Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.

<h4>Background</h4>This review evaluates the hypothesis of beneficial non-specific effects of the standard-titre measles vaccine.<h4>Methods</h4>We conducted a systematic review and meta-analysis of randomised controlled trials. Trials included standard or high-titre live att...

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Main Authors: Louise A Fournais, Anne C Zimakoff, Andreas Jensen, Jeppe H Svanholm, Ingvild Fosse, Lone G Stensballe
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0321982
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author Louise A Fournais
Anne C Zimakoff
Andreas Jensen
Jeppe H Svanholm
Ingvild Fosse
Lone G Stensballe
author_facet Louise A Fournais
Anne C Zimakoff
Andreas Jensen
Jeppe H Svanholm
Ingvild Fosse
Lone G Stensballe
author_sort Louise A Fournais
collection DOAJ
description <h4>Background</h4>This review evaluates the hypothesis of beneficial non-specific effects of the standard-titre measles vaccine.<h4>Methods</h4>We conducted a systematic review and meta-analysis of randomised controlled trials. Trials included standard or high-titre live attenuated measles containing vaccines compared to other vaccines or placebo. The primary outcomes were mortality and morbidity. Secondary outcomes were infections, antibiotic use, atopy, allergies, asthma, and atopic dermatitis.<h4>Findings</h4>23 articles were included in this systematic review. Mortality: Two doses of measles vaccine vs. only one dose showed no significant effect on mortality; risk ratio (RR) = 1.05 (95% CI: 0.78 to 1.41), p = 0.76. The analysis was based on a relative risk reduction (RRR) of 25% and a control group event rate of 2.32% as measured in the actual trials included in the analysis. In males, the association was rejected: RR = 1.09 (0.86 to 1.37), p = 0.47. In females, the association was not rejected at 25%,but was at 33% level: RR = 1.0 (0.64 to 1.54), p = 0.99. Morbidity: Overall, the hypothesis was rejected: RR = 0.94 (0.80 to 1.10), p = 0.43. The rejection was sustained for both sexes: females RR = 0.95 (0.77 to 1.18), p = 0.6; males RR = 0.92 (0.83 to 1.03), p = 0.13.<h4>Interpretation</h4>Based on evidence from randomised controlled trials, this systematic literature review and meta-analysis did not support the hypothesis of non-specific effects of standard-titre measles containing vaccines. Trial Sequential Analysis indicated that the meta-analysis included sufficient data to reach this conclusion.<h4>Trial registration</h4>PROSPERO CRD42022344473.
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spelling doaj-art-6496987bc54145759c8cb4549bb4bfbe2025-08-20T02:36:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01207e032198210.1371/journal.pone.0321982Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.Louise A FournaisAnne C ZimakoffAndreas JensenJeppe H SvanholmIngvild FosseLone G Stensballe<h4>Background</h4>This review evaluates the hypothesis of beneficial non-specific effects of the standard-titre measles vaccine.<h4>Methods</h4>We conducted a systematic review and meta-analysis of randomised controlled trials. Trials included standard or high-titre live attenuated measles containing vaccines compared to other vaccines or placebo. The primary outcomes were mortality and morbidity. Secondary outcomes were infections, antibiotic use, atopy, allergies, asthma, and atopic dermatitis.<h4>Findings</h4>23 articles were included in this systematic review. Mortality: Two doses of measles vaccine vs. only one dose showed no significant effect on mortality; risk ratio (RR) = 1.05 (95% CI: 0.78 to 1.41), p = 0.76. The analysis was based on a relative risk reduction (RRR) of 25% and a control group event rate of 2.32% as measured in the actual trials included in the analysis. In males, the association was rejected: RR = 1.09 (0.86 to 1.37), p = 0.47. In females, the association was not rejected at 25%,but was at 33% level: RR = 1.0 (0.64 to 1.54), p = 0.99. Morbidity: Overall, the hypothesis was rejected: RR = 0.94 (0.80 to 1.10), p = 0.43. The rejection was sustained for both sexes: females RR = 0.95 (0.77 to 1.18), p = 0.6; males RR = 0.92 (0.83 to 1.03), p = 0.13.<h4>Interpretation</h4>Based on evidence from randomised controlled trials, this systematic literature review and meta-analysis did not support the hypothesis of non-specific effects of standard-titre measles containing vaccines. Trial Sequential Analysis indicated that the meta-analysis included sufficient data to reach this conclusion.<h4>Trial registration</h4>PROSPERO CRD42022344473.https://doi.org/10.1371/journal.pone.0321982
spellingShingle Louise A Fournais
Anne C Zimakoff
Andreas Jensen
Jeppe H Svanholm
Ingvild Fosse
Lone G Stensballe
Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.
PLoS ONE
title Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.
title_full Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.
title_fullStr Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.
title_full_unstemmed Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.
title_short Measles vaccines and non-specific effects on mortality or morbidity: A systematic review and meta-analysis.
title_sort measles vaccines and non specific effects on mortality or morbidity a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0321982
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