Non-specific effects of vaccines in developing countries

doi:10.1136/bmj.321.7274.1423

BMJ 2000;321:1423-1424 ( 9 December )

Editorials

Non-specific effects of vaccines in developing countries

We need evidence about the effect of vaccines on mortality from all causes

Papers p 1435

The first 150 words of the full text of this article appear below.

Immunisation has led to spectacular reductions in mortality in both developed and developing countries.¹ However, we knowtoo little about the overall effect of vaccines. We have takenvaccines and schedules that are effective in developed countrieswith low levels of childhood mortality and used them in populationswith high death rates without studying their effect on totalmortality.

In this week's BMJ Kristensen and colleagues report some startling results from a prospective cohort study in Guinea-Bissau,which was performed in remarkably difficult circumstances (p 1435).²Their findings show that both BCG and measles vaccines halvedchild mortality $---$ a spectacular effect that should be exploitedto reduce substantially the number of children dying in developingcountries. However, the combination of diphtheria, pertussis,and tetanus (DPT) and polio vaccines seemed to increase mortality(mortality ratio 1.84 (95% confidence interval 1.10 to 3.10)).

The increase in mortality from the DPT and polio vaccines . . . [Full text of this article]

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Relevant Article

Routine vaccinations and child survival: follow up study in Guinea-Bissau, West Africa • Commentary: an unexpected finding that needs confirmation or rejection: Ines Kristensen, Peter Aaby, Henrik Jensen, and Paul Fine
BMJ 2000 321: 1435. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Benn, C. S., Bale, C., Sommerfelt, H., Friis, H., Aaby, P. (2003). Hypothesis: Vitamin A supplementation and childhood mortality: amplification of the non-specific effects of vaccines?. Int J Epidemiol 32: 822-828 [Abstract] [Full text]
Kabir, Z. (2003). Is all-cause mortality a useful epidemiological endpoint in vaccine trials? An example of BCG (Bacille-Calmette-Guerine). Int J Epidemiol 32: 161-162 [Full text]

Rapid Responses:

Read all Rapid Responses

Confounding Factors.: B M Hegde
bmj.com, 9 Dec 2000 [Full text]
Yes, facts support Prof. Hegde ideas!: A L�pez Pe�a
bmj.com, 11 Dec 2000 [Full text]
Concerns about non-specific effects of vaccines in general: Wouter Havinga
bmj.com, 6 Jan 2001 [Full text]
Non-specific effects of measles vaccines in rural India: Zubair Kabir
bmj.com, 9 Jan 2001 [Full text]
Or is it due to an improved diet: Wouter Havinga
bmj.com, 11 Jan 2001 [Full text]
Hypoproteinaemia, and the effects of infections and vaccines: Frank Shann
bmj.com, 2 Feb 2001 [Full text]