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Specific and non targeted effects of a two-dose strategy with stand ard measles vaccine. Implications for immunization programmes

Objective

The general objectives are:

* To reduce childhood mortality in developing countries through better control of measles infection by developing a better immunization strategy.
* To investigate the hypothesis that standard titre measles immunization is associated with non-targeted beneficial effects on childhood morbidity and mortality in developing countries.

The measurable, specific objectives are:

* To examine whether a two-dose strategy for measles immunization at 6 and 9 months of age can reduce measles incidence by 50% through better coverage or improved seroconversion.
* To examine whether a two-dose strategy for measles immunization at 6 and 9 months of age can reduce childhood mortality by 20% through better coverage, better protection against measles or non targeted beneficial effects.
* To determine the magnitude and duration of non-measles related changes in morbidity patterns after standard titre measles immunization, in particular to test whether measles immunization is associated with a 15% reduction in the risk of diarrhoea.
* To determine non-measles related immunological changes among recipients of measles vaccine in order to establish possible pathways for the non targeted effects of standard titre measles immunization.
Expected Outcome

* Vaccine efficacy: vaccine efficacy will be assessed both as cumulative incidence from the time of entering the study at six months of age and as protection rate following exposure from a measles case in the same house.

* Measles antibodies: measles antibody responses as well as decay in measles antibodies levels will be analysed for a subgroup of individuals. Since previous studies have shown that antibody titre below 125 miU are not protective, children with such low titres at 18 months of age will be offered reimmunization.

* Mortality: cumulative mortality will be analysed from entry into the study at 6 months of age or later to the censoring date.

* Research training: training abroad of one Guinean physician in research methodology.
* Conducting the trial of two-dose standard titre measles vaccination in Bissau.
* Conducting the studies of morbidity and anthropometry.
* Performing the immunological studies included in the two-dose trial.
* Performing data-control and data-analysis.

Funding Scheme

CSC - Cost-sharing contracts

Coordinator

STATENS SERUM INSTITUT
Address
5,Artillerivej 5
2300 Koepenhagen
Denmark

Participants (2)

Medical Research Council
The Gambia
Address

20 Banjul
Ministry of Public Health Guinea-Bissau
Guinea-Bissau
Address

Bissau