Child Mortality
Out-of-sequence DTP and measles vaccinations and child mortality in Guinea-Bissau: a reanalysis.
SYNOPSIS
Out-of-sequence vaccinations may increase child mortality.
CITATION
Thysen SM, Rodrigues A, Aaby P, et al. British Medical Journal Open 2019;9:e024893; doi:10.1136/bmjopen-2018-024893.
SUMMARY
This study’s objective was to assess whether the sequence of diphtheria-tetanus-pertussis vaccine (DTP) and measles vaccine (MV) was associated with child survival. Using a data set previously used to assess non-specific effects of vaccines with no consideration of vaccination sequence researchers found that out-of-sequence vaccinations in children were associated with higher mortality compared with children vaccinated in-sequence.
The introduction of diphtheria-tetanus-pertussis vaccine and child mortality in rural GuineaBissau: an observational study.
SYNOPSIS
The MR (mortality rate) was 1.81 (95% Cl: 0.95, 3.45) for the first dose of DTP and 4.36 (95% Cl: 1.28, 14.9) for the second and third dose
CITATION
Aaby P, Jensen H, Gomes J, Fernandes M, Lisse IM. International Journal of Epidemiology. 2004 Apr;33(2):374-80.
SUMMARY
Prior to the introduction of vaccines, children who were absent at a village examination had the same mortality as children who were present. During 1984-1987, children receiving DTP at 2-8 months of age had higher mortality over the next 6 months, the mortality rate ratio (MR) being 1.92 (95% CI: 1.04, 3.52) compared with DTP-unvaccinated children, adjusting for age, sex, season, period, BCG, and region. The MR was 1.81 (95% CI: 0.95, 3.45) for the first dose of DTP and 4.36 (95% CI: 1.28, 14.9) for the second and third dose. BCG was associated with slightly lower mortality (MR = 0.63, 95% CI: 0.30, 1.33), the MR for DTP and BCG being significantly inversed. Researchers found in low-income countries with high mortality, DTP as the last vaccine received may be associated with slightly increased mortality. Since the pattern was inversed for BCG, the effect is unlikely to be due to higher-risk children having received vaccination. The role of DTP in high mortality areas needs to be clarified.