Effectiveness of measles vaccination and vitamin A treatment.

Published

Journal Article (Review)

BACKGROUND: The current strategy utilized by WHO/United Nations Children's Fund (UNICEF) to reach the Global Immunization Vision and Strategy 2010 measles reduction goal includes increasing coverage of measles vaccine, vitamin A treatment and supplementation in addition to offering two doses of vaccine to all children. METHODS: We conducted a systematic review of published randomized controlled trials (RCTs) and quasi-experimental (QE) studies in order to determine effect estimates of measles vaccine and vitamin A treatment for the Lives Saved Tool (LiST). We utilized a standardized abstraction and grading format in order to determine effect estimates for measles mortality employing the standard Child Health Epidemiology Research Group Rules for Evidence Review. RESULTS: We identified three measles vaccine RCTs and two QE studies with data on prevention of measles disease. A meta-analysis of these studies found that vaccination was 85% [95% confidence interval (CI) 83-87] effective in preventing measles disease, which will be used as a proxy for measles mortality in LiST for countries vaccinating before one year of age. The literature also suggests that a conservative 95% effect estimate is reasonable to employ when vaccinating at 1 year or later and 98% for two doses of vaccine based on serology reviews. We included six high-quality RCTs in the meta-analysis of vitamin A treatment of measles which found no significant reduction in measles morality. However, when stratifying by vitamin A treatment dose, at least two doses were found to reduce measles mortality by 62% (95% CI 19-82). CONCLUSION: Measles vaccine and vitamin A treatment are effective interventions to prevent measles mortality in children.

Full Text

Duke Authors

Cited Authors

  • Sudfeld, CR; Navar, AM; Halsey, NA

Published Date

  • April 2010

Published In

Volume / Issue

  • 39 Suppl 1 /

Start / End Page

  • i48 - i55

PubMed ID

  • 20348126

Pubmed Central ID

  • 20348126

Electronic International Standard Serial Number (EISSN)

  • 1464-3685

Digital Object Identifier (DOI)

  • 10.1093/ije/dyq021

Language

  • eng

Conference Location

  • England