Fournais Louise A, Zimakoff Anne C, Jensen Andreas, Svanholm Jeppe H, Fosse Ingvild, Stensballe Lone G
The Child and Adolescent Department, The Danish National University Hospital, Copenhagen, Denmark.
The Child and Adolescent Department, Hvidovre University Hospital, Hvidovre, Denmark.
PLoS One. 2025 Jul 2;20(7):e0321982. doi: 10.1371/journal.pone.0321982. eCollection 2025.
This review evaluates the hypothesis of beneficial non-specific effects of the standard-titre measles vaccine.
We conducted a systematic review and meta-analysis of randomised controlled trials. Trials included standard or high-titre live attenuated measles containing vaccines compared to other vaccines or placebo. The primary outcomes were mortality and morbidity. Secondary outcomes were infections, antibiotic use, atopy, allergies, asthma, and atopic dermatitis.
23 articles were included in this systematic review. Mortality: Two doses of measles vaccine vs. only one dose showed no significant effect on mortality; risk ratio (RR) = 1.05 (95% CI: 0.78 to 1.41), p = 0.76. The analysis was based on a relative risk reduction (RRR) of 25% and a control group event rate of 2.32% as measured in the actual trials included in the analysis. In males, the association was rejected: RR = 1.09 (0.86 to 1.37), p = 0.47. In females, the association was not rejected at 25%,but was at 33% level: RR = 1.0 (0.64 to 1.54), p = 0.99. Morbidity: Overall, the hypothesis was rejected: RR = 0.94 (0.80 to 1.10), p = 0.43. The rejection was sustained for both sexes: females RR = 0.95 (0.77 to 1.18), p = 0.6; males RR = 0.92 (0.83 to 1.03), p = 0.13.
Based on evidence from randomised controlled trials, this systematic literature review and meta-analysis did not support the hypothesis of non-specific effects of standard-titre measles containing vaccines. Trial Sequential Analysis indicated that the meta-analysis included sufficient data to reach this conclusion.
PROSPERO CRD42022344473.
本综述评估标准效价麻疹疫苗有益非特异性效应的假说。
我们对随机对照试验进行了系统综述和荟萃分析。试验包括将含标准效价或高效价减毒活麻疹疫苗与其他疫苗或安慰剂进行比较。主要结局为死亡率和发病率。次要结局为感染、抗生素使用、特应性、过敏、哮喘和特应性皮炎。
本系统综述纳入了23篇文章。死亡率：两剂麻疹疫苗与仅一剂相比，对死亡率无显著影响；风险比（RR）=1.05（95%置信区间：0.78至1.41），p = 0.76。该分析基于分析中纳入的实际试验所测得的25%的相对风险降低率（RRR）和2.32%的对照组事件发生率。在男性中，该关联被否定：RR = 1.09（0.86至1.37），p = 0.47。在女性中，该关联在25%水平未被否定，但在33%水平被否定：RR = 1.0（0.64至1.54），p = 0.99。发病率：总体而言，该假说被否定：RR = 0.94（0.80至1.10），p = 0.43。男女两性均维持该否定结果：女性RR = 0.95（0.77至1.18），p = 0.6；男性RR = 0.92（0.83至1.03），p = 0.13。
基于随机对照试验的证据，本系统文献综述和荟萃分析不支持含标准效价麻疹疫苗非特异性效应的假说。试验序贯分析表明，荟萃分析纳入了足够的数据以得出该结论。
PROSPERO CRD42022344473。
