BCG vaccination and allergy: A systematic review and meta-analysis

Arnoldussen, Denise L.; Linehan, Mary; Sheikh, Aziz

doi:10.1016/j.jaci.2010.07.039

Cited by 90 publications

(89 citation statements)

References 35 publications

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“…One study purports a protective effect of Bacillus Calmette-Guérin (BCG) vaccination for asthma [44], and another denies a role of tuberculosis in preventing atopy [45]. One interesting study suggested that local Th1 immunity in the lung might be the mechanism for BCG vaccination and decreased risk of asthma [46].…”

Section: Varicella Tuberculosis and Parasitesmentioning

confidence: 99%

The hygiene hypothesis revisited

Fishbein

Fuleihan

2012

Current Opinion in Pediatrics

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Section: Varicella Tuberculosis and Parasitesmentioning

confidence: 99%

The hygiene hypothesis revisited

Fishbein

Fuleihan

2012

Current Opinion in Pediatrics

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“…1 Most effective at preventing miliary and meningeal forms of pediatric tuberculosis, 2-4 the vaccine has gained much attention in recent years for its unintended health benefits, including risk reductions in cancer, 5,6 asthma 7,8 and overall child mortality. [9][10][11] Some evidence suggests BCG vaccination may also be associated with lower risks of acute lower respiratory infections (ALRI) and respiratory syncytial virus in children from GuineaBissau.…”

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confidence: 99%

Acute Lower Respiratory Infection Among Bacille Calmette-Guérin (BCG)–Vaccinated Children

Hollm-Delgado¹,

Stuart

Black³

2014

Pediatrics

110

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WHAT'S KNOWN ON THIS SUBJECT: Bacille Calmette-Guerin (BCG) vaccination may provide benefits beyond protecting against pediatric tuberculosis. Evidence suggests links between cellmediated immunity from tuberculosis and bacterial/viral-related pneumonia but the impact of BCG on acute lower respiratory infection is not fully known.WHAT THIS STUDY ADDS: BCG-vaccinated children had a lower risk of suspected acute lower respiratory infection. Protection was amplified when children were vaccinated against diphtheriatetanus-pertussis (DTP). Number of DTP doses did not modify this effect, but order in which vaccines were received did. abstract OBJECTIVE: To determine whether Bacille Calmette-Guerin (BCG) vaccination is linked to the risk of acute lower respiratory infection (ALRI) among children ,5 years of age. METHODS: Data from Macro International Demographic and HealthSurveys and United Nations Children' s Fund Multiple Indicator Cluster Surveys were used to identify a primary cohort of 58 021 children in 19 countries (2005)(2006)(2007)(2008)(2009)(2010) and a secondary cohort of 93 301 children in 18 countries (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007). Information was collected by trained interviewers during home visits using standardized questionnaires, review of vaccination health cards, and measurement of health indicators.RESULTS: BCG vaccination was associated with a 17% to 37% risk reduction for suspected ALRI in both cohorts. The only vaccine or vitamin supplement to modify the effect of BCG was diphtheria-tetanuspertussis (DTP; P , .001). The order in which the vaccines were first received was central to this phenomena (BCG before DTP, adjusted/propensity score-weighted relative risk [apRR]: 0.79, 95% confidence interval [CI]: 0.70-0.89; BCG with DTP, apRR: 0.82, 95% CI: 0.71-0.94; and BCG after DTP, apRR: 1.00, 95% CI: 0.87-1.13) but not number of DTP doses received. Other modifiers included vaccine strain used in immunization programs, chlorinating drinking water, using wood-burning fuel cook stoves, and owning livestock.CONCLUSIONS: Children vaccinated with BCG had a significantly lower risk of suspected ALRI. Clarification is needed as to whether this is due to reductions in the underlying risk of tuberculosis or ALRI per se.

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“…Review of the literature showed that the number of controlled epidemiological studies on vaccine-adverse event pairs not already classified by expert committee reports was limited. Furthermore, we found only few published clinical trials specifically investigating any of the included vaccine-adverse event pairs and only three meta-analyses [19][20][21]. While the NC category comprises three quite different types of evidence, Table 5 specifies these sub-categories for transparency.…”

Section: Classification Of Vaccine-adverse Event Pairsmentioning

confidence: 99%