BCG vaccination at birth may have beneficial, non-specific effects on the survival of low-birth-weight children
13 September 2011
Researchers from the Bandim Health Project, Statens Serum Institut, report in a randomised study of 2,320 low-birth-weight children in Guinea-Bissau, West Africa, that early BCG vaccination at birth may improve the survival chances of these children in the neonatal period.
Non-specific effects of vaccinations
Several studies from West Africa show that routine vaccinations, e.g. BCG vaccination, in low-income countries may have non-specific effects on mortality which are not associated with protection against the disease itself.
Early versus delayed BCG vaccination
In most low-income countries normal-birth-weight children (>2.5 kg) are BCG-vaccinated at birth. Low-birth-weight children are not vaccinated at birth, but only when they have gained weight. In the period 2004-2008, Bandim Health Project in Guinea-Bissau recruited 2,330 low-birth-weight children for a randomised study of eary BCG vaccination (at birth) versus late (delayed) BCG vaccination. The children were visited at home at 2, 6, and 12 months of age.
Early BG vaccination of low-birth-weight children may make a difference to survival
BCG associated with lower neonatal mortality
Mortality rates were compared for children randomised to early BCG or the usual delayed BCG vaccination. In the neonatal period, 27 children died in the group of BCG-vaccinated children and 48 children in the control group. The reduction of the mortality was due primarily to fewer cases of neonatal sepsis, respiratory infections/breathing problems and fever. The results indicate that BCG may have a stimulating effect on the immune system against infections and thus may improve survival. The effect of early BCG vaccination was significant among newborns with a birth weight <1.5 kg.
Early BCG vaccination has beneficial, non-specific effects on survival
Early BCG vaccination only had a beneficial effect in the neonatal period when most children have not received other vaccinations. The effect was no longer significant after the first year of life. Though the researchers did not find a directly significant effect on mortality in the first year of life, the massive reduction of neonatal mortality is very important.
Read the scientific article
Aaby P, Roth A, Ravn H, Napirna BM, Rodrigues A, Lisse IM, Stensballe L, Diness BR, Lausch KR, Lund N, Biering-Sørensen S, Whittle H, Benn CS. Randomized trial of BCG vaccination at birth to low-birth-weight children: beneficial non-specific effects in neonatal period? J Infect Dis 2011;204:245-52
What is BCG vaccine?
Vaccination against tuberculosis is also referred to as Calmette vaccination or BCG vaccination