Non-specific effects of vaccination on child survival: prospective cohort study in Burkina Faso.
OBJECTIVE: To study the effect of vaccination on mortality before 2 years of age in a developing country. DESIGN: Prospective cohort study. SETTING: Rural communities in Burkina Faso. PARTICIPANTS: 9085 children born in the study area between 1985 and 1993. MAIN OUTCOME MEASURE: Child death rate. RESULTS: Mortality before 2 years of age was lower in children who had been vaccinated: those vaccinated with BCG only had significantly lower mortality (risk ratio for vaccinated v unvaccinated children 0.37, 95% confidence interval 0.29 to 0.48) as did those vaccinated with diphtheria, tetanus, and pertussis only (0.24, 0.13 to 0.43). The second dose of diphtheria, tetanus, and pertussis was not associated with lower mortality (0.80, 0.58 to 1.12). CONCLUSION: Vaccination with diphtheria, tetanus, and pertussis as well as BCG is associated with better survival of children up to 2 years of age.