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Researchers are studying the effects of measles vaccine on child growth, cognition and academic performance.
Measles is a highly contagious virus that spreads through the air through pin droplets when an infected person coughs or sneezes. The first symptoms begin to appear seven days after infection. These included; fever, lethargy, cough, stuffy nose and conjunctivitis (inflamed eyes or pink eyes). The iconic rash then begins with the appearance of small spots behind the ears and on the face, descending to the torso and eventually spreading to the limbs. It does not look like the dramatic hospital scene we imagined, measles does not seem so bad?
Deadly complications
The problem with measles is that it works by infecting immune cells that travel throughout the body, which means that many organs are prone to infection, which can lead to many side effects. Complications include; otitis media (inflammation of the middle ear) that can lead to deafness, corneal scarring that can lead to blindness, croup, diarrhea and pneumonia. The measles virus inhibits the immune system and makes patients vulnerable to secondary infections such as bacterial pneumonia, which can be fatal. Measles can also cause encephalitis – swelling of the brain that can lead to brain damage and death. Infants and young children under five are at high risk for these complications. There is no antiviral treatment for measles and doctors can only treat the symptoms as they occur. In the case of measles, prevention is better than cure.
Vaccinations against measles
The measles vaccine is what is called a live attenuated virus. Vaccines have been developed by developing measles in chicken cells for a long time. This has produced a weaker strain of the virus that is harmless. The attenuated virus is still able to replicate but does not cause the same devastating disease as seen with a normal measles infection. The idea is that the vaccine causes the immune system to recognize measles so that it can react quickly if it encounters the virus. An immunized patient has lifetime protection against infection. The measles vaccine is an injection given to children at the age of nine months and a second booster injection is administered every fifteen to eighteen months. Measles immunization worked incredibly well and averted 21.1 million deaths in 2000-2017. In 2002, America eliminated measles, proving that vaccination was a practical and effective strategy of protection against measles infection. Recently, however, there has been a resurgence of measles outbreaks in America and Europe. Vaccination hesitations and travel around the world are the main factors contributing to these epidemics.
Hesitation to vaccination
Vaccine safety is raising concerns, preventing or delaying the immunization of children of affected parents. Common side effects of measles vaccine include fever, rash and pain at the injection site. There are rare cases of febrile convulsions, caused by fever. These crises do not have a lasting impact on health. Thrombocytopenia is another rare side effect. This is a low platelet count that is often transient. Potential adverse side effects badociated with measles vaccination have recently been widely considered, but interesting research has been conducted on the potential benefits badociated with the vaccine.
Can the measles vaccine make children smarter?
In a recent US study published in Vaccine, the researchers wanted to know if the measles vaccine had an impact on the results of cognition and schooling. They also wanted to know whether or not the vaccine affected growth and development. The researchers focused their study on children from Ethiopia, India and Vietnam. Scientists used the information collected in the Young Lives study and examined information from 2,000 children in each country. They divided the children in each country into vaccinated or unvaccinated groups. They then compared cognitive abilities, schooling indicators and growth between the two groups when the children were 7 or 8 years old and still between 11 and 12 years old. Researchers used height, weight and BMI scores to measure growth. They used standardized tests to measure cognition, including the Peabody Picture Vocabulary Test (PPVT), the Math Test, the First Grade Reading Assessment (EGRA) and two binary measures (Ability to reading and writing). The level of schooling was measured by the grades obtained by the children. The group found that there was a link between vaccination and higher cognitive function, better academic performance, and better growth.
The study presented is observational and this type of study has inherent biases. Confounding factors such as nutrition, school resources, children's health status and environmental factors that may affect the study results have not been taken into account. The conclusions drawn from this type of survey must be viewed with skepticism, as the results indicate an badociation and not a cause-and-effect relationship. It is also important to note that one of the authors has openly declared a conflict of interest and received financial donations from several pharmaceutical companies that produce measles vaccines.
Given these limitations, it is promising to think that measles vaccine could provide other benefits than avoiding a life-threatening disease.
Written by Tarryn Bourhill Msc, PhD Candidate
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References:
Laksono, B.M., de Vries, R.D., McQuaid, S., Duprex, W.P. and Swart, R.L. Measles Virus. Invasion of the host and pathogenesis. Viruses 8, Doi: 10.3390 / v8080210 (2016).
Goodson, J.L. and Seward, J.F. Measles 50 years after the use of the measles vaccine. Infect Dis Clin North Am 29, 725-743, doi: 10.1016 / j.idc.2015.08.001 (2015).
Holzmann, H., Hengel, H., Tenbusch, M. and Doerr, H. Measles Eradication: The Challenges. Medical microbiology and immunology 205201-208 (2016).
Bankamp, B., Hickman, C., Icenogle, J. P. and Rota, P. A. Successes and challenges in the prevention of measles, mumps and rubella by vaccination. Current opinion in virology 34110-116 (2019).
Minor, P. D. Live attenuated vaccines: historical successes and current challenges. Virology 479379-392 (2015).
Mbadad, E. Measles and Human Movement in Europe. Travel Medicine Journal 25, tay091 (2018).
Dubé, E. et al. Improving vaccination rates: acceptance, hesitation and refusal of vaccines in Canada: challenges and possible approaches. Canada Communicable Disease Report 42246 (2016).
WHO, W. h. o. FACT SHEET VACCINE OBSERVATION RATES VACCINES FOR MEAT, VAPINS AND VACCINES AGAINST RUBELLA. (2014).
Nandi, A. et al. Anthropometric, cognitive and school benefits of measles immunization: Longitudinal cohort badysis in Ethiopia, India and Vietnam. Vaccine, doi: https: //doi.org/10.1016/j.vaccine.2019.06.025 (2019).
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