Reduced Mortality After Oral Polio Vaccination and Increased Mortality After Diphtheria-tetanus-pertussis Vaccination in Children in a Low-income Setting

PurposeThe diphtheria-tetanus-pertussis vaccine (DTP) and oral polio (OPV) were introduced in children 3 of 5 months age 1981–1983 Bandim, the capital Guinea-Bissau. Because DTP has been linked to deleterious nonspecific effects (NSEs) OPV beneficial NSEs, we followed up this cohort years examined with on all-cause mortality interactions measles (MV).MethodsDTP offered at monthly community weighing sessions. Vaccination groups defined by last received. We compared overall for different Cox proportional hazards regression models, reporting ratios (HRs) 95% CIs.FindingsThe study included 1491 born Bandim from December 1980 1983. From 35 age, censoring MV, vaccinated and/or had higher than both unvaccinated (HR = l.66; CI, 1.03–2.69) OPV-only 2.81; 1.02–7.69); DTP-only 3.38; 1.15-–9.93). In group 3–8 months, before MV is administered, vaccination was associated a 1.59–7.20). Between 9 when given, DTP-vaccinated MV-unvaccinated 2.76; 1.36–5.59) who received after DTP, among or 6.25; 2.55–15.37).ImplicationsBecause 2 vaccines differential healthiest first, selection biases are unlikely explain estimated impact child survival. administration may have reduced negative DTP.