2024-12-11 カリフォルニア大学バークレー校 (UCB)
<関連情報>
- https://publichealth.berkeley.edu/news-media/research-highlights/undernutrition-may-be-key-driver-of-measles-outbreaks
- https://www.sciencedirect.com/science/article/abs/pii/S0264410X24012465
南アフリカの就学前児童における低栄養と麻疹、破傷風、インフルエンザ菌b型(Hib)ワクチン接種に対する抗体反応: VHEMBE出生コホート研究 Undernutrition and antibody response to measles, tetanus and Haemophilus Influenzae type b (Hib) vaccination in pre-school south African children: The VHEMBE birth cohort study
Brenda Eskenazi, Stephen Rauch, Basant Elsiwi, Riana Bornman, Muvhulawa Obida, Angela Brewer, Brian J. Ward, Jonathan Chevrier
Vaccine Available online: 10 December 2024
DOI:https://doi.org/10.1016/j.vaccine.2024.126564
Highlights
- Infectious diseases are a major source of childhood morbidity/mortality worldwide.
- Undernutrition may affect the immune response to certain vaccines.
- The VHEMBE study examined relationships between undernutrition and antibody levels.
- Undernourished vaccinated children had lower measles antibody levels at 3.5/5 years.
- Undernutrition was associated with lower tetanus antibodies in girls but not boys
Abstract
Background
Under-vaccination is undoubtedly driving recent worldwide measles outbreaks, but undernutrition may also be playing a role in low- and middle-income countries. Studies have shown reduced immune response to vaccines in undernourished children but few have followed children beyond infancy, when they are more likely to be exposed to infectious diseases.
Methods
In the Venda Health Examination of Mothers, Babies and the Environment (VHEMBE) South African birth cohort study, we examined the relationship between undernutrition, as measured by stunting and other growth measures, and vaccine-specific serum antibody level to three different vaccine types: measles, tetanus and Haemophilus influenzae type b (Hib). We included 621 fully-vaccinated children with anthropometric measurements at ages 1, 2, and 3.5 years and antibody levels at 3.5 and 5 years.
Results
At 5 years of age, 90.4% of fully-vaccinated children were protected against measles, 66.7% against tetanus, and 56.1% against Hib. Children who were stunted or had any indicator of diminished growth at 3.5 years averaged a 24.1% (95% CI = -44.2, 0.6) or a 27.2% (95% CI = -45.1, -1.3) lower antibody titer for measles, respectively, relative to those with normal growth. In addition, girls, but not boys, with any indicator of diminished growth at 3.5 years averaged a 36.8% (-59.3, -7.0) lower antibody titer for tetanus. We found no association between undernutrition and Hib antibody titers.
Conclusions
Early life undernutrition may be associated with lower induction or persistence of antibody responses to certain vaccines. Addressing child undernutrition may improve vaccine efficacy and reduce the burden of vaccine-preventable diseases.
