Female children living in Bangladesh are especially vulnerable and have a higher mortality rate than male children. The results also show that vaccinating female children for measles significantly raised their chances of survival overall, bringing them to almost the same mortality rate as unvaccinated males. However, the difference in survival rate between vaccinated and unvaccinated girls was in proportion to the increase in survival between vaccinated and unvaccinated boys, and was therefore not statistically significant.
The study by Dr. Koenig and colleagues does not address why measles vaccine provides this disproportionate benefit to more vulnerable children. They hypothesize that the vaccine may stimulate the immune system in non-specific ways. Measles has a devastating effect on children with poor nutrition and the disease can also lead to prolonged infections, both of which may be more of a factor among children of low socioeconomic status. The researchers say more research is needed to determine if the health equity effect also applies to other child survival interventions as well.
Measles vaccine is not a new technology, but in many countries vaccine coverage is as low as 50 percent. The majority of the unvaccinated children are from the most vulnerable social and economic groups, yet these are the children who could benefit the most from measles vaccination. Our findings make a compelling case for developing targeted programs and policies to ensure that measles vaccine reaches the most disadvantaged children to further reduce inequities in child survival, adds Dr. Koenig.
Contact: Tim Parsons or Ming Tai
Johns Hopkins University Bloomberg School of Public Health