Fisker AB, et al. - The effect of an additional early measles vaccine (MV) on mortality and measles antibody levels was investigated. Researchers recognized no reduction in all-cause mortality with early MV. At age 4–7 months, most children were susceptible to measles infection and responded with high antibody levels to early MV.

Methods

• Researchers randomized children aged 4–7 months 1:1 to an extra early standard dose of MV (Edmonston-Zagreb strain) or no extra MV 4 weeks after the third diphtheria-tetanus-pertussis-hepatitis B-Haemophilus influenzae type b vaccine at rural health and demographic surveillance sites in Burkina Faso and Guinea-Bissau.
• Routine MV at 9 months was administered to all children.
• Mortality was assessed via home visits and was compared from enrollment to age 3 years using Cox proportional hazards models, censoring for subsequent nontrial MV.
• Measles antibody levels were assessed via blood sampling of the subgroups of participants.

Results

• Researchers enrolled 8,309 children from 18 July 2012 to 3 December 2015; among these 145 deaths were registered (mortality rate: 16/1000 person-years).
• They noted lower mortality than anticipated; mortality did not differ by randomization group (hazard ratio, 1.05; 95% confidence interval, 0.75–1.46).
• Protective measles antibody levels were noted in 4% (16/447) of children in Burkina Faso and 21% (90/422) in Guinea-Bissau at enrollment.
• They noted that no measles-unvaccinated/-unexposed child had protective levels, while 92% (306/333) of early MV recipients had protective levels by age 9 months.
• Protective levels were identified in 98% (186/189) in the early MV group and 97% (196/202) in the control group at final follow-up.