Randomized trials to study the nonspecific effects of vaccines in children in low-income countries.


Shann, F; Nohynek, H; Scott, JA; Hesseling, A; Flanagan, KL; Working Group on Nonspecific Effects of Vaccines; (2010) Randomized trials to study the nonspecific effects of vaccines in children in low-income countries. The Pediatric infectious disease journal, 29 (5). pp. 457-61. ISSN 0891-3668 DOI: 10.1097/INF.0b013e3181c91361

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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.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Vaccine Centre
PubMed ID: 20431383
Web of Science ID: 277218600015
URI: http://researchonline.lshtm.ac.uk/id/eprint/29534

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