MeaslesPhase 4NCT00168662
Non-Specific Effects of Standard Titre Measles Vaccination
A Phase 4 study testing Measles and inactivated polio vaccine in people with Measles, run by Bandim Health Project at 1 site in Guinea-Bissau.
Trial summary
The general objectives of the proposed research work are: A1) to reduce childhood mortality in developing countries through better control of measles infection by finding the best immunization strategy, and A2) to investigate the hypothesis that standard titre measles immunization is associated with non targeted… Read more about this study
- Who is it for?
- Ages 6 to 8 monthsHealthy volunteers can take part
- Conditions the study is for
- Measles
- What is being tested?
- Measles and inactivated polio vaccine
- Type of treatment
- Vaccines
- How many people
- 7,800 participants
- Where
- 1 siteGuinea-Bissau
- Study dates
- Mar 1995to Jan 2006
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 to 8 months
- All sexes
- Healthy volunteers accepted
- Child
Inclusion Criteria: Infants of 6 months of age registered in the Bandim Health Project registration system and currently living in the Bandim Health Project areas: Bandim I, Bandim II, Belem and Mindará
Exclusion Criteria: Severe illness requiring hospitalisation
Trial locations and contacts
1 site in 1 country.
Guinea-Bissau1 site
Bandim Health Project
Bissau, Apartado 861, 1004 Bissau Codex
About this study
Official title: Trial of Two-Dose Standard Measles Vaccination Schedule: Long-Term Impact on Morbidity and Mortality of a Two-Dose Vaccination Schedule at 6 and 9 Months of Age Compared With a Standard Regimen of One Dose at 9 Months of Age
The general objectives of the proposed research work are:
A1) to reduce childhood mortality in developing countries through better control of measles infection by finding the best immunization strategy, and A2) to investigate the hypothesis that standard titre measles immunization is associated with non targeted beneficial effects on childhood morbidity and mortality in developing countries.
Read more
The measurable, specific objectives of the present proposal are:
B1) to examine whether a two-dose strategy for measles immunization at 6 and 9 months of age can reduce measles incidence by 50% through better coverage or improved seroconversion, and B2) to examine whether a two-dose strategy for measles immunization at 6 and 9 months of age can reduce childhood mortality by 20% through better coverage, better protection against measles or non targeted beneficial effects, and B3) to determine the magnitude and duration of non-measles related changes in morbidity patterns after standard titre measles immunization, in particular to test whether measles immunization is associated with a 15% reduction in the risk of diarrhoea, and B4) to determine non-measles related immunological changes among recipients of measles vaccine in order to establish possible pathways for the non targeted effects of standard titre measles immunization.
Read the detailed description
Background. Measles is the major killer among vaccine preventable diseases with an estimated one million deaths/year in developing countries. Though a good vaccine exists, the current immunization strategy of one dose at 9 months is far from optimal; too many children get measles before the age of immunization, coverage is too low when immunization has to wait until 9 months of age, and the protective efficacy is insufficient with the current vaccine given at 9 months of age. There is therefore a need for alternative immunization strategies or new vaccines.
Evaluations of vaccines have usually been based on a disease specific perspective; i.e. evaluation of specific immunity, and protective efficacy against the specific disease, its complications and mortality. However, our research from Guinea-Bissau, Senegal and Bangladesh has indicated that measles immunization and measles infection may have non-specific beneficial effects. The present protocol is an attempt to assess the magnitude and possible mechanisms of the non targeted beneficial effects of measles immunization and measles infection as well as an attempt to assess some of the practical implications of the hypothesis about non-specific beneficial effects.
Approach and methodologies. We tested a two dose measles immunization strategy at 6 and 9 months compared with the currently recommended strategy of one dose at 9 months. The children were be randomized to receive measles immunization at 6 and 9 months of age or inactivated polio at 6 months and measles at 9 months of age.
The non targeted effects of measles immunization on mortality and morbidity are best studied within a randomized trial comparing immunized and unimmunized children. In order to study the impact on non-measles related morbidity, some children recruited for the immunization trial will be included in weekly morbidity surveillance for diarrhoea, respiratory infections and malaria which are the most important disease complexes for childhood mortality in Guinea-Bissau.
Possible immunological differences between measles immunized and unimmunized children will be examined through measurements of T-lymphocyte levels, neopterin, beta2-microglobulin, delayed hypersensitivity (Multitest), allergic reactions (skin prick tests), antibody responses to other antigens (tetanus) and thymus growth (by sonography). Functional differences will be tested by response to a second vaccine antigen (HBV) at 7½ and 9 months of age when only one group has received measles vaccine.
- Conditions
- Measles
- Being tested
- Measles and inactivated polio vaccine
- Keywords
- Non-specific effects of vaccines, Infant mortality, Child mortality, Mortality, Morbidity, Measles vaccine, Measles, Immunisation, Low income country, Guinea-Bissau, Bandim Health Project, Immunology
- Medical subject headings
- Measles, Infant Death
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Measles and inactivated polio vaccineBiological
What is being measured
The primary outcome is the main question the study is designed to answer.
Vaccination coverage
Vaccine efficacy
Measles specific mortality
All cause mortality until 3 years of age
Secondary outcomes (11)
Measles antibodies at 6, 7½, 9, 10½ and 18 months of age
T-cells at 6, 7½, 9, 10½ and 18 months of age
Thymus size at 6, 7½, 9, 10½ months of age
Neopterin level at 7½ months of age
Beta-2-microglobulin level at 7½ months of age
Hepatitis B antibodies at 7½, 9 and 10½ months of age
Tetanus antibodies at 9 months og age
Delayed type hypersensitivity at 7½ months of age
Skin prick test (allergy) at 7½ months of age
Morbidity from 6 to 18 months of age
Anthropometric measures at 6, 7½, 9, 10½ and 18 months of age
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Sep 2005 (estimated)
- Study startMar 1995
- Primary completionJan 2006
- Study completionJan 2006
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for MeaslesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 7,800 participants
Sponsor and investigators
- Lead sponsor
- Bandim Health Project
- Sponsor type
- University, hospital or other
- Collaborators
- International Cooperation with Developing Countries, Danish Council for Development Research, Medical Research Council Unit, The Gambia
- Investigators
- PETER AABY, MSc, Dr. Med, Study director, Bandim Health Project
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00168662
- Sponsor's protocol ID
- IC18-CT95-0011-Twodose1
- Other IDs
- EU grant: IC18-CT95-0011
- Status last verified
- Feb 2008
- First submitted
- 9 Sep 2005
- Last updated
- 26 Feb 2008
- Results posted
- No
Publications
Veirum JE, Sodemann M, Biai S, Jakobsen M, Garly ML, Hedegaard K, Jensen H, Aaby P. Routine vaccinations associated with divergent effects on female and male mortality at the paediatric ward in Bissau, Guinea-Bissau. Vaccine. 2005 Jan 19;23(9):1197-204. doi: 10.1016/j.vaccine.2004.02.053.
PubMed 15629363Garly ML, Martins CL, Bale C, da Costa F, Dias F, Whittle H, Aaby P. Early two-dose measles vaccination schedule in Guinea-Bissau: good protection and coverage in infancy. Int J Epidemiol. 1999 Apr;28(2):347-52. doi: 10.1093/ije/28.2.347.
PubMed 10342702Garly ML, Bale C, Martins CL, Monteiro M, George E, Kidd M, Dias F, Aaby P, Whittle HC. Measles antibody responses after early two dose trials in Guinea-Bissau with Edmonston-Zagreb and Schwarz standard-titre measles vaccine: better antibody increase from booster dose of the Edmonston-Zagreb vaccine. Vaccine. 2001 Feb 28;19(15-16):1951-9. doi: 10.1016/s0264-410x(00)00431-x.
PubMed 11228365Garly ML, Bale C, Martins CL, Balde MA, Hedegaard KL, Whittle HC, Aaby P. BCG vaccination among West African infants is associated with less anergy to tuberculin and diphtheria-tetanus antigens. Vaccine. 2001 Nov 12;20(3-4):468-74. doi: 10.1016/s0264-410x(01)00339-5.
PubMed 11672911Aaby P, Jensen H, Garly ML, Bale C, Martins C, Lisse I. Routine vaccinations and child survival in a war situation with high mortality: effect of gender. Vaccine. 2002 Nov 22;21(1-2):15-20. doi: 10.1016/s0264-410x(02)00441-3.
PubMed 12443658Garly ML, Martins CL, Bale C, Balde MA, Hedegaard KL, Gustafson P, Lisse IM, Whittle HC, Aaby P. BCG scar and positive tuberculin reaction associated with reduced child mortality in West Africa. A non-specific beneficial effect of BCG? Vaccine. 2003 Jun 20;21(21-22):2782-90. doi: 10.1016/s0264-410x(03)00181-6.
PubMed 12798618Aaby P, Garly ML, Bale C, Martins C, Jensen H, Lisse I, Whittle H. Survival of previously measles-vaccinated and measles-unvaccinated children in an emergency situation: an unplanned study. Pediatr Infect Dis J. 2003 Sep;22(9):798-805. doi: 10.1097/01.inf.0000083821.33187.b5.
PubMed 14506371Aaby P, Jensen H, Rodrigues A, Garly ML, Benn CS, Lisse IM, Simondon F. Divergent female-male mortality ratios associated with different routine vaccinations among female-male twin pairs. Int J Epidemiol. 2004 Apr;33(2):367-73. doi: 10.1093/ije/dyh004.
PubMed 15082642Garly ML, Jensen H, Martins CL, Bale C, Balde MA, Lisse IM, Aaby P. Hepatitis B vaccination associated with higher female than male mortality in Guinea-bissau: an observational study. Pediatr Infect Dis J. 2004 Dec;23(12):1086-92.
PubMed 15626943Roth A, Gustafson P, Nhaga A, Djana Q, Poulsen A, Garly ML, Jensen H, Sodemann M, Rodriques A, Aaby P. BCG vaccination scar associated with better childhood survival in Guinea-Bissau. Int J Epidemiol. 2005 Jun;34(3):540-7. doi: 10.1093/ije/dyh392. Epub 2005 Jan 19.
PubMed 15659474
Study at a glance
From the registry record, last updated by the sponsor on 26 Feb 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Trial of Two-Dose Standard Measles Vaccination Schedule: Long-Term Impact on Morbidity and Mortality of a Two-Dose Vaccination Schedule at 6 and 9 Months of Age Compared With a Standard Regimen of One Dose at 9 Months of Age
- ClinicalTrials.gov ID
- NCT00168662
- Acronym / sponsor ID
- IC18-CT95-0011-Twodose1
- Conditions
- Measles
- Keywords
- Non-specific effects of vaccines, Infant mortality, Child mortality, Mortality, Morbidity, Measles vaccine, Measles, Immunisation
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 7,800 participants
- Lead sponsor
- Bandim Health ProjectUniversity, hospital or other
- Collaborators
- International Cooperation with Developing Countries, Danish Council for Development Research, Medical Research Council Unit, The Gambia
- Study start
- Mar 1995
- Primary completion
- Jan 2006 (actual)
- Study completion
- Jan 2006 (actual)
- First posted
- 15 Sep 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The general objectives of the proposed research work are:
A1) to reduce childhood mortality in developing countries through better control of measles infection by finding the best immunization strategy, and A2) to investigate the hypothesis that standard titre measles immunization is associated with non targeted beneficial effects on childhood morbidity and mortality in developing countries.
The measurable, specific objectives of the present proposal are:
B1) to examine whether a two-dose strategy for measles immunization at 6 and 9 months of age can reduce measles incidence by 50% through better coverage or improved seroconversion, and B2) to examine whether a two-dose strategy for measles immunization at 6 and 9 months of age can reduce childhood mortality by 20% through better coverage, better protection against measles or non targeted beneficial effects, and B3) to determine the magnitude and duration of non-measles related changes in morbidity patterns after standard titre measles immunization, in particular to test whether measles immunization is associated with a 15% reduction in the risk of diarrhoea, and B4) to determine non-measles related immunological changes among recipients of measles vaccine in order to establish possible pathways for the non targeted effects of standard titre measles immunization.
Detailed description
Background. Measles is the major killer among vaccine preventable diseases with an estimated one million deaths/year in developing countries. Though a good vaccine exists, the current immunization strategy of one dose at 9 months is far from optimal; too many children get measles before the age of immunization, coverage is too low when immunization has to wait until 9 months of age, and the protective efficacy is insufficient with the current vaccine given at 9 months of age. There is therefore a need for alternative immunization strategies or new vaccines.
Evaluations of vaccines have usually been based on a disease specific perspective; i.e. evaluation of specific immunity, and protective efficacy against the specific disease, its complications and mortality. However, our research from Guinea-Bissau, Senegal and Bangladesh has indicated that measles immunization and measles infection may have non-specific beneficial effects. The present protocol is an attempt to assess the magnitude and possible mechanisms of the non targeted beneficial effects of measles immunization and measles infection as well as an attempt to assess some of the practical implications of the hypothesis about non-specific beneficial effects.
Approach and methodologies. We tested a two dose measles immunization strategy at 6 and 9 months compared with the currently recommended strategy of one dose at 9 months. The children were be randomized to receive measles immunization at 6 and 9 months of age or inactivated polio at 6 months and measles at 9 months of age.
The non targeted effects of measles immunization on mortality and morbidity are best studied within a randomized trial comparing immunized and unimmunized children. In order to study the impact on non-measles related morbidity, some children recruited for the immunization trial will be included in weekly morbidity surveillance for diarrhoea, respiratory infections and malaria which are the most important disease complexes for childhood mortality in Guinea-Bissau.
Possible immunological differences between measles immunized and unimmunized children will be examined through measurements of T-lymphocyte levels, neopterin, beta2-microglobulin, delayed hypersensitivity (Multitest), allergic reactions (skin prick tests), antibody responses to other antigens (tetanus) and thymus growth (by sonography). Functional differences will be tested by response to a second vaccine antigen (HBV) at 7½ and 9 months of age when only one group has received measles vaccine.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
Who may qualify
- Ages
- 6 to 8 months
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Measles and inactivated polio vaccine | Biological | – |
Primary outcome
Vaccination coverage
Vaccine efficacy
Measles specific mortality
All cause mortality until 3 years of age
11 secondary outcomes
Measles antibodies at 6, 7½, 9, 10½ and 18 months of age
T-cells at 6, 7½, 9, 10½ and 18 months of age
Thymus size at 6, 7½, 9, 10½ months of age
Neopterin level at 7½ months of age
Beta-2-microglobulin level at 7½ months of age
Hepatitis B antibodies at 7½, 9 and 10½ months of age
Tetanus antibodies at 9 months og age
Delayed type hypersensitivity at 7½ months of age
Skin prick test (allergy) at 7½ months of age
Morbidity from 6 to 18 months of age
Anthropometric measures at 6, 7½, 9, 10½ and 18 months of age
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Feb 2008.
- Background: PubMed 15629363Veirum JE, Sodemann M, Biai S, Jakobsen M, Garly ML, Hedegaard K, Jensen H, Aaby P. Routine vaccinations associated with divergent effects on female and male mortality at the paediatric ward in Bissau, Guinea-Bissau. Vaccine. 2005 Jan 19;23(9):1197-204. doi: 10.1016/j.vaccine.2004.02.053.
- Results publication: PubMed 10342702Garly ML, Martins CL, Bale C, da Costa F, Dias F, Whittle H, Aaby P. Early two-dose measles vaccination schedule in Guinea-Bissau: good protection and coverage in infancy. Int J Epidemiol. 1999 Apr;28(2):347-52. doi: 10.1093/ije/28.2.347.
- Results publication: PubMed 11228365Garly ML, Bale C, Martins CL, Monteiro M, George E, Kidd M, Dias F, Aaby P, Whittle HC. Measles antibody responses after early two dose trials in Guinea-Bissau with Edmonston-Zagreb and Schwarz standard-titre measles vaccine: better antibody increase from booster dose of the Edmonston-Zagreb vaccine. Vaccine. 2001 Feb 28;19(15-16):1951-9. doi: 10.1016/s0264-410x(00)00431-x.
- Results publication: PubMed 11672911Garly ML, Bale C, Martins CL, Balde MA, Hedegaard KL, Whittle HC, Aaby P. BCG vaccination among West African infants is associated with less anergy to tuberculin and diphtheria-tetanus antigens. Vaccine. 2001 Nov 12;20(3-4):468-74. doi: 10.1016/s0264-410x(01)00339-5.
- Results publication: PubMed 12443658Aaby P, Jensen H, Garly ML, Bale C, Martins C, Lisse I. Routine vaccinations and child survival in a war situation with high mortality: effect of gender. Vaccine. 2002 Nov 22;21(1-2):15-20. doi: 10.1016/s0264-410x(02)00441-3.
- Results publication: PubMed 12798618Garly ML, Martins CL, Bale C, Balde MA, Hedegaard KL, Gustafson P, Lisse IM, Whittle HC, Aaby P. BCG scar and positive tuberculin reaction associated with reduced child mortality in West Africa. A non-specific beneficial effect of BCG? Vaccine. 2003 Jun 20;21(21-22):2782-90. doi: 10.1016/s0264-410x(03)00181-6.
- Results publication: PubMed 14506371Aaby P, Garly ML, Bale C, Martins C, Jensen H, Lisse I, Whittle H. Survival of previously measles-vaccinated and measles-unvaccinated children in an emergency situation: an unplanned study. Pediatr Infect Dis J. 2003 Sep;22(9):798-805. doi: 10.1097/01.inf.0000083821.33187.b5.
- Results publication: PubMed 15082642Aaby P, Jensen H, Rodrigues A, Garly ML, Benn CS, Lisse IM, Simondon F. Divergent female-male mortality ratios associated with different routine vaccinations among female-male twin pairs. Int J Epidemiol. 2004 Apr;33(2):367-73. doi: 10.1093/ije/dyh004.
- Results publication: PubMed 15626943Garly ML, Jensen H, Martins CL, Bale C, Balde MA, Lisse IM, Aaby P. Hepatitis B vaccination associated with higher female than male mortality in Guinea-bissau: an observational study. Pediatr Infect Dis J. 2004 Dec;23(12):1086-92.
- Results publication: PubMed 15659474Roth A, Gustafson P, Nhaga A, Djana Q, Poulsen A, Garly ML, Jensen H, Sodemann M, Rodriques A, Aaby P. BCG vaccination scar associated with better childhood survival in Guinea-Bissau. Int J Epidemiol. 2005 Jun;34(3):540-7. doi: 10.1093/ije/dyh392. Epub 2005 Jan 19.
- Statens Serum Institut, DenmarkLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
PETER AABY, MSc, Dr. Med study director
Bandim Health Project
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Measles and inactivated polio vaccine in people with Measles, run by Bandim Health Project at 1 site in Guinea-Bissau.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Feb 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Guinea-Bissau. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Vaccination coverage. The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00168662, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Feb 2008.