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Andersen A, Fisker AB, Rodrigues A, et al. National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials. Front Public Health. 2018;6:13doi: 10.3389/fpubh.2018.00013.
Andersen, A., Fisker, A. B., Rodrigues, A., Martins, C., Ravn, H., Lund, N., Biering-Sørensen, S., Benn, C. S., & Aaby, P. (2018). National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials. Frontiers in public health, 613. https://doi.org/10.3389/fpubh.2018.00013
Andersen, Andreas, et al. "National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials." Frontiers in public health vol. 6 (2018): 13. doi: https://doi.org/10.3389/fpubh.2018.00013
Andersen A, Fisker AB, Rodrigues A, Martins C, Ravn H, Lund N, Biering-Sørensen S, Benn CS, Aaby P. National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials. Front Public Health. 2018 Feb 02;6:13. doi: 10.3389/fpubh.2018.00013. eCollection 2018. PMID: 29456992; PMCID: PMC5801299.
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Front Public Health. 2018 Feb 02;6:13. doi: 10.3389/fpubh.2018.00013. eCollection 2018.

National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials.

Frontiers in public health

Andreas Andersen, Ane Baerent Fisker, Amabelia Rodrigues, Cesario Martins, Henrik Ravn, Najaaraq Lund, Sofie Biering-Sørensen, Christine Stabell Benn, Peter Aaby

Affiliations

  1. Research Centre for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark.
  2. Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau.
  3. Institute for Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.

PMID: 29456992 PMCID: PMC5801299 DOI: 10.3389/fpubh.2018.00013

Abstract

BACKGROUND: A recent WHO review concluded that live BCG and measles vaccine (MV) may have beneficial non-specific effects (NSEs) reducing mortality from non-targeted diseases. NSEs of oral polio vaccine (OPV) were not examined. If OPV vaccination campaigns reduce the mortality rate, it would suggest beneficial NSEs.

SETTING: Between 2002 and 2014, Guinea-Bissau had 15 general OPV campaigns and other campaigns with OPV plus vitamin A supplementation (VAS), VAS-only, MV, and H1N1 vaccine. In this period, we conducted seven randomized controlled trials (RCTs) with mortality as main outcome.

METHODS: Within these RCTs, we assessed whether the mortality rate was lower after-campaign than before-campaign. We used Cox models with age as underlying time and further adjusted for low birth-weight, season and time trend in mortality. We calculated the adjusted mortality rate ratio (MRR) for after-campaign vs before-campaign.

RESULTS: The mortality rate was lower after OPV-only campaigns than before, the MRR being 0.81 (95% CI = 0.68-0.95). With each additional dose of campaign-OPV the mortality rate declined further (MRR = 0.87 (95% CI: 0.79-0.96) per dose) (test for trend,

CONCLUSION: Bissau had no case of polio infection so the results suggest that campaign-OPV has beneficial NSEs. Discontinuation of OPV-campaigns in low-income countries may affect general child mortality levels negatively.

Keywords: MDG4; campaigns; child mortality; non-specific effects of vaccines; oral polio vaccine

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