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Evaluation of non-specific effects of infant immunizations on early infant mortality in a southern Indian population

  1. Lawrence H. Moulton1,
  2. Lakshmi Rahmathullah2,
  3. Neal A. Halsey1,
  4. R. D. Thulasiraj3,
  5. Joanne Katz1,
  6. James M. Tielsch1

Article first published online: 6 SEP 2005

DOI: 10.1111/j.1365-3156.2005.01434.x

Issue

Tropical Medicine & International Health

Tropical Medicine & International Health

Volume 10, Issue 10, pages 947–955, October 2005

Additional Information

How to Cite

Moulton, L. H., Rahmathullah, L., Halsey, N. A., Thulasiraj, R. D., Katz, J. and Tielsch, J. M. (2005), Evaluation of non-specific effects of infant immunizations on early infant mortality in a southern Indian population. Tropical Medicine & International Health, 10: 947–955. doi: 10.1111/j.1365-3156.2005.01434.x

Author Information

  1. 1

    Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

  2. 2

    Aravind Centre for Women, Children and Community Health, Madurai, Tamil Nadu, India

  3. 3

    Lions-Aravind Institute for Community Ophthalmology, Madurai, Tamil Nadu, India

*Authors Lawrence H. Moulton (corresponding author), Neal A. Halsey, Joanne Katz, and James M. Tielsch, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Rm. E5519, Baltimore, MD 21205-2103, USA. Tel.: +1-410-955-6370; Fax: +1-530-325-6867; E-mail: lmoulton@jhsph.edu, nhalsey@jhsph.edu, jkatz@jhsph.edu, jtielsch@jhsph.edu Lakshmi Rahmathullah, Aravind Centre for Women, Children and Community Health, Madurai, Tamil Nadu, India. Tel.: +91-452-532-653; Fax: +91-452-530-984; E-mail: healthforfamily@yahoo.co.in R. D. Thulasiraj, Lions-Aravind Institute for Community Ophthalmology, Madurai, Tamil Nadu, India. E-mail: thulsi@aravind.org

Publication History

  1. Issue published online: 6 SEP 2005
  2. Article first published online: 6 SEP 2005

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Keywords:

  • vaccines;
  • infant mortality;
  • vitamin A;
  • BCG;
  • DTP

Summary

Objective  The aim of this study was to assess the relationship between receipt of routine childhood immunizations and infant mortality before 6 months of age.

Methods  This was an observational study of 10 274 infants, in a randomized trial of vitamin A supplementation, who received the study dose and survived to at least 1 week of age. The primary outcome was mortality before 6 months of age, analysed in Cox regression models as a function of vaccine receipt and gender.

Results  Receipt of Bacille Calmette Guerin (BCG) or diphtheria, tetanus, polio (DTP) vaccine was associated with significant reductions of one-half to two-thirds of mortality hazards; among girls, those who received both BCG and DTP experienced higher mortality than those who received only one of the two vaccines (hazards ratio 2.4; 95% confidence interval 1.2–5.0).

Conclusion  The reduced mortality rate associated with receipt of BCG or DTP may be due to both biological and selection factors; the analyses regarding the combined effect of these vaccines and gender need to be replicated in other settings.

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