ArticleArchives of disease in childhood2012
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.
Article in Archives of disease in childhood, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Is diphtheria-tetanus-pertussis (DTP) associated with increased female mortality? A meta-analysis testing the hypotheses of sex-differential non-specific effects of DTP vaccine.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2016Pooled it
- Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review.BMJ (Clinical research ed.) · 2016Pooled it
- Non-specific immunological effects of selected routine childhood immunisations: systematic review.BMJ (Clinical research ed.) · 2016Pooled it
- Non-specific effects of BCG and DTP vaccination on infant mortality: An analysis of birth cohorts in Ghana and Tanzania.Vaccine · 2022Trial
- Differential effects of BCG vaccine on immune responses induced by vi polysaccharide typhoid fever vaccination: an explorative randomized trial.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Trial
- Nonspecific effect of BCG vaccination at birth on early childhood infections: a randomized, clinical multicenter trial.Pediatric research · 2016Trial
- The effect of neonatal vitamin A supplementation on growth in the first year of life among low-birth-weight infants in Guinea-Bissau: two by two factorial randomised controlled trial.BMC pediatrics · 2013Trial
- Do Pentavalent (DTwP-Hib-HBV) vaccines have sex-differential nonspecific effects? An observational study.Human vaccines & immunotherapeutics · 2023Observational
- Review
- A narrative review of nonspecific effects of pediatric vaccines on child mortality and morbidity.Human vaccines & immunotherapeutics · 2021Review
- Parental Bacillus Calmette-Guérin vaccine scars decrease infant mortality in the first six weeks of life: A retrospective cohort study.EClinicalMedicine · 2021Article
- Penta is associated with an increased female-male mortality ratio: cohort study from Bangladesh.Human vaccines & immunotherapeutics · 2021Article
- Rabies Vaccination of 6-Week-Old Puppies Born to Immunized Mothers: A Randomized Controlled Trial in a High-Mortality Population of Owned, Free-Roaming Dogs.Tropical medicine and infectious disease · 2020Article
- Can earlier BCG vaccination reduce early infant mortality? Study protocol for a cluster randomised trial in Guinea-Bissau.BMJ open · 2019Article
- Influence of Key Health Related Indicators on Adult Mortality: Result from UN Member Countries.Iranian journal of public health · 2018Article
- Evidence of Increase in Mortality After the Introduction of Diphtheria-Tetanus-Pertussis Vaccine to Children Aged 6-35 Months in Guinea-Bissau: A Time for Reflection?Frontiers in public health · 2018Article
- Non-specific effects of measles, mumps, and rubella (MMR) vaccination in high income setting: population based cohort study in the Netherlands.BMJ (Clinical research ed.) · 2017Article
- Article
- Commentary: BCG has no beneficial non-specific effects on Greenland. An answer to the wrong question?International journal of epidemiology · 2016Article
- Non-specific effects of childhood vaccines.BMJ (Clinical research ed.) · 2016Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 4 countries.
Funding
Abstract
backgroundStudies from low-income countries have suggested that diphtheria-tetanus-pertussis (DTP) vaccine provided after Bacille Calmette-Guerin (BCG) vaccination may have a negative effect on female survival. The authors examined the effect of DTP in a cohort of low birthweight (LBW) infants.
methods2320 LBW newborns were visited at 2, 6 and 12 months of age to assess nutritional and vaccination status. The authors examined survival until the 6-month visit for children who were DTP vaccinated and DTP unvaccinated at the 2-month visit.
resultsTwo-thirds of the children had received DTP at 2 months and 50 deaths occurred between the 2-month and 6-month visits. DTP vaccinated children had a better anthropometric status for all indices than DTP unvaccinated children. Small mid-upper arm circumference (MUAC) was the strongest predictor of mortality. The death rate ratio (DRR) for DTP vaccinated versus DTP unvaccinated children differed significantly for girls (DRR 2.45; 95% CI 0.93 to 6.45) and boys (DRR 0.53; 95% CI 0.23 to 1.20) (p=0.018, homogeneity test). Adjusting for MUAC, the overall effect for DTP vaccinated children was 2.62 (95% CI 1.34 to 5.09); DRR 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.
conclusionSurprisingly, even though the children with the best nutritional status were vaccinated early, early DTP vaccination was associated with increased mortality for girls.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.