Comparison of BCG vaccination at birth and at third month of life.

Abstract

Tuberculosis is an important health problem in developing countries and the BCG vaccine plays an important part in preventing the disease. There are different reports about the preventive value of BCG. Some of them claim that it is satisfactory while others suggest that it provides little protection. There are also varying ideas about the optimum time to vaccinate babies, some studies suggesting that late vaccination confers a high degree of protection. This prospective controlied study has been undertaken to evaluate the value of BCG vaccine given to babies during their first three days of life versus its value when given in their third month of life. Evaluation was measured by the results of tests with purified protein derivative (PPD), by vaccine scars, and by the complications of the vaccine. It was found that BCG given at the end of the third month provides a higher rate of response and fewer complications than when given during the first three days of life.BCG plays a significant part in protection against tuberculosis, which is one of the most important problems in developing countries. Nevertheless, the protective effect of vaccine remains a highly controversial subject, and has been reported to range from 80% to less than 5%. '4 In many countries the first BCG vaccine is received at birth, but it has been suggested that this requires further evaluation.' 7 8 A controlled prospective study has been recommended' 7 to compare BCG results from vaccination at birth and those at the third month of life. This prospective controlled study was planned to compare tuberculin response, BCG scar, and the complications of the vaccine given in the first three days compared with the third month of life. Subjects and methods The subjects selected for the study were healthy, full term babies of over 2500 g born either in the Uludag University Medical School Hospital or City Maternity Hospital in Bursa between October 1989 and January 1990. All the babies were followed up to 12 months. Babies who had a history of tuberculosis among their family or close contacts were excluded from the study.Babies were randomly divided into two groups. Four hundred babies in the first group (group I) were vaccinated with BCG intradermally in the left shoulder in the first three days of life, and the second group of 400 babies (group II) was vaccinated in the same manner at the end of the third month (90±3 days) of life. Vaccines were given to both groups by the same trained personnel. At the beginning of the study the mothers of the babies under study were carefully examined and their BCG scars and induration of purified protein derivative (PPD) were recorded. For the babies in group II, a PPD test was carried out before the BCG vaccination. The babies in both groups were examined every three months until they were 12 months old, PPD tests were performed three months after BCG vaccination and at the end of the first year. A full examination was performed in the follow up and BCG complications were recorded. Lymphadenopathies of mo...

Interleukin 12 exerts a differential effect on the maturation of neonatal and adult human CD45R0- CD4 T cells.

“…Given that low progression or "resistance" to HIV infection is associated with preferential expression of Thl cytokines and that, conversely, progression of the disease is associated with dominant expression of Th2 cytokines, it is reasonable to speculate that the more rapid evolution of neonatal HIV infection is related to the early expression of IL-4 (2). The preventive value of BCG vaccination remains diversely appreciated (54), and it was reported recently that BCG given during the first 3 d of life is much less efficient and generates more complications than when given after 3 mo (55). These unpublished observations).…”

Delaying Bacillus Calmette-Guérin Vaccination from Birth to 4 1/2 Months of Age Reduces Postvaccination Th1 and IL-17 Responses but Leads to Comparable Mycobacterial Responses at 9 Months of Age

“…Many animal models also support this theory (28)(29)(30)(31)(32)(33)(34)(35). However, previous studies that have delayed the BCG vaccine in human infants have found similar IFN-g responses to purified protein derivative (PPD), increased TST reactivity and increased polyfunctional T cells after in vitro stimulation with BCG vaccine (36)(37)(38)(39)(40), although BCG efficacy was not determined in these studies.…”

Immunization with DNA vaccines in early life: advantages and limitations as compared to conventional vaccines

“…It could account for the age-dependent clinical pattern of infectious diseases such as hepatitis, mononucleosis or toxoplasmosis in which symptoms are believed to be essentially immune mediated and which remain mostly asymptomatic in young children compared to adults. It would also explain the lower immunogenicity and higher frequency of complications following BCG immunization performed at birth rather than at a few months of age [11,16]. Finally, it could be linked to the preferential induction of allergic reactions upon early exposure to environmental antigens.…”