LONG-TERM MEASLES-INDUCED IMMUNOMODULATION INCREASES OVERALL CHILDHOOD INFECTIOUS DISEASE MORTALITY

Friday, 8th of May 2015

“Vaccination against measles has many benefits, not only lifelong protection against this potentially serious virus. Mina et al. analyzed data collected since mass vaccination began in high-income countries when measles was common. Measles vaccination is associated with less mortality from other childhood infections. Measles is known to cause transient immunosuppression, but close inspection of the mortality data suggests that it disables immune memory for 2 to 3 years. Vaccination thus does more than safeguard children against measles; it also stops other infections taking advantage of measles-induced immune damage.”

LONG-TERM MEASLES-INDUCED IMMUNOMODULATION INCREASES OVERALL CHILDHOOD INFECTIOUS DISEASE MORTALITY

1. Michael J. Mina¹,²,*,
2. C. Jessica E. Metcalf¹,³,
3. Rik L. de Swart⁴,
4. A. D. M. E. Osterhaus⁴,
5. Bryan T. Grenfell¹,³

+ Author Affiliations

1. ¹Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
2. ²Medical Scientist Training Program, School of Medicine, Emory University, Atlanta, GA, USA.
3. ³Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
4. ⁴Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands.

1. ↵*Corresponding author. E-mail: michael.j.mina@gmail.com

• Abstract below ; full text is available to journal subscribers.

Immunosuppression after measles is known to predispose people to opportunistic infections for a period of several weeks to months. Using population-level data, we show that measles has a more prolonged effect on host resistance, extending over 2 to 3 years. We find that nonmeasles infectious disease mortality in high-income countries is tightly coupled to measles incidence at this lag, in both the pre- and post-vaccine eras. We conclude that long-term immunologic sequelae of measles drive interannual fluctuations in nonmeasles deaths. This is consistent with recent experimental work that attributes the immunosuppressive effects of measles to depletion of B and T lymphocytes. Our data provide an explanation for the long-term benefits of measles vaccination in preventing all-cause infectious disease. By preventing measles-associated immune memory loss, vaccination protects polymicrobial herd immunity.

• Received for publication 24 November 2014.
• Accepted for publication 1 April 2015.