Table 5

Vaccine efficacy against overall mortality for one dose of standard-titre measles vaccine before 9 months of age

CountryPeriodComparisonResults (95% CI)
Early measles vaccination at 7 months of age compared with children unvaccinated community
 Congo111974–1977MV administered at 7 months of age; children followed to 21 and 34 months of age. Mortality from 7 to 21 months of age for vaccinated children (3/230.5 person-years) compared with unvaccinated children from control area (21/470.7 person-years)MRR for 7–21 months =0.29 (0.09–0.98)
MRR for 7–34 months =0.52 (0.21–1.27)
Comparing MV at 4–8 months vs MV at 9–11 months of age
 Guinea-Bissau571980–1982Natural experiment: MV at 4–8 months vs MV at 9–11 months compared from 9 to 60 months of ageMRR (MV 4–8 months/MV 9–11 months) 0.69 (0.46–1.08)
Comparing children randomised to MV at 6 months vs IPV at 6 months during a war situation
 Guinea-Bissau581998Children were randomised to MV (4/214) or inactivated polio vaccine (11/219) at 6 months of age. Due to a war, they did not receive the planned MV at 9 months. Follow-up for 3 months in a war situation70% (13–92)
  • Sources: All studies examining the general effect of standard measles vaccine (MV) on child survival (as compiled by all available reviews30 ,53 ,54) have been screened for information on measles vaccination before 9 months of age. There have been several other studies of the impact of MV before 12 months of age on child survival59–67 but most of these studies could not distinguish the effect of MV before 9 months of age. However, all studies suggested that early MV had a better effect on child survival than later MV. The studies where children received diphtheria–pertussis–tetanus or inactivated polio vaccine (IPV) with early MV or shortly after MV have not been included in the present table55 ,56 ,68 since this sequence have unfortunate consequences.55 ,68 No additional studies of one-dose measles vaccination/immunisation before 9 months of age reporting impact on mortality were found by PubMed searches. MMR, mortality rate ratio.