Global shortages of BCG vaccine and tuberculous meningitis in children

Preez, Karen Du; Seddon, James A; Schaaf, H. Simon; Hesseling, Anneke C.; Starke, Jeffrey R.; Osman, Muhammad; Lombard, Carl; Solomons, Regan

doi:10.1016/s2214-109x(18)30474-1

Cited by 48 publications

(33 citation statements)

References 6 publications

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“…5,6 The risk associated with low vaccination coverage is highlighted by the dramatic increase in the incidence of TB meningitis in young children reported in association with BCG stock-outs. 7 Although manufacturer and supply chain issues are now largely resolved, supply remains fragile due to the limited number of production facilities available globally. 8 BCG has potential non-specific effects including putative impact on In addition to protecting against TB (its intended target disease), BCG vaccination modulates the immune response to subsequent infections caused by other pathogensthrough the induction of innate immune memory and heterologous lymphocyte activation, resulting in enhanced cytokine production, macrophage activity, T-cell responses and antibody titres, leading to reduced morbidity and mortality.…”

mentioning

confidence: 99%

Bacille Calmette-Guérin (BCG) vaccine and the COVID-19 pandemic: responsible stewardship is needed

Schaaf

Preez

Kruger

et al. 2020

int j tuberc lung dis

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We believe that responsible stewardship of the bacille Calmette-Guérin (BCG) vaccine in the context of the COVID-19 epidemic is urgently needed. Live attenuated BCG is currently the only licensed vaccine to protect against tuberculosis (TB). Neonatal BCG vaccination has proven efficacy in protecting infants and young children against life-threatening disseminated forms of TB, including TB meningitis and miliary TB. 1-4 Global BCG supply shortages in

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mentioning

confidence: 99%

Bacille Calmette-Guérin (BCG) vaccine and the COVID-19 pandemic: responsible stewardship is needed

Schaaf

Preez

Kruger

et al. 2020

int j tuberc lung dis

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show abstract

“…Therefore, it was pertinent to evaluate the protection and immune responses of 3000 CFU in mice, an equivalent dose of BCG 3 x 10 5 CFU in infants; 3. For the BCG dose sparing in preclinical studies, concerns were raised in 2016 18 for the shortage of global BCG vaccine and the published study in 2019 19 highlighted the effect of shortage with the rise of TB meningitis in children. The shortage in global BCG supply has also led to a rethinking of the established treatment guidelines in rationing of the administration of BCG for bladder cancer 20 .…”

Section: Correlation Of Cytokine/chemokine With Tb Burden In the Lungmentioning

confidence: 99%

Efficacy and immunogenicity of different BCG doses in BALB/c and CB6F1 mice when challenged with H37Rv or Beijing HN878

Khatri

Keeble

Dagg

et al. 2020

Preprint

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In this study, 2 strains of mice (BALB/c and CB6F1) were vaccinated with a range of Bacille Calmette Guerin (BCG) Danish doses from 300,000 to 30 CFU/mouse, followed by either immunogenicity evaluation or aerosol infection with Mycobacterium tuberculosis (a laboratory strain H37Rv or West-Beijing HN878 strain). The results indicated that both strains of mice when infected with HN878 exhibited significant protection in their lungs with BCG doses at 300,000 to 3000 CFU (BALB/c) and 300,000 to 300 CFU (CB6F1). Whereas, both strains of mice when infected with H37Rv, significant protection was seen in BCG doses at 300,000 to 300 CFU. Immunological evaluation revealed interesting results; i) both strains of mice demonstrated a significant increase in the frequencies of BCG specific IFN[gamma]+ IL2+ TNF[alpha]+ CD4 T cells in the BCG doses at 300,000 to 3000 CFU (BALB/c) and 300,000 to 300 CFU (CB6F1); ii) secretion of IL2 and IFN[gamma]; were correlated with the bacterial burden in the lungs of HN878 infected CB6F1 mice. The study demonstrated a BCG dose at 3000 CFU (an equivalent single human dose in the mice by body weight index) is protective in both strains of mice and the use of a virulent clinical isolate in testing new tuberculosis vaccine/advancing research is recommended.

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“…Negative Auswirkungen auf die Kindersterblichkeit in den betroffenen Ländern müssen angenommen werden [1,2,14,16]. In Südafrika zeigte sich einer Studie zufolge bereits ein signifikanter Anstieg der Fallzahlen für tuberkulöse Meningitis im Jahr 2017, der den Studiendaten zufolge auf einen Rückgang der BCG-Impfungen um 6 % zurückzuführen ist [17]…”

Section: Bcg-impfung Weltweitunclassified

Mitteilungsseiten des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose (DZK)

2020

Pneumologie

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Global shortages of BCG vaccine and tuberculous meningitis in children

Cited by 48 publications

References 6 publications

Bacille Calmette-Guérin (BCG) vaccine and the COVID-19 pandemic: responsible stewardship is needed

Bacille Calmette-Guérin (BCG) vaccine and the COVID-19 pandemic: responsible stewardship is needed

Efficacy and immunogenicity of different BCG doses in BALB/c and CB6F1 mice when challenged with H37Rv or Beijing HN878

Mitteilungsseiten des Deutschen Zentralkomitees zur Bekämpfung der Tuberkulose (DZK)

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