Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review
Background: Live vaccines against measles (MV), tuberculosis (BCG), polio (OPV) and smallpox reduce mortality more than explained by target-disease prevention. The beneficial nonspecific effects (NSEs) of MV are strongest when MV is given in presence of maternal antibodies. We therefore hypothesised...
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doaj-a8f0230399cc4cd5b06ef638376178a62020-11-25T02:04:57ZengElsevierEBioMedicine2352-39642016-08-0110C31231710.1016/j.ebiom.2016.07.016Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A ReviewChristine S. Benn0Ane B. Fisker1Hilton C. Whittle2Peter Aaby3Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-BissauBandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-BissauThe London School of Hygiene and Tropical Medicine, Keppel Street, London, UKBandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-BissauBackground: Live vaccines against measles (MV), tuberculosis (BCG), polio (OPV) and smallpox reduce mortality more than explained by target-disease prevention. The beneficial nonspecific effects (NSEs) of MV are strongest when MV is given in presence of maternal antibodies. We therefore hypothesised that revaccination in presence of prior immunity enhances beneficial NSEs. Methods: Literature search for studies of revaccination and mortality. Findings: In two randomised trials (RCTs), two doses versus one dose of MV reduced all-cause mortality by 63% (95% CI: 23–83%) from 9 to 18 months of age. In a quasi-experimental study two doses before and after 9 months compared with one dose of MV after 9 months of age reduced mortality by 59% (25–81%). BCG-revaccination significantly enhanced BCG's effect against overall child mortality in two RCTs. In a natural experiment study of OPV campaigns over a 13-year-period in Guinea-Bissau, each additional dose of OPV was associated with a 13% (4–21%) reduction in mortality rate. The beneficial NSEs of smallpox vaccination for survival increased significantly with the number of smallpox vaccination scars. Interpretation: Revaccination with live vaccines led to substantial reductions in overall mortality. These findings challenge current understanding of vaccines and may explain the beneficial effects of campaigns with live vaccines.http://www.sciencedirect.com/science/article/pii/S2352396416303218BCGBoostingMeasles vaccineNonspecific effects of vaccinesOral polio vaccineRevaccination |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Christine S. Benn Ane B. Fisker Hilton C. Whittle Peter Aaby |
spellingShingle |
Christine S. Benn Ane B. Fisker Hilton C. Whittle Peter Aaby Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review EBioMedicine BCG Boosting Measles vaccine Nonspecific effects of vaccines Oral polio vaccine Revaccination |
author_facet |
Christine S. Benn Ane B. Fisker Hilton C. Whittle Peter Aaby |
author_sort |
Christine S. Benn |
title |
Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review |
title_short |
Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review |
title_full |
Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review |
title_fullStr |
Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review |
title_full_unstemmed |
Revaccination with Live Attenuated Vaccines Confer Additional Beneficial Nonspecific Effects on Overall Survival: A Review |
title_sort |
revaccination with live attenuated vaccines confer additional beneficial nonspecific effects on overall survival: a review |
publisher |
Elsevier |
series |
EBioMedicine |
issn |
2352-3964 |
publishDate |
2016-08-01 |
description |
Background: Live vaccines against measles (MV), tuberculosis (BCG), polio (OPV) and smallpox reduce mortality more than explained by target-disease prevention. The beneficial nonspecific effects (NSEs) of MV are strongest when MV is given in presence of maternal antibodies. We therefore hypothesised that revaccination in presence of prior immunity enhances beneficial NSEs.
Methods: Literature search for studies of revaccination and mortality.
Findings: In two randomised trials (RCTs), two doses versus one dose of MV reduced all-cause mortality by 63% (95% CI: 23–83%) from 9 to 18 months of age. In a quasi-experimental study two doses before and after 9 months compared with one dose of MV after 9 months of age reduced mortality by 59% (25–81%). BCG-revaccination significantly enhanced BCG's effect against overall child mortality in two RCTs. In a natural experiment study of OPV campaigns over a 13-year-period in Guinea-Bissau, each additional dose of OPV was associated with a 13% (4–21%) reduction in mortality rate. The beneficial NSEs of smallpox vaccination for survival increased significantly with the number of smallpox vaccination scars.
Interpretation: Revaccination with live vaccines led to substantial reductions in overall mortality. These findings challenge current understanding of vaccines and may explain the beneficial effects of campaigns with live vaccines. |
topic |
BCG Boosting Measles vaccine Nonspecific effects of vaccines Oral polio vaccine Revaccination |
url |
http://www.sciencedirect.com/science/article/pii/S2352396416303218 |
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