Evaluation of the Immune Response to a 2-Dose Measles Vaccination Schedule Administered at 6 and 9 Months of Age to HIV-Infected and HIV-Uninfected Children in Malawi


Helfand, RF; Witte, D; Fowlkes, A; Garcia, P; Yang, C; Fudzulani, R; Walls, L; Bae, S; Strebel, P; Broadhead, R; Bellini, WJ; Cutts, F; (2008) Evaluation of the Immune Response to a 2-Dose Measles Vaccination Schedule Administered at 6 and 9 Months of Age to HIV-Infected and HIV-Uninfected Children in Malawi. The Journal of infectious diseases, 198 (10). pp. 1457-1465. ISSN 0022-1899 DOI: 10.1086/592756

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Abstract

Background. The World Health Organization recommends that infants at high risk for developing measles before 9 months of age, including human immunodeficiency virus (HIV)-infected infants, receive measles vaccination (MV) at 6 and 9 months of age. Methods. Children born to HIV-infected mothers received MV at 6 and 9 months, and children of HIV-uninfected mothers were randomized to receive MV at 6 and 9 months, MV at 9 months, or routine MV without follow-up. Blood samples were obtained before and 3 months after each MV. Data were collected on adverse events for 21 days after each MV, at all clinic visits, on any hospitalization, and for subjects who died. HIV-infection status was determined by antibody assays and polymerase chain reaction; the presence of measles IgG was determined by EIA. Results. Twenty-two hundred mother-infant pairs were enrolled. After the first and second doses of measles vaccine, respectively, the percentages of children who were measles seropositive were 59% (36 of 61) and 64% (29 of 45) among HIV-infected children, 68% (152 of 223) and 94% (189 of 202) among HIV-exposed but uninfected children, and 62% (288 of 467) and 92% (385 of 417) among HIV-unexposed children. Of 521 HIV-unexposed children vaccinated only at 9 months, 398 (76%) were measles seropositive at 12 months. No serious vaccine-related adverse events were identified. Conclusions. An early, 2-doseMVschedule was immunogenic, but a higher proportion of HIV-infected children remained susceptible to measles, compared with HIV-uninfected children (whether HIV exposed or HIV unexposed).

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Vaccine Centre
PubMed ID: 18828743
Web of Science ID: 260472400007
URI: http://researchonline.lshtm.ac.uk/id/eprint/6247

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