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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Non-specific and sex-differential effects of vaccinations on child survival in rural western India
Vaccine, Volume 30, No. 50, Year 2012
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Description
Background: Studies from Africa have suggested marked non-specific effects (NSEs) of routine vaccinations with effects on child survival. There have been few studies from Asia. We re-analyzed a study from Maharashtra, India, which had collected information on vaccinations during infancy and survival until 5 years of age. Design: 4138 children born between 1987 and 1989 were visited at home every three months to collect information on nutritional status and vaccinations. Since nutritional status was a determinant of time to vaccinations, we adjusted for nutritional status in the analyzes of the association between vaccinations and mortality. Setting: 45 contiguous villages in Shirur Administrative Block in Pune District. Main outcome measures: Mortality rate ratios (MRR) for different vaccination status groups. Results: The study area has male preferential treatment, but the female-male mortality ratio varied between age groups with different pre-dominant vaccines; it was high in the age group in which diphtheria-tetanus-pertussis (DTP) vaccine predominates and low in the age group in which measles vaccine (MV) is given. Children who followed the WHO recommended schedule of first BCG and then DTP vaccination were vaccinated earlier than other children (p<0.01). Two-thirds of the children had received BCG and DTP out-of-sequence, i.e. BCG and DTP simultaneously or BCG after DTP. Children who received BCG and DTP simultaneously or BCG as most recent vaccination had significantly lower mortality than children having DTP as the most recent vaccination, the mortality rate ratio being 0.15 (0.03-0.70). Conclusions: BCG out-of-sequence may be associated with lower mortality than DTP as the most recent vaccination. Given the public health implications, this possibility should be tested in randomized trials. Excess female mortality may also be related to vaccination policy. © 2012 Elsevier Ltd.
Authors & Co-Authors
Hirve, Siddhivinayak S.
India, Pune
Kem Hospital
Denmark, Copenhagen
Statens Serum Institut
Ghana, Accra
Indepth Network
Bavdekar, Ashish R.
India, Pune
Kem Hospital
Denmark, Copenhagen
Statens Serum Institut
Ghana, Accra
Indepth Network
Juvekar, Sanjay Kamlakar
India, Pune
Kem Hospital
Denmark, Copenhagen
Statens Serum Institut
Ghana, Accra
Indepth Network
Benn, Christine Stabell
India, Pune
Kem Hospital
Denmark, Copenhagen
Statens Serum Institut
Ghana, Accra
Indepth Network
Nielsen, Johannes H.
India, Pune
Kem Hospital
Denmark, Copenhagen
Statens Serum Institut
Ghana, Accra
Indepth Network
Aaby, Peter
India, Pune
Kem Hospital
Denmark, Copenhagen
Statens Serum Institut
Ghana, Accra
Indepth Network
Statistics
Citations: 85
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1016/j.vaccine.2012.09.035
ISSN:
0264410X
e-ISSN:
18732518
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health
Participants Gender
Male
Female