Stand by for a campaign to vaccinate children against measles even earlier, following a major study into the use of vaccines in a developing country.
Children in developed countries tend to be vaccinated against measles after 15 months, compared with nine months in developing countries. In 1989, the World Health Organization stated that vaccination before nine months was a substantial cause of death. It was considered dangerous to inject a child until it had lost maternal antibodies.
However, a study in Guinea-Bissau has concluded that children who were given the standard measles vaccine between four and eight months were less likely to die than those given it between nine and 11 months.
Earlier tests with the high dose Edmonston-Zagreb vaccine had revealed higher mortality rates among girls under nine months than among those given the standard Schwarz vaccine after that age. However, death usually occurred some two years after the inoculations.
The new findings, by Peter Aaby et al, of the Epidemiology Research Unit in Copenhagen, Denmark (BMJ, 20 November 1993), could now open the door to earlier programmes of standard vaccine inoculations among babies aged between four and eight months. "This has implications for measles immunization strategy in developing countries," they conclude.
Commenting on the findings, A. J. Hall and F.T. Cutts, both senior lecturers at the London School of Hygiene and Tropical Medicine, say that high level vaccinations could cause long term disruption of the immune system, including an imbalance in the type of helper T-cell response, as suggested by the increase in deaths up to two years later among children who were given the high level dosage.
Only 175 cases of measles and 30 cases of mumps were reported in the US in the first six months of the year. This compares to nearly 14,000 cases reported in 1990 and higher than normal levels in the equally well vaccinated UK.
More evidence that measles is a cyclical disease.