From the original article: Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children: an observational study within a randomised trial:
What is already known on this topic
- ▶ Live vaccines such as measles vaccine and Bacille Calmette-Guerin have non-specific beneficial effects in areas with high mortality.
- ▶ Previous studies from several low-income African countries have suggested that inactivated vaccines, including diphtheria-tetanus-pertussis (DTP), may have non-specific negative effects for survival of girls.
- ▶ WHO sponsored studies which have found a beneficial effect of DTP have major methodological problems.
What this study adds
- ▶ Adjusted for nutritional status, DTP vaccinated children, particularly girls, had threefold higher mortality between 2 and 6 months of age.
- ▶ Nutritional status was a strong predictor of mortality among boys but not girls.
- ▶ There is a continuing contradiction between studies of DTP from low-income countries and current policy.
"Adjusting for mid upper arm circumference (a surrogate measure of nutritional status), the overall effect for DTP vaccinated children was 2.62 (95% CI 1.34 to 5.09); the death rate ratio was 5.68 (95% CI 1.83 to 17.7) for girls and 1.29 (95% CI 0.56 to 2.97) for boys (p=0.023, homogeneity test). While anthropometric indices were a strong predictor of mortality among boys, there was little or no association for girls."
[If these adjustments are accurate, it seems both girls and boys died at higher than expected rates.--Nass]