The introduction of diphtheria-tetanus-pertussis vaccine and child mortality in rural GuineaBissau: an observational study.
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
Aaby P, Jensen H, Gomes J, Fernandes M, Lisse IM. International Journal of Epidemiology. 2004 Apr;33(2):374-80.
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.