There were 12 studies: 10 cohort and 2 case-control.
Estimates of vaccine efficacy against death were heterogeneous. (X2=26.3; df=9; P=0.002).
Standard measles immunisation had a large effect on mortality (30-80% reduction on mortality).
The studies comparing children from the same community show a reduction in mortality in the range of 38-86%.
In studies comparing immunised and unimmunised children from different communities, estimates of vaccine efficacy against death were in a range of 30%-67%.
Efficacy was highest in the studies with short follow-up and when children were immunised in infancy (range 44-100%).
Vaccine efficacy was much greater than the proportion of deaths attributed to acute measles disease. In four studies, efficacy against death remained almost unchanged when the measles cases were excluded from the analysis. Diphtheria-tetanus-pertussis and polio vaccinations were not associated with reductions in mortality.