Aaby P, Andersen M, Sodemann M, Jakobsen M, Gomes J, Fernandes M
Statens Seruminstitut, København.
Ugeskr Laeger. 1994 Oct 3;156(40):5857-61.
Recent studies have found administration of high-titre measles vaccine before 9 months of age to be associated with reduced survival. Since this suggests that early immunization could be unsafe, we examined the results of immunization campaigns with Schwarz standard measles vaccine carried out in 1980-1983 in three areas of Guinea-Bissau. Children were followed to death, migration or the age of five years. Children immunized at 4-8 months of age, of whom many were later re-immunized, had lower mortality between nine months and five years of age compared with children vaccinated at 9-11 months of age. The improved survival was unrelated to better protection against measles. There was no sign of socio-cultural differences between children immunized at different ages. Vaccination before 9 months of age is apparently safe and it may reduce childhood mortality compared with the currently recommended strategy of immunizing from nine months of age. Randomized trials are needed to confirm these observations which may have implications for the measles immunization strategy for developing countries.
近期研究发现，在9月龄前接种高滴度麻疹疫苗与生存率降低有关。鉴于此表明早期免疫可能不安全，我们研究了1980年至1983年在几内亚比绍三个地区开展的使用施瓦茨标准麻疹疫苗的免疫活动结果。对儿童进行跟踪直至死亡、迁移或满五岁。4至8月龄免疫的儿童（其中许多儿童后来再次免疫）在9月龄至5岁之间的死亡率低于9至11月龄接种疫苗的儿童。生存率的提高与预防麻疹的更好保护无关。不同年龄免疫的儿童之间没有社会文化差异的迹象。9月龄前接种疫苗显然是安全的，与目前建议的9月龄开始免疫的策略相比，它可能降低儿童死亡率。需要进行随机试验来证实这些观察结果，这可能对发展中国家的麻疹免疫策略有影响。
