Effect of age at vaccination on the measles vaccine effectiveness and immunogenicity: systematic review and meta-analysis

被引:22
作者
Carazo, Sara [1 ]
Billard, Marie-Noelle [2 ]
Boutin, Amelie [2 ]
De Serres, Gaston [1 ,2 ,3 ]
机构
[1] Laval Univ, Dept Social & Prevent Med, 1050 Ave Med, Quebec City, PQ G1V 0A6, Canada
[2] Univ Laval, CHU Quebec, Res Ctr, 2400 Ave Estimauville, Quebec City, PQ G1E 7G9, Canada
[3] Inst Natl Sante Publ Quebec, 2400 Ave Estimauville, Quebec City, PQ G1E 7G9, Canada
关键词
Measles vaccine; Age; Immunogenicity; Effectiveness; TITER EDMONSTON-ZAGREB; COMBINED YELLOW-FEVER; RUBELLA MMR VACCINE; RISK-FACTORS; IMMUNE-RESPONSE; ANTIBODY-RESPONSE; UNITED-STATES; AIK-C; IMMUNIZATION STRATEGIES; MATERNAL ANTIBODIES;
D O I
10.1186/s12879-020-4870-x
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background The objectives of this review were to evaluate the effect of age at administration of the first dose of a measles-containing vaccine (MCV1) on protection against measles and on antibody response after one- and two-dose measles vaccinations. Methods We conducted a systematic review of the PubMed/MEDLINE, Embase, Web of Science and Cochrane databases (1964-2017) to identify observational studies estimating vaccine effectiveness and/or measles attack rates by age at first vaccination as well as experimental studies comparing seroconversion by age at first vaccination. Random effect models were used to pool measles risk ratios (RR), measles odds ratios (OR) and seroconversion RR of MCV1 administered at < 9, 9-11 or >= 15 months compared with 12 or 12-14 months of age. Results We included 41 and 67 studies in the measles protection and immunogenicity analyses. Older age at MCV1, from 6 to >= 15 months, improved antibody response and measles protection among one-dose recipients. Pooled measles RR ranged from 3.56 (95%CI: 1.28, 9.88) for MCV1 at < 9 months to 0.48 (95%CI: 0.36, 0.63) for MCV1 at >= 15 months, both compared to 12-14 months. Pooled seroconversion RR ranged from 0.93 (95%CI: 0.90, 0.96) for MCV1 at 9-11 months to 1.03 (95%CI: 1.00, 1.06) for MCV1 at >= 15 months, both compared to 12 months. After a second dose, serological studies reported high seropositivity regardless of age at administration of MCV1 while epidemiological data based on few studies suggested lower protection with earlier age at MCV1. Conclusions Earlier age at MCV1 decreases measles protection and immunogenicity after one dose and might still have an impact on vaccine failures after two doses of measles vaccine. While two-dose vaccination coverage is most critical to interrupt measles transmission, older age at first vaccination may be necessary to keep the high level of population immunity needed to maintain it.
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页数:18
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