Experts back earlier vaccinations for measles

July - August, 2008  |  Volume 7, Issue 4

Fogarty scientists published an editorial in BMJ (British Medical Journal) in late July generally supporting findings of a Danish research team calling for measles vaccinations for children in low- and middle-income countries to start at 4.5 months of age instead of the global norm of 9-15 months.

A mugshot of a boy with measles. Photo: CDC
Photo: CDC

In the editorial, Center scientist Dr. Helene Broutin-de-Magny and Dr. Mark Miller, director of Fogarty's Division of International Epidemiology and Population Studies, said the study should be an impetus for policy makers to consider new anti-measles strategies if further research validates the findings.

The original study by Dr. Peter Aaby of the Danish Epidemiology Science Centre and colleagues was based on randomized clinical trials of 1,333 infants in Guinea-Bisseau.

They found that the earlier vaccination provided more than 90 per cent protection against infection and 100 percent protection against hospitalization for measles.

The study also found a nearly four-and-a-half times reduction in monthly measles incidence among those who were vaccinated at the earlier age.

Normally, a mother's natural immunity protects an infant against measles starting at about 9 months, but as more mothers have been vaccinated themselves, few of the natural measles antibodies are transferred to the child.

"As the authors did not control for vaccination or HIV status of the mothers...results are context-specific and warrant further exploration in various settings," Broutin-de-Magny and Miller editorialized.

"Nevertheless, the study is relevant and timely, since it offers policy makers potential alternative vaccination strategies to explore with further research," they said.

Broutin-de-Magny and Miller cautioned concluded that the goal of high vaccine coverage should not come at the expense of more timely vaccination and that earlier vaccination should not substitute for other infant doses given between 9 and 15 months.

The also suggested that future research should focus on duration of maternal antibodies in children, with consideration for the vaccination and HIV statuses of the mothers.

Early vaccination against measles in developing countries. H Broutin and MA Miller. BMJ 2008;337:a406

Protective efficacy of standard Edmonston-Zagreb measles vaccination in infants aged 4.5 months: interim analysis of a randomised clinical trial. Cesario L Martins, May-Lill Garly, Carlito Bale, Amabelia Rodrigues, Henrik Ravn, Hilton C Whittle, Ida M Lisse, Peter Aaby. BMJ 2008;337:a661

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