Randomized Trials to Study the Nonspecific Effects of Vaccines in Children in Low-Income Countries
- 1 May 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Pediatric Infectious Disease Journal
- Vol. 29 (5), 457-461
- https://doi.org/10.1097/inf.0b013e3181c91361
Abstract
The Expanded Program on Immunization (EPI) has led to large reductions in morbidity and mortality among children in low-income countries. However, the basic EPI schedule may no longer be optimal because of changes in vaccines, programs, and epidemiologic circumstances. In addition, evidence has accumulated that some EPI vaccines may have nonspecific effects that increase or decrease mortality from subsequent infections with other unrelated organisms. There is therefore a need for randomized trials to evaluate the effects of alternative EPI schedules on all-cause mortality, as well as vaccine efficacy against the target diseases. We have reviewed the available literature on the nonspecific effects of vaccines on mortality, and compiled a list of potential trials that might address this issue. We have then ranked the trials based on the potential importance of the results and the ethical and practical considerations. Trials of early BCG vaccination in low-birth-weight babies, early measles vaccination, and altered timing of DTP vaccination all have a high priority. © 2010 Lippincott Williams & Wilkins.NotKeywords
This publication has 26 references indexed in Scilit:
- The effect of vitamin A supplementation administered with missing vaccines during national immunization days in Guinea-BissauInternational Journal of Epidemiology, 2008
- Protective efficacy of standard Edmonston-Zagreb measles vaccination in infants aged 4.5 months: interim analysis of a randomised clinical trialBMJ, 2008
- Effect of 50 000 IU vitamin A given with BCG vaccine on mortality in infants in Guinea-Bissau: randomised placebo controlled trialBMJ, 2008
- The impact of successive infections on the lung microenvironmentImmunology, 2007
- Effect of ivermectin on the cellular and humoral immune responses of rabbitsLife Sciences, 2007
- Infections and allergy — helminths, hygiene and host immune regulationCurrent Opinion in Immunology, 2005
- Low Birth Weight Infants and Calmette-Guérin Bacillus Vaccination at BirthThe Pediatric Infectious Disease Journal, 2004
- The introduction of diphtheria-tetanus-pertussis vaccine and child mortality in rural Guinea-Bissau: an observational studyInternational Journal of Epidemiology, 2004
- Divergent female-male mortality ratios associated with different routine vaccinations among female-male twin pairsInternational Journal of Epidemiology, 2004
- Survival of previously measles-vaccinated and measles-unvaccinated children in an emergency situation: an unplanned studyThe Pediatric Infectious Disease Journal, 2003