Comparison of Frequency of Measles Complications Among Vaccinated and Non-Vaccinated Children Presenting at Tertiary Care Hospital

Abstract

Measles remains a highly contagious viral infection and continues to contribute substantially to childhood morbidity in developing countries despite the availability of an effective vaccine. Unvaccinated children are more likely to develop severe complications such as bronchopneumonia, diarrhea, dehydration, otitis media, and encephalitis. Evaluating the burden of complications among vaccinated and non-vaccinated children may help strengthen immunization strategies in high-risk settings. Objective: To compare the frequency of measles-related complications among vaccinated and non-vaccinated children presenting to a tertiary care hospital. Methods: A randomized controlled study was conducted in the Department of Pediatrics at Arif Memorial Teaching Hospital, Lahore, Pakistan, from 3rd June 2025 to 3rd November 2025. A total of 234 children with clinically diagnosed measles were enrolled and randomly assigned to vaccinated (n = 117) and non-vaccinated (n = 117) groups using consecutive sampling. Demographic and clinical data were collected through detailed history, clinical examination, and relevant investigations. Children were monitored for complications including bronchopneumonia, upper respiratory tract infection, diarrhea, oral ulcer, dehydration, otitis media, malnutrition, and encephalitis. Data were analyzed using SPSS version 25. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. The chi-square test was used to compare complication frequencies between groups, with p ≤ 0.05 considered statistically significant. Results: The mean age of participants was 6.48 ± 3.72 years, with 134 (57.3%) males and 100 (42.7%) females. Most children belonged to low or lower-middle socioeconomic groups. Bronchopneumonia was the most common complication and occurred significantly more often among non-vaccinated children (59.0%) compared with vaccinated children (46.2%) (p = 0.041). Diarrhea was also significantly higher in the non-vaccinated group (51.3%) compared with vaccinated children (32.5%) (p = 0.003). Other complications, including dehydration, otitis media, malnutrition, and encephalitis, were observed more frequently among non-vaccinated children, although these differences were not statistically significant. Vaccinated children also demonstrated a slightly shorter mean duration of hospital stay. Conclusion: Measles complications were consistently more frequent among non-vaccinated children, with significant differences observed for bronchopneumonia and diarrhea. These findings suggest that measles vaccination reduces disease severity and complication rates among pediatric patients.