Effectiveness of measles vaccination and vitamin A treatment

Christopher R. Sudfeld, Ann Marie Navar, Neal A. Halsey

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)i48-i55
JournalInternational journal of epidemiology
Volume39
Issue numberSUPPL. 1
DOIs
StatePublished - Apr 1 2010

Keywords

  • Measles
  • Treatment
  • Vaccine
  • Vitamin A

ASJC Scopus subject areas

  • Epidemiology

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