Infant immunization and the occurrence of atopic disease in Dutch and German children: A nested case‐control study

Abstract

Our goal was to assess the role of early childhood vaccination in the occurrence of respiratory symptoms and allergic sensitization in 7-8-year-old Dutch and German children. A nested case-control study was conducted among children participating in a large longitudinal study on respiratory health, to study the relationship between vaccination (bacille Calmette-Guérin (BCG), pertussis, measles/mumps, rubella, and Haemophilus influenza type b (Hib)) and respiratory symptoms and allergic sensitization. Parents of 510 7-8-year-old children with respiratory complaints and an equal number of randomly selected children without respiratory complaints were asked to complete a questionnaire. Blood samples were collected for specific serum IgE analysis. Vaccination status was assessed through the records of the participating Municipal Health Services. No association between vaccination against pertussis, measles, rubella, or Hib and respiratory symptoms or allergic sensitization was found. For sensitization against house dust mite, BCG vaccination resulted in an increased risk (OR, 2.28; 95% CI, 1.05-4.96). Birth order was inversely associated with allergic sensitization, but was not related to respiratory symptoms. We found an association between BCG vaccination and the subsequent risk for sensitization against house dust mite. No evidence was found for an association between vaccination and respiratory symptoms. Earlier reports of an association of birth order with atopic disease were supported by the results of the present study.

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

“…19,21,25,28,31,33 Sensitization to common allergens Ten studies investigated the relationship between BCG vaccination and allergic sensitization. [17][18][19]23,25,27,[29][30]32,34 Five of these studies considered sensitization as judged by increased specific IgE levels to 1 or more allergens (see Tables E1 and E2 in this article's Online Repository at www.jacionline.org for details about these studies and the specific IgE measures assessed). 18,23,25,30,32 Seven studies considered evidence of sensitization as determined by a positive skin prick test (SPT) response, this being determined by at least 1 positive reaction, where a positive reaction was described as a wheal size of 2 mm or greater or 3 mm or greater (see Table E3 in this article's Online Repository at www.jacionline.org).…”

“…[17][18][19]23,25,27,[29][30]32,34 Five of these studies considered sensitization as judged by increased specific IgE levels to 1 or more allergens (see Tables E1 and E2 in this article's Online Repository at www.jacionline.org for details about these studies and the specific IgE measures assessed). 18,23,25,30,32 Seven studies considered evidence of sensitization as determined by a positive skin prick test (SPT) response, this being determined by at least 1 positive reaction, where a positive reaction was described as a wheal size of 2 mm or greater or 3 mm or greater (see Table E3 in this article's Online Repository at www.jacionline.org). [17][18][19]23,27,29,34 The pooling of the 5 studies investigating specific IgE levels estimated an overall OR of 1.31 (95% CI, 1.07-1.60) for the risk of sensitization in those who were vaccinated compared with those were not (Fig 2).…”

“…17 The main features of the 17 included studies are detailed in Table I. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Of particular note was that there was only 1 RCT 32 ; the remaining 16 studies used either cohort (n 5 7, 6 of which were retrospective and only 1 of which was prospective), 17,18,[22][23][24][26][27] case-control (n 5 2) 20,30 or cross-sectional (n 5 7) designs. 19,21,25,28,31,33 Sensitization to common allergens Ten studies investigated the relationship between BCG vaccination and allergic sensitization.…”

BCG Immunization at Birth and Atopic Diseases in a Homogeneous Population of Spanish Schoolchildren

“…A further limitation is the noninclusion of the family history of atopy in the information obtained from the parents and, consequently, in the multivariate analysis. Other studies finding either a protective effect of BCG on asthma [17] or not [23] have not included this factor in their analyses. It is quite unlikely that adjusting for the family history of atopy would have modified the effects of BCG immunization on asthma and hay fever found in this study, due to the homogenous genetic and environmental background of the population of the children surveyed.…”

Preventie van allergie bij kinderen

“…Blootstelling aan mycobacteriën door BCG-vaccinatie van pasgeborenen verkleint de kans op allergie niet. 17,18 Hoewel uit een Finse studie bleek dat de suppletie van probiotica aan zwangere en zogende moeders de kans op eczeem bij de zuigeling halveerde, 19 is deze bevinding in vergelijkende studies niet bevestigd 20,21 en ging die bovendien niet gepaard met daling van de prevalentie van andere allergische ziekten, zoals astma, of met vermindering van allergische sensibilisatie. 19 Bovendien is de prevalentie van eczeem in Finland niet afgenomen sinds suppletie van probiotica op grote schaal wordt toegepast.…”