BMJ 2015;350:h2006 doi: 10.1136/bmj.h2006 (Published 16 April 2015)
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Research News
RESEARCH NEWS Inhaled measles vaccine is less protective than injected vaccine, study shows Susan Mayor London
Aerosolised measles vaccine is immunogenic but less so than subcutaneous vaccination, says a study reported in the New England Journal of Medicine comparing these two approaches among children in India.
Despite the availability of a safe and effective injectable measles vaccine major outbreaks have continued, particularly in countries with poor health service infrastructure. An aerosolised measles vaccine was developed in Mexico and has been used there since 1980, but efficacy data have been inconsistent. Researchers compared the two measles vaccination approaches by randomly assigning 1001 children to the aerosolised vaccine and 1003 to a subcutaneous vaccine.1 The children were from villages served by eight primary health centres in Pune, western India, and were aged 9.0-11.9 months, although most (72.9%) were under 9.9 months.
researchers, led by Ana Maria Henao-Restrepo, of the World Health Organization in Geneva, Switzerland.
Despite their findings the authors said that aerosolised vaccine might be more effective when used in older children. They considered that it could also be used as the second measles vaccine in children previously given subcutaneous vaccination, as studies have shown that it induces higher and more sustained levels of serologic protection when used in this way.
“Third, if aerosolised vaccine increases the coverage of primary vaccination, this strategy could be more cost effective than two dose vaccination at lower levels of coverage,” the research group concluded.
Study nurses gave the aerosolised vaccine through a nebuliser attached to the child’s face by a single use face mask. Children having the subcutaneous vaccine were injected in the left upper arm. Results showed lower immunogenicity with the aerosolised measles vaccine. By 91 days after vaccination 85.4% (95% confidence interval 82.5 to 88.0) of children given the aerosolised vaccine were seropositive for measles. Nearly 10% more children (94.6% (92.7 to 96.1)) who received the subcutaneous vaccine were seropositive. This meant that the aerosolised vaccine failed to meet the non-inferiority margin of 5% difference in seropositivity. “Aerosolised vaccine against measles was immunogenic but, at the prespecified margin, was inferior to the subcutaneous vaccine with respect to the rate of seropositivity,” said the
For personal use only: See rights and reprints http://www.bmj.com/permissions
1
Low N, Bavdekar A, Jeyaseelan L, et al. A randomized, controlled trial of an aerosolized vaccine against measles. N Engl J Med 2015;372:1519-29.
Cite this as: BMJ 2015;350:h2006 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Research News
RESEARCH NEWS Inhaled measles vaccine is less protective than injected vaccine, study shows Susan Mayor London
Aerosolised measles vaccine is immunogenic but less so than subcutaneous vaccination, says a study reported in the New England Journal of Medicine comparing these two approaches among children in India.
Despite the availability of a safe and effective injectable measles vaccine major outbreaks have continued, particularly in countries with poor health service infrastructure. An aerosolised measles vaccine was developed in Mexico and has been used there since 1980, but efficacy data have been inconsistent. Researchers compared the two measles vaccination approaches by randomly assigning 1001 children to the aerosolised vaccine and 1003 to a subcutaneous vaccine.1 The children were from villages served by eight primary health centres in Pune, western India, and were aged 9.0-11.9 months, although most (72.9%) were under 9.9 months.
researchers, led by Ana Maria Henao-Restrepo, of the World Health Organization in Geneva, Switzerland.
Despite their findings the authors said that aerosolised vaccine might be more effective when used in older children. They considered that it could also be used as the second measles vaccine in children previously given subcutaneous vaccination, as studies have shown that it induces higher and more sustained levels of serologic protection when used in this way.
“Third, if aerosolised vaccine increases the coverage of primary vaccination, this strategy could be more cost effective than two dose vaccination at lower levels of coverage,” the research group concluded.
Study nurses gave the aerosolised vaccine through a nebuliser attached to the child’s face by a single use face mask. Children having the subcutaneous vaccine were injected in the left upper arm. Results showed lower immunogenicity with the aerosolised measles vaccine. By 91 days after vaccination 85.4% (95% confidence interval 82.5 to 88.0) of children given the aerosolised vaccine were seropositive for measles. Nearly 10% more children (94.6% (92.7 to 96.1)) who received the subcutaneous vaccine were seropositive. This meant that the aerosolised vaccine failed to meet the non-inferiority margin of 5% difference in seropositivity. “Aerosolised vaccine against measles was immunogenic but, at the prespecified margin, was inferior to the subcutaneous vaccine with respect to the rate of seropositivity,” said the
For personal use only: See rights and reprints http://www.bmj.com/permissions
1
Low N, Bavdekar A, Jeyaseelan L, et al. A randomized, controlled trial of an aerosolized vaccine against measles. N Engl J Med 2015;372:1519-29.
Cite this as: BMJ 2015;350:h2006 © BMJ Publishing Group Ltd 2015
Subscribe: http://www.bmj.com/subscribe
