CI 0.81-2.09) (rest of interaction between sex and vaccine, P=0.067). The tendency to reduced survival benefit for girls following receipt of high-titre measles vaccines substantiated observations from randomized trials in Guinea-Bissau, Senegal, and Haiti. Existing data provide little support for the notion that high-titre vaccine is deleterious bur it may not have the same beneficial effects as standard-titre measles vaccine.