Effect of BCG vaccination on risk of Mycobacterium tuberculosis infection in children with household tuberculosis contact: a prospective community-based study

Soysal, Ahmet; Millington, Kerry; Bakır, Mustafa; Dosanjh, Davinder; Aslan, Yasemin; Deeks, Jonathan J; Efe, Serpil; Staveley, Imogen; Ewer, Katie; Lalvani, Ajit

doi:10.1016/s0140-6736(05)67534-4

Cited by 266 publications

(206 citation statements)

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“…[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] A recent meta-analysis of the efficacy of BCG vaccine against the pulmonary, meningeal and disseminated forms of TB included 21 randomized or quasi-randomized clinical trials: 18 involving patients with pulmonary TB, and 6 involving patients with meningeal and/or military forms. 30 The panel marginally supports a recommendation for use subjects vaccinated at birth (RR 0.41, 95% CI 0,29-0.58).…”

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

“…28 After adjusting for ethnicity, closeness in class and shared activities, BCG vaccination continued to show a protective effect against infection (OR 0.16, 95% CI 0.05-0.54), with a corrected RR of 26% (95% CI 0.09-0.69) corresponding to a 74% reduction in RR (95% CI 31-91%). 28 Soysal et al evaluated the effect of BCG vaccine in reducing the risk of infection and tubercular disease in a cohort study of 979 Turkish children who had been in contact with cases of active TB [29]. Multivariate logistic regression showed that the vaccination was associated with 92% reduction in the RR of disease (95% CI 71-98%) and a 34% reduction in the RR of LTBI (95% CI 12-35%), even after correcting for possible confounding factors.…”

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

“…Multivariate logistic regression showed that the vaccination was associated with 92% reduction in the RR of disease (95% CI 71-98%) and a 34% reduction in the RR of LTBI (95% CI 12-35%), even after correcting for possible confounding factors. 29 …”

Section: What Is the Current Role Of Bcg Vaccination?mentioning

confidence: 99%

“…44 However, many pediatric studies have not found any significant difference in the rates of TST positivity between vaccinated and unvaccinated children. 45 The bibliographical search identified 6 cohort studies that have evaluated the effect of BCG vaccine on TST responses, 27,29,[47][48][49] and recent studies comparing the TST and IGRA responses of vaccinated subjects have shown that BCG vaccination does affect TST positivity. 27,29,46 A multicentre study by .…”

Section: Does Bcg Vaccination Affect Tst Responses?mentioning

confidence: 99%

“…45 The bibliographical search identified 6 cohort studies that have evaluated the effect of BCG vaccine on TST responses, 27,29,[47][48][49] and recent studies comparing the TST and IGRA responses of vaccinated subjects have shown that BCG vaccination does affect TST positivity. 27,29,46 A multicentre study by . 27 Vaccinated children showed significantly larger areas of hardening (median 14 mm; interquartile range 10-17 mm) than unvaccinated children (median 10 mm; interquartile range 0-14 mm; p < 0.001).…”

Section: Does Bcg Vaccination Affect Tst Responses?mentioning

confidence: 99%

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Recommendations for pediatric tuberculosis vaccination in Italy

Montagnani

Esposito

Galli

et al. 2015

Human Vaccines & Immunotherapeutics

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Bacillus Calmette-Guerin (BCG) vaccine is still the only vaccine approved for the prevention of tuberculosis (TB), and is widely used in highly endemic countries, where all newborns receive a single intradermal dose immediately after birth; however, the recommendations concerning its use in Europe vary widely from country to country. This document describes the recommendations of a group of Italian scientific societies concerning its pediatric use in Italy, the persistence of the protection it provides, its safety, its interference with tuberculin skin test (TST) responses, and the children who should be vaccinated. The experts conclude that BCG vaccination provides a good level of protection against tuberculous meningitis and disseminated forms, and a fair level of protection against pulmonary disease; the protective effective lasts at least 10 years, and revaccination offers no advantages over a single administration. The vaccine is safe in immunocompetent subjects, and affects the response to a TST for at least 6 y On the basis of these observations, we recommend its use in Italy in all TST-negative immunocompetent newborns and breastfeeding infants aged <6 months, and all TST-negative children aged between 6 months and 5 y who come from highly epidemic areas, or whose parents come from highly endemic areas, or who have been in contact with a family member with active TB without contracting the disease themselves.

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