{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:13:11Z","timestamp":1787289191112,"version":"build-2736575974"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005862","name":"Danish Council for Development Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005862","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Ministry of Foreign Affairs","award":["104.Dan.8.f."],"award-info":[{"award-number":["104.Dan.8.f."]}]},{"name":"Novo Nordisk Foundation;","award":["Health-F3-2011-261375"],"award-info":[{"award-number":["Health-F3-2011-261375"]}]},{"name":"ERC","award":["ERC-2009-StG-243149"],"award-info":[{"award-number":["ERC-2009-StG-243149"]}]},{"DOI":"10.13039\/501100001732","name":"Danish National Research Foundation","doi-asserted-by":"crossref","award":["DNRF108"],"award-info":[{"award-number":["DNRF108"]}],"id":[{"id":"10.13039\/501100001732","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The live vaccines bacille Calmette-Gu\u00e9rin (BCG) and measles vaccine have beneficial nonspecific effects (NSEs) reducing mortality, more than can be explained by prevention of tuberculosis or measles infection. Live oral polio vaccine (OPV) will be stopped after polio eradication; we therefore reviewed the potential NSEs of OPV.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>OPV has been provided in 3 contexts: (1) coadministration of OPV and diphtheria-tetanus-pertussis (DTP) vaccine at 6, 10, and 14 weeks of age; (2) at birth (OPV0) with BCG; and (3) in OPV campaigns (C-OPVs) initiated to eradicate polio infection. We searched PubMed and Embase for studies of OPV with mortality as an outcome. We used meta-analysis to obtain the combined relative risk (RR) of mortality associated with different uses of OPV.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>First, in natural experiments when DTP was missing, OPV-only compared with DTP\u2009+\u2009OPV was associated with 3-fold lower mortality in community studies (RR, 0.33 [95% confidence interval {CI}, .14\u2013.75]) and a hospital study (RR, 0.29 [95% CI, .11\u2013.77]). Conversely, when OPV was missing, DTP-only was associated with 3-fold higher mortality than DTP\u2009+\u2009OPV (RR, 3.23 [95% CI, 1.27\u20138.21]). Second, in a randomized controlled trial, BCG\u2009+\u2009OPV0 vs BCG\u2009+\u2009no OPV0 was associated with 32% (95% CI, 0\u201355%) lower infant mortality. Beneficial NSEs were stronger with early use of OPV0. Third, in 5 population-based studies from Guinea-Bissau and Bangladesh, the mortality rate was 24% (95% CI, 17%\u201331%) lower after C-OPVs than before C-OPVs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There have been few clinical polio cases reported in this century, and no confounding factors or bias would explain all these patterns. The only consistent interpretation is that OPV has beneficial NSEs, reducing nonpolio child mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofac340","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T08:59:10Z","timestamp":1658912350000},"source":"Crossref","is-referenced-by-count":10,"title":["Stopping Oral Polio Vaccine (OPV) After Defeating Poliomyelitis in Low- and Middle-Income Countries: Harmful Unintended Consequences? Review of the Nonspecific Effects of OPV"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8331-1389","authenticated-orcid":false,"given":"Peter","family":"Aaby","sequence":"first","affiliation":[{"name":"Bandim Health Project, Indepth Network , Bissau , Guinea-Bissau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3384-7489","authenticated-orcid":false,"given":"Sebastian","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Bandim Health Project, Indepth Network , Bissau , Guinea-Bissau"},{"name":"Odense Patient Data Explorative Network, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane B","family":"Fisker","sequence":"additional","affiliation":[{"name":"Bandim Health Project, Indepth Network , Bissau , Guinea-Bissau"},{"name":"Odense Patient Data Explorative Network, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Line M","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Bandim Health Project, Indepth Network , Bissau , Guinea-Bissau"},{"name":"Odense Patient Data Explorative Network, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Welaga","sequence":"additional","affiliation":[{"name":"Navrongo Health Research Centre , Navrongo , Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed M A","family":"Hanifi","sequence":"additional","affiliation":[{"name":"Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka , Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesario L","family":"Martins","sequence":"additional","affiliation":[{"name":"Bandim Health Project, Indepth Network , Bissau , Guinea-Bissau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amabelia","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Bandim Health Project, Indepth Network , Bissau , Guinea-Bissau"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Chumakov","sequence":"additional","affiliation":[{"name":"Office of Vaccines Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration , Silver Spring, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine S","family":"Benn","sequence":"additional","affiliation":[{"name":"Odense Patient Data Explorative Network, Institute of Clinical Research, University of Southern Denmark , Odense , Denmark"},{"name":"Danish Institute of Advanced Science, Odense University Hospital, University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"2022080317035413900_ofac340-B1","article-title":"Polio global eradication initiative. 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