Is early measles vaccination associated with stronger survival benefits than later measles vaccination?

Wednesday, 19th of September 2018 Print


BMC Public Health. 2018 Aug 7;18(1):984. doi: 10.1186/s12889-018-5866-y.

Is early measles vaccination associated with stronger survival benefits than later measles vaccination?

Hansen JS12 Thysen SM123 Rodrigues A2 Martins C2 Fisker AB456.

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Measles vaccine (MV) may protect against non-measles mortality. We tested whether survival depended on age of measles vaccination.


Bandim Health Project follows children under 5 years of age through a Health and Demographic Surveillance System in rural Guinea-Bissau. Children aged 6-36 months with a vaccination card inspected were followed to the next visit or for a maximum of 6 months. In Cox proportional-hazards models adjusted for age and village cluster we compared the survival of children vaccinated with MV early (< 9 months) as recommended (9-11 months) or late (> 12+ months) with the survival of measles-unvaccinated children. Among measles-vaccinated children we modelled the effect of age at measles vaccination linearly to assess mortality changes per month increase in vaccination age.


From 1999 to 2006 14813 children (31725 observations) were included. Children vaccinated with MV had a Hazard Ratio (HR) of 0.76 (95% CI: 0.63-0.91) compared with measles-unvaccinated children; censoring measles deaths did not change the results (HR = 0.79 (0.65-0.95)). For early MV the HR was 0.68 (0.53-0.87) for MV as recommended the HR was 0.77 (0.62-0.96) and for late MV the HR was 0.86 (0.67-1.11). Limiting the analysis to measles-vaccinated children age at measles vaccination was associated with a 2.6% (0.4-5.1%) increase in mortality per month increase in vaccination age.


Early MV was associated with a large survival advantage. The current policy to increase vaccination age when measles control improves may not optimize the impact of MV on child survival.


Childhood mortality; Measles vaccine; Non-specific/heterologous effects of vaccines

PMID: 30086732 PMCID: PMC6081866 DOI: 10.1186/s12889-018-5866-y

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