Evaluating associations between vaccine response and malnutrition, gut function, and enteric infections in the MAL-ED cohort study: methods and challenges.

Journal Article (Journal Article)

Most vaccine assessments have occurred in well-nourished populations of higher socioeconomic status. However, vaccines are often used in populations with high incidences of malnutrition and infections, in whom the effectiveness of some vaccines is inferior for unknown reasons. The degree and extent of vaccine underperformance have not been systematically studied for most vaccines across differing epidemiologic settings. This paper outlines the methods used and challenges associated with measuring immunological responses to oral vaccines against poliovirus and rotavirus, and parenteral vaccines against pertussis, tetanus, and measles in an observational study that monitored daily illness, monthly growth, intestinal inflammation and permeability, pathogen burden, dietary intake, and micronutrient status in children in 8 countries. This evaluation of vaccine response in the context of low- and middle-income countries is intended to address the gaps in knowledge of the heterogeneity in vaccine response in diverse epidemiological settings and the interplay between infections, nutrition, and immune response.

Full Text

Duke Authors

Cited Authors

  • Hoest, C; Seidman, JC; Pan, W; Ambikapathi, R; Kang, G; Kosek, M; Knobler, S; Mason, CJ; Miller, M; MAL-ED Network Investigators,

Published Date

  • November 2014

Published In

Volume / Issue

  • 59 Suppl 4 /

Start / End Page

  • S273 - S279

PubMed ID

  • 25305297

Pubmed Central ID

  • PMC4204607

Electronic International Standard Serial Number (EISSN)

  • 1537-6591

International Standard Serial Number (ISSN)

  • 1058-4838

Digital Object Identifier (DOI)

  • 10.1093/cid/ciu611


  • eng